We carried out a review of the data available to us about Brabyns House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Brabyns House, you can give feedback on this service.
About the service
Brabyns House is a residential care home providing personal and nursing care to 33 people aged 65 and over at the time of the inspection. The service can support up to 39 people.
Brabyns House accommodates people over two floors in one large adapted building.
People’s experience of using this service and what we found
We identified some low-level concerns with medicines and environmental safety that were rectified during and after the inspection. The home was very clean, and personal protective equipment (PPE) was readily available and used. There was a safe system in place for visitors to the home. Staffing levels were appropriate for the needs of the people living at the home. Staff we spoke with were knowledgeable around how to identify people at risk and knew how to report any concerns. Safe recruitment checks were in place.
The registered manager had good links with other organisations and built relationships with key people such as the local authority and health protection teams. Statutory notifications were submitted as required. We received positive feedback from people, staff and families about the management team. Staff felt supported and involved in the service. The registered manager was visible around the home and kept oversight of operations through good channels of communication.
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 12 July 2018).
Why we inspected
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.
We received concerns in relation to the management of medicines, staffing levels and infection control. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brabyns 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.
Brabyns House Care Home is a 2-storey residential care home providing personal care and accommodation to up to 39 older people. At the time of inspection there were 33 people living at the service.
We found the following examples of good practice:
The service had introduced a safe pod for visitors to see their relatives through glass. The pod required a visitor booking slot and was disinfected in between uses to minimise any risk of cross contamination.
Due to the home's design, it was possible to cohort people and staff, and introduce zoning areas. There were four small lounges and two separate staircases. Staff were able to support small groups of people to minimise mixing of people and staff.
The service followed guidance on the admission of new people to the home. Staff ensured new residents did not feel isolated on admission by providing some one to one staff interactions and reassurance.
Staff were monitored throughout the day for the correct use of PPE and regular hand washing audits were completed.
The service completed risk assessments and implemented risk management plans where people were medically at a higher risk of serious illness from Covid-19.
The home was very clean with extensive cleaning schedules in place. Hand sanitising and PPE stations were available around the home.
Brabyns House is located within walking distance of Marple village which has shops, pubs and restaurants. Public transport is also easily accessible. Brabyns House offers accommodation for up to 39 people who require assistance with personal care and support. At the time of inspection there were 36 people living in the home.
Brabyns House 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.
At our last inspection of Brabyns House in September 2016, the home was rated as ‘Requires Improvement’ with one breach of the Health and Social Care Act 2008 Regulation 19, relating to safe recruitment and one breach of the Care Quality Commissions (Registration) Regulations 2009 relating to submitting notifications to CQC. A requirement notice was issued in relation to the Regulation 19 breach. At this inspection we found the home had addressed this and the home were meeting the regulations appropriately.
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 2008 and associated Regulations about how the service is run.
People living at Brabyns House and their relatives told us they felt safe. Staff working at the home had received training on safeguarding which relates to protecting people from the risk of harm and abuse. The home had clear policies and procedures to ensure people were safeguarded.
The home used a system to calculate how many staff were needed to ensure people were supported safely. We saw this was regularly reviewed in response to changes in people’s needs. The staff we spoke with said they felt they always had enough time and staff to support people safely.
Staff had been recruited safely and all necessary checks had been completed prior to new members of staff starting work. Staff were skilled and received a broad range of training necessary for their roles. Staff received regular supervision and feedback to support them with their on going development.
The home were working within the requirements of the mental capacity act (MCA), applications for deprivation of liberty safeguards (DOLS) had been made where people had been assessed as lacking the capacity to make some of their own choices and decisions.
People we spoke with said the food in the home was very good. The registered manager said she wanted people to have a restaurant style experience. We saw the dining room was set with linen and flowers and looked welcoming. Meals were varied and people living in the home were able to have a choice of menu or an alternative if they wished. Snacks and drinks were available at all times. People's dietary needs were met and people who needed support to maintain their nutrition had clear plans and appropriate support provided.
People living in the home praised the caring attitude of the staff and management. During the inspection we observed staff interacted kindly and with patience at all times. Staff were seen to ask people before providing support and to behave discreetly in communal areas. Staff we spoke described how they supported people to uphold their dignity.
People’s care needs, their preferences and wishes had been fully considered and recorded in their care plans. We saw people had been involved in assessments and reviews. Care plans had been updated regularly to reflect any changes. People’s interests and previous experiences had been recorded and activities in the home reflected these.
There was a complaints policy in place with information about how to raise any concerns displayed in the communal areas and also included in the home’s information pack. We found complaints had been recorded and responded to in a timely way.
Governance systems in the home were effective in monitoring the quality and provision of care and support. Regular staff meetings ensured staff were up to date and able to discuss any areas of interest or concern. Daily handovers ensured people’s needs and any changes had been identified and met.
There was a positive atmosphere in the home, staff spoke highly of the management team and their commitment to high quality care. People living in the home and their visitors also praised the management and felt able to raise anything at any time.
The home is registered to provide accommodation and care for up to 39 older people, including people who are living with dementia. On the day of the inspection, there were 35 people living at the home. The home is situated in Marple, close to Stockport, in Greater Manchester. The premises had two floors and the first floor was accessed by a passenger lift. There were attractive gardens and car parking spaces to the front of the premises.
The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with CQC 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.
On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. However, we found the home’s recruitment and selection policies and procedures had not been operated effectively. This meant there was a lack of evidence that only people considered suitable to work with vulnerable people were employed at Brabyns House.
This was a breach of Regulation 19 (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Some notifications had not been submitted to CQC as required by regulation. This meant that we were not able to determine whether appropriate action had been taken following any accidents or incidents.
This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009: Notifications of other incidents.
Staff told us they were well supported by the registered manager and senior staff group. They confirmed that they received induction training when they were new in post and told us they were happy with the training provided for them.
People told us that they felt safe living at the home. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.
There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
We checked medication systems and saw that medicines were stored, recorded and administered safely, although minor improvements were needed. Staff who had responsibility for the administration of medication had received appropriate training.
People who lived at the home and relatives told us that staff were very caring and that they respected people’s privacy and dignity. We saw that there were positive relationships between people who lived at the home, relatives and staff, and that staff had a good understanding of people’s individual care and support needs.
People’s family and friends were made welcome at the home. A variety of activities were provided to meet people’s individual needs, and people were encouraged to take part.
People told us they were very happy with the food provided. We saw that people's nutritional needs had been assessed and their individual food and drink requirements were met.
There were systems in place to seek feedback from people who lived at the home, relatives and staff. People told us they were confident their complaints and concerns would be listened to. Any complaints made to the home had been investigated and appropriate action had been taken to make any identified improvements.
Staff, people who lived at the home and relatives told us that the home was well managed. Quality audits undertaken by the registered manager were designed to identify that systems at the home were protecting people’s safety and well-being, and we saw that some audits had resulted in improvements being made.
We considered the evidence collected under the outcomes and addressed the following questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Below is a summary of what we found. Please read the full report for the evidence supporting our summary.
Is the service safe?
People were cared for in an environment that was well-maintained and where needed, improvements were being made.
People were treated with dignity and respect by staff. People told us they had no concerns about the care they received.
The home had policies in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and it was acknowledged by the Registered Manager that management and care staff would benefit from additional training in these areas.
There were systems in place to effectively manage people's medication and medication was stored appropriately and securely.
Is the service effective?
People's care needs were assessed with their involvement, and where appropriate their families were also involved. People's care plans provided person centred guidance for staff in how to deliver their care. Staff understood the importance of working with people and their relatives to provide good care and showed an understanding of people's support and emotional needs.
People were provided with balanced, nutritious meals, which the people we spoke with told us they enjoyed. People were supported with their nutritional needs by appropriately trained staff.
Is the service caring?
People were encouraged to spend time visiting the home before moving in. This provided opportunities to build relationships with staff and the people they would be living with. We saw that people were spoken to with warmth and respect. Staff explained to people what they were assisting them with and why. The support they received was calm and unhurried. A relative we spoke with told us they were made to feel welcome by staff, who provided them with reassurance about their relative's stay. They also told us they were regularly invited to eat a meal with their relative, which was an important social activity to them.
Is the service responsive?
A visiting health care professional told us in their experience people received good care, staff were keen to learn and discuss people's care needs and that staff had a good relationship with local medical professionals.
There was a complaints procedure in place and the people we spoke with felt able to express their concerns, although they had not felt the need to. The views of people who used the service and their relatives were sought and responded to.
Is the service well led?
There was an effective management team in place and the staff we spoke with felt supported in their role. There were quality assurance systems in place to identify and address shortfalls in the service, although it was acknowledged by the Registered Manager that these could be developed further.
We found that people were at risk of injury because radiators in some of the bedrooms were too hot to the touch. Also there were a number of different styles of windows which did not meet with current health and safety requirements.
We have received confirmation and seen copies of invoices to show that low surface temperature radiators have been installed and that where necessary new toughened glass double glazing and/or single glazing units have been fitted.
People told us 'The manager is good and fair and listens to what you have to say;' 'We are always made to feel welcome and the door is always answered promptly:' 'We are very pleased with the care given to the residents;' 'We have seen an improvement since the Deputy Manager came;' 'I am very happy with my own little room it is home to me;' 'I go out in garden every day when the weather is ok and speak to the gardeners;' 'I have own way of doing things.'
We found during our inspection of the building that there was some risk to the safety of the people who lived at Brabyns House. We found that radiators in some bedrooms were very hot and were not protected and also the variety of windows throughout the home meant that not all met with health and safety requirements. We discussed our concerns with the Deputy Manager.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.
We spoke to some people who use the service and a relative when we visited on 3 July 2012. People we spoke to told us that generally they were satisfied with the care and support given to them at the home. They said 'Exceedingly good here', 'I cannot fault the care' 'Excellent, I feel it's like my home'. Some people we spoke to said they did not feel well involved with their care and were not familiar with their care plans. However a relative of someone who uses the service told us they were fully involved with their relatives care and were familiar with the care plan. People who use the service told us they felt staff listened to them and would respect their wishes where possible when being cared for. We were told by a relative staff were approachable and felt one would be able to contribute views and suggestions regarding care and that this would be listened to. People told us the food was very good. There was one choice on the menu at mealtimes however we were told that they could request an alternative if they wanted to and this was respected.
All the people we spoke to told us they were treated well and with dignity and respect. People said 'They look after me well', 'They treat me with respect' 'It's like being at home'.
One relative we spoke with told us how their father's condition had greatly improved since living here. They were pleased with the overall care which addressed all needs including physical, emotional, psychological, and dietary. They felt staff were approachable and respectful. We were also told there was a good regime of activities to stimulate people.