Archived: Brantwood Residential Care Home

Brantwood Residential Care Home provides personal care for up to 21 people. They were supporting 18 at the time of inspection. The home is spread across two floors.

People’s experience of using this service and what we found

People were safe and well cared for and were protected from the risk of abuse. However, we made some recommendations about the safeguarding policy, and safeguarding training.

People told us that staff knew them well and they could meet all of their needs and likes and dislikes.

People could give feedback to the provider about their experience of using the service. Relatives told us they knew who to contact if they had any concerns or compliments.

Governance systems required updating to ensure risks and areas for improvements to care identified. We made recommendations about the management of risk and regulatory requirements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook this targeted inspection to check on a specific concern we had about how the service manages safeguarding issues, staffing levels and complaints, and their understanding of regulatory requirements. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Brantwood Residential Care Home is registered to provide accommodation for up to 21 people who require nursing or personal care. The service is located in a residential area of Sandbach close to local amenities. At the time of the inspection there were 18 people accommodated at the service.

People’s experience of using this service

People told us they were settled and happy living at Brantwood. People said that the managers and staff team were kind and caring and promoted their independence where possible. They told us they got their medicines on time and staff supported them with all their needs as required.

People's needs had been assessed, care plans developed, and risk assessments put in place to ensure people's individual needs could be met and risks reduced or mitigated. People told us they were fully involved in this process.

Staff had developed positive relationships with people and their family members. They had a good understanding of how to meet each person's individual needs. We saw people’s dietary needs were managed with reference to individual needs and choice. People's privacy and dignity was consistently respected.

People told us that they felt safe in the home. Safe recruitment procedures were in place and staff were supported in their role with appropriate training and supervision. The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported. The staff and management team worked closely with health and social care professionals.

There were a selection of audits carried out. Actions identified we used to continually develop and improve the service. Feedback from people and their family members was regularly sought.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection:

The last rating for this service was Good (published 12 May 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The home provides care, support and accommodation for up to 21 older people. At the time of the inspection there were 16 people living in the home. All bedrooms had en-suite facilities, including some with en-suite bath or shower. Most bedrooms were on the ground floor, and those on the first floor could be accessed by a stairlift. There was a large dining room, two lounges and other seating areas. People had access to a pleasant garden at the rear of the home and there was a small car park at the front for visitors.

At the last inspection in September 2015 the service was rated good overall, but required improvement in the safe domain because we found a breach in the regulations related to fire

safety and the monitoring of hot water temperatures. At this inspection we found these matters had been addressed.

Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

People received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided.

We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to maintain relationships with friends and family and that the activities provided by the home were sufficient for their needs.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. These included daily observation, checks on records and seeking the views of people about the quality of care being provided to them.

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'.

We looked at care plan records and saw that they did not contain comprehensive assessments of basic needs. They did not set out a current plan of care or evaluate the effectiveness of the care given. We saw that general entries were made by staff every day. We did not find that improvement to the records had been made since our former inspection in June 2013 when we found shortcomings in the standards of the records.

We reviewed staffing levels and recruitment systems. All staff files and the care plans for people were filed securely and there were good recruitment and staff management processes in place.

The home is adapted from an original Victorian house which had been extended and developed over time. People living, visiting and working at the home spoke very positively about the owner and manager and their commitment to making this care home a good place to live.

We spoke with people who used the service and observed care practices. We saw staff interact with people in inclusive and engaging ways. They offered sensitive support to people who needed help with the activities of daily living.