Archived: Brightlands

Updated 30 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 inspection took place on 13 October 2015 and was unannounced.

Our inspection team consisted of two inspectors and one expert-by-experience who spoke with people using the service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had knowledge and understanding of people with learning disability and residential care homes.

This inspection was carried out to check if the provider had made improvements to the service since our inspection in February 2015. Before the inspection, we looked at previous inspection reports and notifications about important events that had taken place at the home, which the provider is required to tell us about by law. We looked at safeguarding and whistleblowing information we had received.

During our inspection, our expert by experience spoke with nine people, inspectors spoke with three people and observed care and support in communal areas as some people were not able to verbally communicate their experiences. We also spoke with 12 support workers, two senior support workers, the registered manager, the operations manager and the maintenance man. We contacted other health and social care professionals who provided health and social care services to people. These included community nurses, doctors, speech and language therapist, local authority care managers and commissioners of services.

We observed people’s care and support in communal areas throughout our visit, to help us to understand the experiences people had. We looked at the provider’s records. These included four people’s records, care plans, risk assessments and daily care records. We looked at a sample of audits the registered manager sent to us, satisfaction surveys, staff rotas, and policies and procedures.

Updated 30 December 2015

The inspection took place on 26 February 2015 and it was unannounced.

Brightlands is registered to provide accommodation and personal care for up to 13 people with a learning disability. Each person who lives in the service is provided with en-suite facilities for their own use. Accommodation is provided over three floors and there is a stair lift to the first floor only.

At our last inspection on 08 July 2014, we found that the provider was in breach of regulations relating to cleanliness and infection control, management of medicines, safety and suitability of premises, supporting workers and assessing and monitoring the quality of service provision. We requested the provider submit an action plan on how and when they planned to improve the service. The provider submitted an action plan to show how they planned to improve the service by November 2014.

There was a registered manager at the service. 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.

Risk assessments failed to tell staff what action to take when people removed their catheter bag bag, and could lead to cross infection. Local infection control procedures were not available for staff to comply with. We have made a recommendation about this.

Staffing levels were too low to meet people’s needs. The shift times were varied and not consistent. The staff roster did not evidence how people received their support hours and did not detail which staff was allocated to which person in order to fulfil the additional support. We have made a recommendation about this.

Medicines were administered covertly, hidden in food. There was no covert medicine administration protocol in place. The correct process for covert administration of medicine had not been followed. We have made a recommendation about this.

Staff had completed training in a range of areas that reflected their job roles. Staff had received one to one supervision however, they had not received regular annual appraisals to identify any additional training and skills that maybe required to support people.

People told us they enjoyed the food, had plenty to eat and drink. However, where people needed help with eating, we saw that they were rushed, which made them were unhappy.

While some people were encouraged to take part in activities and leisure pursuits of their choice, and to go out into the community as they wished, some other people were not encouraged and supported to be actively engaged in activities inside and outside of the home. We have made a recommendation about this.

The staff we spoke with were able to tell us the action they would take to ensure that people were protected from abuse. All staff had received training about safeguarding.

Thorough recruitment checks were carried out prior to staff working in the service. This ensured staff were suitable to work with people.

The provider had a clear set of visions and values. Our observations and what we were told by staff showed us that these values had not been successfully implemented by the staff who worked at the service.

There were systems in place to protect people from abuse. The staff were aware of their roles and responsibilities in relation to protecting people from abuse. Relatives felt people were safe in the service and indicated that if they had any concerns they were confident these would be quickly addressed by the registered manager.

Where people lacked the mental capacity to make decisions the registered manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

People were supported to attend health care appointments and visits from health care professionals such as district nurses.

People’s needs were fully assessed with them before they moved to the service to make sure that they could meet their needs. Assessments were reviewed with the person concerned and their relatives and care plans had been updated as people’s needs changed.

Staff demonstrated respect for people’s dignity during our visit, they were discreet in their conversations with one another and with people who were in communal areas of the service. People knew how to make a complaint if they were unhappy about any aspect of the service.

People spoke positively about the way the service was run. Members of staff told us that the registered manager was very approachable and understanding. They said they were encouraged to raise issues or make suggestions and felt they were listened to.

During this inspection we found a breach of Regulation 14 of the Health and Social Care Act

2008 (Regulated Activities) Regulations 2010, which corresponds to regulations 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff failed to adhere to professional’s guidance on people’s food intake.

You can see what action we told the provider to take at the back of the full version of this report.