Broadmeadow Court Residential Care Home

We found the following examples of good practice.

• There was a visiting policy and procedure in place which had been shared with relatives. The provider was looking at developing their approach by planning to develop a hub within the grounds of the home for people to receive visits from relatives.

• When visits had been restricted other methods were used to ensure people continued to have contact with their loved ones such as, video calls and window visits. The registered manager kept in regular contact with relatives and newsletters were sent out.

• The environment was well maintained and clean. Additional cleaning had been implemented to lower the risk of cross transmission.

• Staff were supported by the registered manager during periods of anxiety and staff had been signposted to external wellbeing services.

Further information is in the detailed findings below.

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 asked to consent to care. Staff had received training and were knowledgeable about the principles of the Mental Capacity Act 2005.

People and their relatives told us they felt safe and they received their medicines on time. The provider had identified improvements that were required to some areas of medicines management such as topical creams.

Staff knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to. Accidents and incidents had been reported and medical attention sought where required. Some improvements were required to the system for monitoring people for injuries that occur after unwitnessed falls. The provider was aware of this shortfall and work was in progress to improve this area.

The registered manager had robust recruitment procedures and staffing levels delivered responsive support to people. The home was well maintained, clean and staff had access to protective equipment to protect people from the risk of infections.

Staff received training at the start and throughout their employment to ensure they had the skills to provide effective care. Staff felt very supported by the registered manager and management team.” People told us food and drinks were of a good quality and plentiful. We saw the provider worked with community health professionals to ensure people received effective care.

People told us staff treated them with dignity and were respectful. Our observations supported these views. One person told us, “The place is brilliant because they’re so good to me, not just carers, we’ve turned out to be friends and they’re all very kind to me.” We saw lots of positive interactions between people and staff, no one was rushed, and activities were person-centred. One person told us, “I’m quite content and happy, I love the girls to bits.”

Care plans contained personalised information on people’s health and communication needs plus their likes and dislikes. However, improvements were required to ensure all information was up to date and that staff demonstrated they followed people’s preferences. We noted preferences to personal care were not consistently followed. We have made a recommendation about this.

There was a complaints policy that supported positive engagement and timely action. The provider had systems for supporting people towards the end of their life. This needed to be consistent to ensure all people in the home were given the opportunity to share their end of life care wishes and preferences.

The service was well led. People, staff and relatives spoke positively about the registered manager and management team. There was a positive culture throughout the service which focused on providing care that was individualised. The provider and the registered manager used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role and had sustained improvements and changes in the home.

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 25 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Broadmeadow care home is a service which provides care and accommodation for a maximum of 32 people who are older and/or live with dementia. At the time of our visit, 30 people lived in the home.

The service had a registered manager. 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 at the home were supported by staff who were kind, caring and who understood people’s needs, wants and preferences. People’s privacy and dignity were upheld by staff.

Enough staff were on duty to meet people’s needs. The provider’s recruitment practice provided assurance that all measures had been taken to recruit staff who were safe to work with people. Staff received training and management support to help them effectively meet people’s needs and to keep people safe.

People were supported in line with the principles of the Mental Capacity Act. The manager understood the importance of applying for Deprivation of Liberty Safeguards (DoLS) when there was a need for restrictions to be placed on people’s care to keep them safe.

People enjoyed the food provided and the choice of meals available to them. Timely referrals to the relevant healthcare professional were made when staff had concerns about people’s health. People were also supported to see their GP, dentist and optician when required. People received their medicines as prescribed.

Group and individual activities were provided for people’s enjoyment. People were consulted on the activities provided.

People and relatives knew how to make a complaint if they needed to, although no formal complaints had been made since our last visit. The manager encouraged open communication with people, relatives and staff.

Quality assurance systems were used effectively to keep people safe and to drive improvements in the home. The premises and equipment used were well maintained and safe to use.

During the inspection we spoke with some of the people who used the service and two representatives of people who used the service. We also spoke with the registered manager on duty and the staff who were on duty during the inspection.

We considered our inspection findings to answer the questions we always ask:

Is the service safe?

People who used the service had their needs assessed and risk assessments had been completed to reduce any risks to people's health and well-being.

There were procedures in place to protect people in an emergency.

Staff had been appropriately trained to meet the needs of people who used the service. Further staff training in dementia care would help staff to understand the needs of people a little better.

The provider identified and managed risks to the health and safety of people who used the service, staff who worked there and people who visited.

Is the service effective?

People's health and social care needs were assessed and plans were in place to provide the support they required. People's needs were reviewed but more regular updates of care plans would ensure that care remained effective.

People were supported to maintain their physical and mental health care needs.

The provider was planning to involve representatives more in the care of their relatives.

Is the service caring?

The staff knew people well and the people who used the service looked relaxed and comfortable in the company of staff. We observed positive interactions between the people who used the service and staff. Staff were patient with people and encouraged them, with support, to take responsibility for their daily living tasks. A person who used the service told us: 'I feel safe and well cared for here. The staff are kind and caring".

Is the service responsive?

The home had a complaints procedure. People we spoke with said they would tell the staff if they were worried about anything. A person told us: "You can approach any of the staff about anything. If I had any concerns I would ask the manager and have done in the past".

People living in the home and/or their representatives were enabled to share their opinions with staff, as the provider regularly sought their views and suggestions.

Is the service well led?

Staff who worked at the home felt well supported. One person said: "The manager is very good and I think it is a good company to work for".

There was clear, comprehensive and detailed information to support staff in caring for people and there was guidance for staff when they needed it.

There was a formal staff training and development programme in place. Staff supervision was in place but more frequent supervision would ensure the staff had the opportunity to discuss their own personal development.

There was evidence of quality monitoring having taken place to monitor, audit and improve the services provided.

People living at the home told us that they were happy and satisfied with the care that they received and that they were treated with dignity and respect. One person told us, 'I choose the clothes I want to wear the night before and put them on the chair. The staff help me to put them on in the morning'. Another person told us, 'Most staff are always polite'. We saw that people's needs were assessed and care and treatment was planned to meet their needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We saw evidence that staff had received training to administer medication and an assessment of their knowledge had been done. This meant that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People we spoke with told us that they were happy living at Broadmeadow Court. The atmosphere was relaxed and friendly. Staff were polite and respectful when they approached people. We observed that people were asked what they would like and if they wanted to be involved in an activity. One person told us, "The staff arrange things for us to do". "I enjoy the Bingo but I like spending time on my own as well".

Some people did not have capacity to make decisions and were not able to recall what they did with their time other than to say, "I like to be in my room. It's what I prefer". Where people did not have capacity an assessment had been completed.

We saw that people's health needs were recorded and were being monitored closely and people were supported to receive health services.

There were systems in place to monitor and develop the service to ensure that continually improvements were being made for the benefit of people who used the service.