We undertook an inspection of Brantwood on the 27 June 2014. We spoke with ten people using the service, three visitors and four staff members including the home manager and proprietor during our visit. During our previous inspections carried out on the 6 June 2013 and the 6 March 2014 we set a compliance action because accurate and appropriate care plans were not being maintained. During this inspection we found that the home manager had implemented a new care planning system, all of the care plans had been re-written and now reflected the current needs of the person they related to.
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives; the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We undertook a tour of the building and looked at communal areas, bathing areas and with permission some of the bedrooms. We also looked at the garden area. Without exception the home and its facilities were very well maintained and clean. The bedrooms were homely and comfortable and had obviously been personalised by the person whose room it was.
We saw that risks to people's health and wellbeing had been identified for areas such as falls and nutrition were in place to manage these so the people who lived at the home were safeguarded from unnecessary hazards.
The home manager was aware of the relevant process to follow if there were any safeguarding concerns.
There were appropriate procedures in place should anyone need to be subject to a Deprivation of Liberty Safeguard (DoLS) application or plan. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.
Is the service effective?
We observed that staff interacted well with residents. They took time to ensure that they were fully engaged with the individual and checked that they had understood. Before carrying out interventions with the people using the service they explained what they needed or intended to do and asked if that was alright rather than assume consent. They also spoke to people informally and acknowledged with a smile as they passed through the home and went about their daily tasks.
Is the service caring?
The people using the service who were able to tell us said that they were happy living in the home. Comments included; 'marvellous, staff are lovely and the home is nice, 10 out of 10', 'superb', 'wonderful, lovely family home' and 'I am very happy here'. One person who had stayed elsewhere said, 'this is much better, staff are very good and the food is better'.
We received positive comments about the home and staff members from the visitors we spoke with. Comments included; 'brilliant, they have turned my relative round' and 'I am very happy'.
We asked people directly about the staff members working in Brantwood, comments included; 'staff are good, they cannot do enough for you, very caring', 'marvellous, very good staff' and 'smashing'.
The relationships we saw were warm, respectful, dignified and with plenty of smiles and laughter. The staff members we spoke with could show that they had a good understanding of the people they were supporting and they were able to meet their various needs.
Is the service responsive?
The care plans had been written in a person centred manner. This meant that the individualised care plans focused on the person's individual assessed needs and on how they could be met. The care plans focused on providing support to an individual in different aspects of their daily life, for example how the person was to be supported with promoting their independence and any issues regarding their health so that they were kept as healthy as possible.
Menus were flexible so in practice it meant that at any mealtime the people living in the home had chosen what they were eating.
Is the service well-led?
The provider and home manager live on the premises so information about the safety and quality of service provided was gathered on a continuous and on-going basis via feedback from the people who used the service and their representatives, including their relatives and friends, where appropriate. They were also able to check that the home was running smoothly and that people were being cared for properly on a daily basis. During our inspection one of the people living in the home asked us to pass on to the provider and manager how much they appreciated living at Brantwood. We passed this comment on to them at the end of the inspection visit.
The staff members we spoke to were very positive about the home. Comments included; 'absolutely love it'.