Brandon Trust - 261 Passage Road Care Home

261 Passage Road is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 261 Passage Road care home accommodates five people in one adapted building.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

There was a registered manager for 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.

People told us staff were not ‘bossy’ and were kind and caring towards them. We also saw that the staff we met were kind caring and respectful towards everyone who lived at the home.This showed that people felt safe at the home and with the staff who supported them. People were protected from abuse and the risk of harm. This was because staff were properly trained and knew how to keep people safe.

The provider’s system for the management of people’s medicines ensured they were looked after properly. When people wanted to be, they were supported to be responsible for their own medicines.

Fire drills had now been regularly carried out. This helped minimise risk in the event of a fire as it meant people knew what actions to take to be safe.

People were supported to make choices and have control of their lives. The staff team supported them in the least restrictive ways possible. There were policies and systems in use that supported staff to do this.

People were well supported with their physical health needs and their overall well-being was monitored. If it was needed the staff supported people to see health professionals promptly.

People were supported to choose what they wanted to eat and drink to maintain good health. Menus were put in place based on each person’s likes and dislikes. People were encouraged by the staff to maintain their independence. The staff team respected people’s privacy and dignity.

People were cared for by a consistent team of staff. The staff knew and understood people’s individual needs well. People looked relaxed talking with staff members and raised any issues or concerns with them.

Care and support was flexible and staff responded to people’s individual needs or wishes. Activities were personalised to people’s preferences and interests. Care plans contained useful information to help staff provide the care people need in the ways they preferred.

The quality checking system in place for auditing and monitoring quality and safety was now being used much more effectively. Failings and shortfalls in the service were swiftly picked up and addressed. For example, staff performance issues were identified as well as shortfalls in some record keeping. Actions were being put in place around both these areas.

261 Passage Road is a care home that is registered to provide personal care for up to 5 people. There were 5 people at the home on the day of our visit.

Two people told us a staff member was "bossy" in their manner towards them. Some action had been taken to address these concerns after people had raised their views to senior staff in the home. At our inspection these concerns were repeated to us. We bought this matter to the attention of the registered manager who took action to ensure that people were safe.

Fire drills had not been regularly carried out. This put people at risk as in the event of a fire it would not be clear if people knew what actions to take to be safe.

The governance system that was in place for auditing and monitoring quality and safety was not being used effectively. The failings identified at our visit had not been picked up by recent audits.

There was a registered manager for 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.

There were systems in place to minimise risks to people and to protect them from abuse. People who lived at the some engaged in a positive and warm way with the staff that provided them with personal care and other support.

People were assisted with their care by staff that understand their needs and knew how to provide effective support. The staff we met had a kind and caring manner toward the people they supported. The staff also knew how to ensure that privacy and dignity was maintained when they were supporting people with their care.

People were well supported to eat and drink enough for their health needs. Menus were planned with choices available which reflected the likes and preferences of each person at the home.

People were supported by a team of staff who were properly trained to provide effective care The staff had been on regular training and were developed and supported in their work. This helped them to improve and develop their skills and competencies. Staff were properly supervised in their work and this helped to ensure they were competent in their work. Staff spoke positively about working as a team and the team support that existed among them.

There was a system in place in the home so that the requirements of the Mental Capacity Act 2005 were implemented when needed. This legislation protects the rights of people who lack capacity to make informed decisions.

People were being well supported to take part in a variety of social and therapeutic activities both in the home and the community. These activities were planned based on what people wanted to do each day.

There were recruitment and training processes in place that helped to ensure that staff were properly checked and were knowledgeable. This meant staff were be able to support people effectively.

The staff told us they could address any concerns or raise any matters informally with senior staff and the registered manager. The staff had received formal supervision meetings. At these meetings areas for improvement were regularly addressed with them.

Care records were detailed explained what to do to effectively assist people with their personal care needs. People were well supported with their physical health care needs. Staff consulted with external healthcare professionals to get specialist advice and guidance when it was needed.

The provider had systems in place to support people to make their views known and to make complaints about if they needed too.

Staff understood the provider’s visions and values that they expected staff to follow. One key value was to provide personalised care. The staff told us they put these into practice in the way they supported people at the home.

We found two breaches of Regulations of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we have taken at the back of the report.

The provider wrote to us and informed us they would be compliant with these standards by 31 December 2013.

At this inspection we saw that action had been taken so that people were protected from environmental infection control risks. The bathroom floor had been replaced and room had been redecorated.

We also spoke with three people who used the service .People told us that the staff were 'kind'. The people we spoke with told us they were happy at the home.

We also reviewed the staffing levels to see if there was enough staff on duty to meet people's needs. We did this to check that a previous compliance action we had set in 2012 around staffing levels had been met.

The provider sent us an action plan that detailed how they would achieve compliance with outcome eight of the Health and Social Care Act. During this inspection the actions the provider told us they were planning to take, had been implemented within the service. Monitoring systems were in place and staff were trained in infection control guidelines and good practice principles.

Most of the communal areas of the home were cleaned to an acceptable standard. However during this inspection we found one area of the home had not been cleaned effectively.

We did not speak with people that lived in the home directly about this outcome. However we asked people if they were happy living in home and observed staff interactions with people in the communal areas. People's comments included 'I like going on holiday'. 'I went to Weston and bought Christmas presents'. 'I'm going away again soon'. People were relaxed around staff and were interacting verbally and planning their day.

People's right to consent to their treatment and support was documented and the principles of the Mental Capacity Act were put in to practice. People were cared for in a clean environment, however some minor concerns were found in relation to the monitoring systems in place for cleanliness and infection control. One communal area of the home also required some attention to ensure that it was sufficiently clean.

People were cared for by staff who were well supported in their roles through training and supervision. There were systems in place to monitor the overall quality and safety of the service provided.

We looked at four of the five people's care records in respect of activities to determine whether compliance had been achieved with the Health and Social Care Act. We also looked at the staff rota to determine whether there was sufficient staff on duty, to enable people to take part in meaningful activities in the home and the community.

In addition, we spoke with three members of staff and met with three of the individuals living at 261 Passage Road.

People told us that they were going out more since our last visit. This included a Turkey and Tinsel weekend in Devon for two of the individuals, meals out and trips to the local shops. People continued with their structured day care.

People were supported to maintain contact with their friends and family.

This report should be read in conjunction with our report from the visit in September 2012.