22 August 2018
‘We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’
This unannounced inspection took place on 26 June 2018. The inspection was carried out by one inspector.
Before the inspection, we reviewed information we held about the service including statutory notifications sent to us by the registered manager about incidents and events that occurred at the service. Statutory notifications include information about important events which the provider is required to send us by law. We also looked at the PIR (provider information report) which we had asked the provider to fill in and return before the inspection and a report from the local authority’s quality assurance monitoring visit.
During the inspection we spoke with two people, two relatives, three care staff, the activities coordinator and the registered manager.
As part of the inspection we looked at three care plans for people living at the service, training records of all staff, staff information which included five recruitment records, policies and procedures, accident and incident records and policies and procedures.
22 August 2018
We carried out this unannounced comprehensive inspection to Bramley House Resident Care Home on 26 June 2018. Bramley House is a care home which provides accommodation and personal care to a maximum of 16 older people. Some may also be living with a dementia type illness. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.
The service had a registered manager 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 last inspected this service on 15 July 2017. At that time we identified a breach of legal requirements relating to the management of records within the service. We took enforcement action following this inspection as we had previously identified shortfalls in record keeping during inspections to this service. Following the inspection the registered provider sent us an action plan telling us they planned to address this shortfall. We used this inspection to check whether the registered provider had taken action in line with their action plan.
Bramley House is a small service which is friendly and homely. People were cared for by a small number of staff who knew people well and delivered a person-centred care. People’s choices and opinions were valued and they were actively involved in making decisions about their care.
Staff showed kindness and compassion. People’s dignity and independence was promoted by staff who also showed respect towards the people they cared for. People were cared for by a sufficient number of staff to meet their needs.
People felt safe and staff were aware of safeguarding procedures should any suspected abuse take place. Staff had adequate training and experience to care for people safely. The appropriate recruitment processes and ongoing monitoring of staff ensured that only suitable people worked at the service.
Medicines were managed safely and there were effective infection control procedures. We saw evidence that lessons had been learned when things had gone wrong by adopting procedures to prevent incidents happening again. Risks to people had been identified and plans were in place to help reduce those risks.
People’s care plans took into account their wishes and preferences. People’s needs were assessed and the care people received reflected the needs identified in the assessment. End of life wishes for people had been considered. People had access to a range of activities and they told us if they were unhappy with any aspect of the service they would know who to speak to.
People were provided with a choice of food and drink throughout the day and were supported to maintain their nutrition and hydration needs. People’s health was promoted by access to healthcare services.
The home was well adapted and designed to meet people’s individual needs. Staff followed the principals of the Mental Capacity Act 2005 in relation to people’s consent and any restrictions that may be placed on them.
People and staff praised the registered manager. Staff felt that they were supportive and approachable and people liked the open, welcoming culture of the home. There was effective communication between management, staff, people and their relatives.
There were quality assurance systems in place to identify where improvements were needed. The service worked in partnership with other agencies to deliver joined-up care.