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Bradfield Residential Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 April 2019

The inspection was carried out on the 23 January 2019 and 29 January 2019. The inspection was unannounced on 23 January 2019 and announced on 29 January 2019.

Bradfield residential home is a ‘care home.' People in care home services receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation was provided over three floors. A lift was available to take people between floors. Residential accommodation and personal care were provided for up to 37 older people. Double rooms were offered for couples. There were 33 people living in the service when we inspected. Some people had memory loss or health issues associated with ageing or were living with dementia.

We carried out our last comprehensive inspection of this service on 22 October 2015 and we gave the service an overall rating of ‘Outstanding.’ At this inspection, we found the service Requires Improvement.

Since our last comprehensive inspection in 2015, two new registered managers had registered and shared the responsibility for the management of the service. A registered manager is a person who has registered with CQC 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.

The design, decoration and signage in the service did not meet current standards for individual people living with dementia or with a visual impairment. We made a recommendation about meeting best practice in the design of the premises.

The premises were well maintained, clean and odour free. Risk assessments were in place with actions to minimise risks, to people, staff and visitors. Safe systems of work were used by staff to manage infection control. For example, good hand hygiene, the use of disposable gloves and the use of planned cleaning schedules. However, the registered managers had not properly minimised the risk from waterborne infections, for example legionella. We made a recommendation about meeting health and safety guidance.

Systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. These systems were not fully robust as they had not identified the areas for improvement we found during the inspection.

Safeguarding procedures were in place and staff understood their individual responsibility to protect people from harm and report concerns to the registered managers or if required externally in line with the providers whistle blowing policy. Incidents and accidents were reported and appropriately investigated.

Emergency response contingency plans were in place to maintain the levels of care. For example, if the premises had to be evacuated. Fire systems were tested and staff practised the fire evacuation procedures to maintain their skills. Equipment such as hoist, lifts, gas appliances and electrical systems and equipment were regularly tested.

Comprehensive needs assessments were carried out with people and or with relatives so that the service staff could meet their needs. A care plan was in place based on people’s current needs. The care plans provided personalised information, including people’s life stories. Likes and dislikes, medical needs and lifestyle choices.

Staff understood the risks to people’s individual health and wellbeing and risks were clearly recorded in their care plans. This included hydration and nutrition and health care management. People were supported to eat and drink according to their needs, staff supported people to maintain a balanced diet. Referrals were made to external health care professionals when required. For example, GP’s.

We observed that staff were friendly and caring. There were appropriate systems

Inspection areas

Safe

Requires improvement

Updated 10 April 2019

The service was not safe.

Infection control risks were not effectively minimised.

Medicines were administered and recorded in line with guidance.

Risk assessments were used to minimise general and individual risks.

Staff understood how to reduce the risk of abuse.

Recruitment for new staff was robust and sufficient staff were deployed to meet people�s needs.

Incidents and accidents were recorded and investigated.

Effective

Requires improvement

Updated 10 April 2019

The service was not effective.

The premises had not been adapted to meet people�s individual needs.

People's needs were assessed. Staff referred people to health services when needed.

Staff monitored people�s health and welfare by keeping accurate care records.

People were supported to eat and drink to maintain their health.

The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards were understood by the provider and staff received training about this.

Staff received training and met with their managers to discuss their work performance.

Caring

Good

Updated 10 April 2019

The service was caring.

People had forged good relationships with staff so that they were comfortable and felt well treated.

People were treated as individuals and able to make choices about their care.

People had been involved in planning their care and their views were taken into account.

Responsive

Good

Updated 10 April 2019

The service was responsive.

People were provided with care when they needed it and a person-centred care plan was developed around their needs.

Information about people was updated so that staff were aware if people�s needs changed.

People were encouraged to participate in activities.

People knew how to raise concerns and complaints.

People received compassionate end of life care.

Well-led

Good

Updated 10 April 2019

The service was well-led.

Potential risks and the quality of the service were monitored through regular audits.

The registered managers maintained their skills and knowledge of social care practice.

The management team and staff were clear about the values of the service.

People and their relatives were asked about their experiences of the service.