Brinsworth House

We found the following examples of good practice:

¿ Even prior to the local area entering high alert level restrictions, no visitors were being admitted to the home with window visits facilitated instead.

¿ Where people were in isolation, barrier nursing procedures were effectively implemented. Staff cared for people, who were isolating, in a safe way and limited the risk of the spread of infection.

¿ People were required to isolate in their rooms for five days following routine hospital appointments. Where people attended hospital in an emergency, they were required to isolate for 14 days on returning to the home.

¿ The home was engaged in the ‘whole home’ testing programme. People living in the home were tested for coronavirus on a monthly basis and staff were tested weekly. Antibody testing for staff had also commenced at the time of our inspection.

¿ The service had appropriate infection control policies and procedures in place. The provider/registered manager had kept up to date with government guidance and communicated changes to staff promptly.

¿ People benefitted from a long standing and stable staff team. Staff were well-supported and there was a strong focus on wellbeing and on sharing relevant and up to date information in a timely manner.

Brinsworth House is a care home, providing personal care and nursing care to 37 people aged 65 and over at the time of the inspection. The service can support up to 38 people.

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

People continued to be protected against the risk of abuse, as staff members received on-going safeguarding training and were aware of the provider’s safeguarding policy. Risk management plans in place gave staff guidance on how to mitigate identified risks. People’s medicines were managed in line with good practice. Sufficient numbers of suitable staff were deployed to keep people safe.

People were supported by staff that underwent comprehensive training to enhance their skills and knowledge. People continued to access food and drink that met their dietary needs and requirements. People were supported to access healthcare professional services to monitor and maintain their health and well-being. 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.

People were treated with kindness and compassion and were encouraged to make decisions about their care. People were encouraged to maintain their independence where possible and safe to do so. Staff spoke about people they supported respectfully.

Care plans were not as person-centred as they could be, however the provider addressed this during the inspection. The provider encouraged people to participate in a wide range of activities that reflected their preferences and met their social needs. People were aware of how to raise a concern. People’s end of life care wishes were documented.

We received mixed reviews regarding the management of the service. Despite this, the majority of people confirmed the registered manager was approachable and available to them. Audits were carried out regularly and issues identified were acted on in a timely manner. People’s views were sought through regular house meetings and questionnaires. The registered manager actively sought partnership working to drive improvements.

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

Rating at last inspection

The last rating for this service was Good (published 15 September 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brinsworth House on our website at www.cqc.org.uk.

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.

EABF (known and referred to in this report as Brinsworth House) provides accommodation and nursing care for up to 36 older people, some of whom may be living with dementia. The home is a Victorian listed building with extensions at the rear of the property. Accommodation is arranged over two floors and there is a passenger lift to assist people to get to the upper floor. There were 33 people living at the home at the time of our inspection.

The last inspection of Brinsworth House took place in November 2014 when we found two breaches of regulations relating to consent to care and treatment and management of medicines. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements.

At this inspection we found the provider had followed their action plan and improvements had been made in the required areas.

The home 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.

People and their relatives were positive about the care and support provided. Staff knew people well and treated them in a kind and dignified manner. We observed positive relationships between staff and people at the service throughout our visits. A wide range of activities were provided for people to participate in both in and outside of the home.

Staff told us they received the support and training to care effectively for people and meet their needs. They had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern. They were confident that any concerns raised would be taken seriously by the registered manager and acted upon.

People were protected against the risks associated with the unsafe use and management of medicines. Improved arrangements were in place for the recording, safekeeping and administration of medicines.

We also found improvements had been made so that the service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Where people no longer had the capacity to consent to aspects of their care, we saw the registered manager and staff worked in people’s best interests. Assessments were completed to document the decision making process involving family and medical professionals as appropriate.

Healthwatch Richmond visited in June 2016 reporting that Brinsworth House was a well-run home with good systems in place to care for the residents and that these worked to a high standard. They observed good practice throughout their visit commenting there was a welcoming atmosphere with good interaction between the staff and residents.

Overall comments from people using the service included "fabulous, such a friendly atmosphere", "In general very good here", "I'm lucky to be here" and "what I like about it here is that it is informal".

People told us that they were treated with dignity and respect by care staff who were described as "helpful", "friendly" and "all super".

The majority of people spoken to felt that there could be more things going on to occupy them each day and the provider had already taken steps towards employing a dedicated member of staff to co-ordinate this provision. This may be particularly important for people with higher nursing needs and individuals living with dementia who may require more intensive interactions.

The home should continue to encourage staff to focus on wellbeing and quality of life through practice that is person centred and not task orientated in approach. Focus needs to be on what people can do and making each day different. Work could also take place to further improve the mealtime experience for people using the service.