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Breckside Park Residential Home Good

Reports


Inspection carried out on 15 June 2017

During a routine inspection

This unannounced inspection of Breckside Park took place on 15 & 19 June 2016.

There was a manager in post who was in the process of completing their registration with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Breckside Park is a care home providing personal care for up to 26 older people. The home is situated in a residential area of Anfield in Liverpool. It is close to local shops and public transport links. Accommodation is provided over three floors and a passenger lift is available for people to access all floors.

The home was last inspected in April 2016. During this inspection we found the service was in breach of regulations relating to the safe care and treatment, staffing and governance. The overall rating for this service was ‘requires improvement’. The provider sent us an action plan detailing how they would meet these breaches and we reviewed the action plan as part of this inspection. We found that the provider had taken action and improved in these areas. The service was no longer in breach of these regulations.

During our last inspection in April 2016, the service was in breach of regulations relating to the safe management of medications and the safety of the environment. This was because there was not adequate procedures in place to manage people’s medication needs during the night. Also, there were fire doors wedged open, and razors left in communal bathrooms which could have caused people harm. We checked to see what improvements had been made. There were now staff trained to be able to support people with medication needs during the night. Medication procedures were well managed, however we did see one person not supported adequately with medication, which was addressed at the time of inspection. We found that the service was no longer in breach of this regulation.

During our last inspection in April 2016, the service was in breach of regulations relating to staffing. This was because there was not enough staff employed by the service to support people with activities or complete other tasks, such as the laundry. We checked what improvements had been made at this inspection. Additional members of staff had been employed since the last inspection, such as an activities coordinator and a laundry assistant. The service was no longer in breach of this regulation.

During our last inspection in April 2016, the service was in breach of regulations relating to the governance of the home. This was because records relating to people’s safety were not always kept accurate and up to date. In addition, we found that quality assurance procedures were not robust and did not identify the shortfalls we found during our inspection. We checked what improvements had been made. We found that all records were accurate and completed, and quality assurances systems had improved and was no longer in breach of this regulation.

We looked and the Mental Capacity Act and associated principles and found some inconsistences. Consent was not documented for people, and at least two people who lacked capacity had signed their own care plan without a best interest process being considered. We have made a recommendation regarding this.

Everyone we spoke with told us that they felt safe living at the home. Staff has all been trained in safeguarding and were able to describe the course of action they would take if they felt someone was being harmed. This included whistleblowing.

Staff were being recruited and selected safely, and only started working at the home once all references and checks had taken place.

We had received information prior to our inspection concerning the fire safety of the building. The provider had been set a

Inspection carried out on 28 April 2016

During a routine inspection

This inspection took place on 28 April 2016 and was unannounced.

Breckside Park is a care home providing personal care for up to 26 older people. The home is situated in a residential area of Anfield in Liverpool. It is close to local shops and public transport links. Accommodation is provided over three floors and a passenger lift is available for people to access all floors. During the inspection, there were 22 people living in the home.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We looked at the systems in place for managing medicines in the home and found that systems were not in place to ensure people could receive their medicines when they needed them as night staff were not trained to administer medicines.

The care files we looked at showed staff had completed risk assessments to assess and monitor people’s health and safety. We found however, that not all risks had been assessed appropriately, such as whether people could self-administer medicines safely. Other risk assessments had not been reviewed as people’s needs changed.

We found that the environment was not maintained sufficiently to ensure people’s safety and wellbeing. Broken window restrictors, fire doors being wedged open and faulty equipment all posed risks to people living in the home. We observed some areas of the home and equipment that required cleaning.

Most people we spoke with told us they felt safe living in Breckside Park. Staff we spoke with had a good understanding of safeguarding and told us they would not hesitate to raise any concerns.

We found that there was a system in place to ensure staff were recruited safely. We looked at how the home was staffed and received mixed feedback. Relatives we spoke with did not have any concerns regarding the number of staff on duty, but people living in the home and staff, told us they did not feel there were sufficient numbers of staff on duty at all times.

Deprivation of liberty safeguards (DoLS) were applied for appropriately and we found that consent was sought in line with the principles of the mental capacity act 2005.

Staff were supported in their role through induction, training, supervision and appraisal and staff told us they felt well supported by the registered manager. This helped to ensure that staff had the knowledge and skills to meet people’s needs and help ensure their safety and wellbeing.

People told us they had a choice of meals and we found that dietary needs were catered for within the home.

People told us staff were kind and caring and treated them with respect. One person told us, “They are very good; I get on very well with the staff.” People we spoke with agreed their dignity was maintained by staff and that staff always knocked on their doors and ensured bathroom doors remained closed.

Most care plans we viewed showed that people and their families had been involved in the creation of care plans. Care plans were written in a way to promote independence and staff we spoke with told us they encouraged people to do as much for themselves as possible.

We observed care plans to be in place, providing information and preferences regarding people’s health and social care needs. We found that not all care plans contained current information regarding people's needs, though staff were aware of the support people required.

People told us entertainers came to the home every few weeks, but we found there was a lack of activities available. One person told us, “I get bored.”

Processes were in place to gather feedback from people, such as quality assurance surveys and resident meetings. People told us they felt able to raise any concerns they had

Inspection carried out on 23 September 2014

During a routine inspection

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? As part of this inspection we spoke with two people who use the service, the registered manager and two of the care staff. We also reviewed records relating to the management of the service which included records relating to infection control. Below is a summary of what we found, the summary describes what people who use the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

People had been cared for in an environment that was safe and hygienic .Senior care staff and the registered manager were on duty throughout the day. There were enough staff on duty to meet the needs of the people living at the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to residential services and care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Records we reviewed confirmed that staff had been trained to understand the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

Is the service effective?

People told us that they were happy living at the home and felt their needs were being met. It was clear from what we saw and from speaking with staff, that the staff understood people's individual support needs. One person told us; "I'm alright here." Records confirmed that staff had received training to meet the needs of the people living at the service.

Is the service caring?

People were supported by kind and attentive staff. We saw staff were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and in their own way. Our observations confirmed this.

Is the service responsive?

People's needs had been assessed before they moved into Breckside Park. Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities and had been supported to maintain and develop relationships outside of the service.

Is the service well-led?

Systems were in place for assessing and monitoring the quality of the service. These included regular checks on aspects of the service and seeking the views of people who lived at the home and their relatives. The service was managed in a way that ensured people’s health, safety and welfare were protected and the interests of the people who lived at the home was at the centre of how the service was run and managed.

Inspection carried out on 25 February 2014

During a routine inspection

As part of our inspection we spoke with four people who lived at Breckside Park who told us they were happy living there. Comments included; “The care is alright here. I like the new manager. Things have improved” and “They meet my needs. Absolutely” and “I like it here. I have been in a few different places but I prefer it here” and “Staff help me with my personal care and medication”.

At our last inspection we had concerns about the environment at Breckside Park. This was because the décor was dated and certain furniture and fittings were in a state of disrepair. We saw improvements in this area and it was evident areas of the home had been modernised since our last inspection. This work was ongoing. We noted a smell of cigarette smoke in part of the home. This was become some people who used the service smoked inside the building next to the back door despite being reminded not to do so by staff. We addressed this with the manager during our inspection.

We looked at staff files to ensure staff were recruited appropriately. We found references had been sought from previous employers and CRB (Criminal Records Bureau) checks undertaken.

We spoke with staff to see if they received enough support and training to undertake their work. One member of staff said to us; “The training is good. We did an infection control course recently. The manager is approachable and support is pretty much ongoing”.

Inspection carried out on 22 November 2012

During a routine inspection

We spoke individually with six of the people living at Breckside Park and with two of their relatives. We also spent time observing the day to day support provided to people. We spoke to five members of staff who held different roles within the home.

We found that people living at Breckside Park had been asked their views and opinions of the service they had received and staff had acted on these.

People told us that they had received the help and support they had needed from staff. Their comments included, “They are nice to you, they help” and”I get on with them all”. We found that people had received the support they had needed with their health care. We also found that although people had received support with their personal care this had not always been provided in a timely manner.

People told us that they had felt safe living at Breckside Park and we found that staff were aware of how to identify and report potential safeguarding adults occurrences. However we found that records and risk assessments for protecting people were not sufficiently robust.

People told us that they liked the environment at Breckside Park and appreciated recent improvements. Their comments included, “I like it” and “Great, I’m satisfied”. We found that although some improvements had been made to the environment other areas remained shabby.

Inspection carried out on 16 March 2012

During an inspection to make sure that the improvements required had been made

People told us they felt well supported with their healthcare. One person said “They get the nurse when I need checking over” and another person told us, “They’re very good like that. I only have to say I’m not feeling well and they get somebody in to see me straight away. No messing about”.

Some of the people using the service told us about their routines and it was clear that they had made choices in line with their lifestyle prior to moving to the home. People had been supported to take risks in order to maintain their lifestyle.

During conversations with people living at the home they gave no indication that they felt unsafe or at risk of harm or abuse. People seemed confident to openly express their views and opinions about the service.

People presented as being at ease in the home environment and the atmosphere appeared relaxed. We asked people for their views about the home environment and the comfort of their rooms. They told us they thought the environment was fine, they felt comfortable and were happy with their bedrooms.

People using the service told us staff had treated them well and had been respectful towards them.

Inspection carried out on 27 September 2011

During a routine inspection

We asked people about the choice and control they have over their daily lives. People told us that they choose their own daily routine as to when to get up, choice of meals throughout the day, support with personal care and people are supported to manage their own affairs when possible, for example manage their own money or medication.

Some of the people using the service described their routine and it was clear that they are making choices in line with their lifestyle prior to moving to the home and that they are supported to take risks in order to maintain their lifestyle.

People told us that staff will readily refer them to a nurse or doctor if they are unwell or feel they need medical attention.

One person described their care and support as "excellent" and they told us that they felt staff would do anything for them.

The home provides a relaxed and welcoming atmosphere and people's individual needs and wishes appear to be well respected.

During conversations with people living at the home they gave no indication that they felt unsafe or at risk of harm or abuse.

On the whole the people living at the home presented as being at ease in the environment and there was 'banter' and discussion between the people living at the home and with staff.

We asked people how they were treated by staff and whether staff were respectful towards them and the feedback provided was good.

We asked a number of people using the service what they thought about the home environment, the facilities offered and the comfort of their bedrooms. Each of the people we asked gave us good feedback on these.

We asked people living at the home about the staff team and whether staff are responsive to their needs and treat them with respect and dignity. All feedback given was positive with comments such as 'they're very helpful' and 'the carers are excellent'.

People using the service seemed confident to express their views and opinions about the service openly.

Reports under our old system of regulation (including those from before CQC was created)