• Care Home
  • Care home

Bronte

Overall: Requires improvement read more about inspection ratings

Lower Lane, Ebford, Exeter, Devon, EX3 0QT (01392) 879350

Provided and run by:
Mr T & Mrs C Murphy

Latest inspection summary

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Background to this inspection

Updated 18 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by one inspector.

Service and service type

Bronte is a ‘care home’. 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 manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced. Inspection activity started on 3 August 2021 and ended on 23 August 2021. We visited the location on 3 August 2021.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

During the inspection

We spoke with the Registered Manager, the Provider and three staff including the activities co-ordinator and the cook. We spoke with a visiting GP and one person’s family members. We observed and spoke with people in the communal areas and spoke with three people in their bedrooms. We reviewed a range of records including health and safety records and staff files.

After the inspection

We continued to review documents sent to us electronically. This included the training matrix, policies relating to Covid-19 and the registered managers quality audits. We spoke with five people’s family members, two visiting health professionals and one staff member.

Overall inspection

Requires improvement

Updated 18 September 2021

About the service

Bronte is a residential care home providing personal care to 19 people aged 65 and over at the time of the inspection. The service can support up to 20 people. The property is a single-story building with en-suite bedrooms and communal spaces including a lounge, dining room and conservatory. There are large gardens to the front of the property which people are able to use with the assistance of staff.

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

Risks relating to the physical environment had not been properly assessed and systems in place were not being operated robustly enough to identify where improvements were needed. People were at risk of the spread of infection because the poor maintenance of a communal bathroom made it difficult to keep clean and because of some working practices, such as sharing communal bars of soap. Infection control audits were not being completed and general audits had failed to identify areas of concern, such as a carpet with a strong smell of urine.

Recruitment systems were not operated effectively. Staff were recruited without the required checks being recorded, for example, a full work history, appropriate references and a record of job interviews. Staff had not had recent training in relation to fire, safeguarding or medicines administration. We were told that informal training and supervision had taken place in house and the Registered Manager was confident staff had the appropriate skills and knowledge. We recommended the provider ensure that training in safeguarding and medicines administration is brought up to date.

The providers quality assurance and governance systems had failed to identify where improvements were required and there was no service development or improvement plan in place. Where the Provider was aware improvements were required, such as in the communal bathroom, no action had been taken. The Provider did not have any formal oversight of the quality assurance systems.

Lessons had been learnt from a previous allegation of abuse which was inappropriately investigated by the provider. The Registered Manager and staff we spoke to were able to tell us the correct procedure for reporting concerns and told us they felt confident to do so. People’s families told us they felt comfortable raising any concerns and when they had done so previously, they had been acted on.

Improvements had been made to record keeping and regular fire tests were taking place. People’s individual risks were assessed and regularly reviewed.

We received positive feedback about the quality of care from people, their families, staff and visiting professionals. The culture was open and person-centred; one visiting professional told us that staff had worked hard to understand a person’s individual needs. The Registered Manager was well liked and respected and everybody we spoke to gave positive feedback in relation to their openness and communication.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 April 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 18 February 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety of the premises, infection control and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.