Bromford Lane Care Centre

Updated 19 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 the 12 December 2018 and was unannounced with a return announced visit on the 13 December 2018. The inspection team consisted of four inspectors, two assistance inspectors, two experts by experience and two specialist advisors on the first day and one inspector on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The specialist advisors were registered nurses with professional skills, knowledge and clinical experience in supporting people with complex nursing and dementia care needs.

This service was also selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.

The comprehensive inspection was scheduled and as part of the inspection process we looked at information we already held about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any incidences that put people at risk of harm. We refer to these as notifications. We checked if the provider had sent us notifications in order to plan the areas we wanted to focus on during our inspection. We reviewed regular quality reports sent to us by the local authority to see what information they held about the service. These are reports that tell us if the local authority commissioners have concerns about the service they purchase on behalf of people. There were no additional concerns raised. This helped us to plan the inspection.

We used a number of different methods to help us understand the experiences of people who lived at the service. We spoke with 19 people, 15 relatives, five health and social care professionals, 25 staff members that included seniors, care and domestic staff, five nurses, one unit manager, the clinical lead, the deputy manager and the registered manager. We also spent time observing the daily life in the units including the care and support being delivered. As there were a number of people living at the service who could not tell us about their experience, we undertook a Short Observational Framework for Inspection (SOFI) observations. (SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.)

We sampled 20 people’s care records to see how their support was planned and delivered and nine medication records to see how their medicine was managed. We looked at three recruitment files to check suitable staff members were recruited. The provider’s training records were also looked at to check staff were appropriately trained and supported to deliver care that met people’s individual needs. We also looked at records relating to the management of the service to ensure people received a good quality service.

Updated 19 January 2019

At our last inspection on the 08 and 09 August 2017, we found the service required improvement under the key questions, is the service responsive and well-led with an overall rating of requires improvement for the service. At this inspection we found there had been sufficient improvement to now rate this service as good.

The unannounced inspection took place on the 12 December 2018 with a second announced visit on the 13 December 2018. Bromford Lane Care Centre provides accommodation over three floors comprising five separate units offering support for up to 116 adults with nursing care needs. Two units catering for the needs of people living with dementia, nursing care. Units A and G catering for the requirements of people living with complex needs including alcohol/drug dependency and/or other mental health conditions. The home also provides short stay interim beds (EAB unit) for people discharged from hospital, who may require further assessment of their care and support needs before returning to their own home or another form of care placement. At the time of our inspection there were 114 people living at the 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.

There was 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 and associated Regulations about how the service is run.

People were kept safe. Staff understood how to protect people from risk of harm. People's risks were assessed, monitored and managed to ensure they remained safe. Processes were in place to keep people safe in the event of an emergency such as a fire. People were protected by safe recruitment procedures to ensure suitable staff were recruited. People received their prescribed medicines when required by trained staff. Staff understood their responsibilities in relation to hygiene and infection control.

People told us they received support from staff they felt had the skills required to support them safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were encouraged to eat healthily. People had access to healthcare professionals when needed in order to maintain their health and wellbeing.

Staff encouraged people's independence where practicably possible. People received a service that was caring and respected their privacy. People were supported by staff who knew them well.

People received a service that was responsive to their individual needs. Care plans were personalised and contained details about people's preferences and their routines. People were supported to pursue hobbies and activities that interested them and processes were in place to respond to any issues or complaints. Where people’s faith was important to them, they were supported to continue with following their beliefs. This included their end of life (EOL) wishes.

The registered manager understood their role and responsibilities and staff felt supported and listened to. People and staff were encouraged to give feedback and their views were acted on to enhance the quality of the service provided to people. People and staff were complimentary about the leadership and management of the. The provider worked in conjunction with other agencies to provide people with effective care.

Quality assurance systems were in place to identify where improvements could be made and when needed implement these changes. The provider notified us of significant events that occurred within the home. Feedback was sought from people and their relatives and this was used to improve the service for people.