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Archived: Branch Court Care Home Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 August 2015

This was an unannounced inspection which took place on 10 and 12 June 2015. We had previously inspected this service in July 2014 when we found it was in breach of one of the regulations we reviewed; this was because the home was not suitably adapted for the needs of people living with a dementia. During this inspection we found improvements had been made and the service was now meeting this regulation. However we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to the unsafe management of medicines in the service and the assessment and management of the risks people might experience. You can see what action we told the provider to take at the back of the full version of the report.

Branch Court is a purpose built home which provides accommodation for up to 30 older people who require support with personal care needs. At the time of our inspection there were 29 people using the service.

There was a registered manager in place at Branch Court. 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.

The systems for managing medicines in the service needed to be improved to ensure that people always received their medicines as prescribed.

Care plans included information about the risks people might experience such as those related to falls, skin integrity and nutrition. However we found risk assessments had not always been regularly reviewed and updated to take into account people’s changing needs. This meant there was a risk people might receive unsafe care.

People who used the service told us they felt safe in Branch Court and that staff were kind and caring. This was confirmed by our observations during the inspection.

Staff had received training in safeguarding adults and were able to tell us of the correct action to take should they have any concerns about people who used the service. Staff were aware of the procedures to follow to should they observe poor practice in the service.

Staff were safely recruited and received the induction, training and supervision they required for their roles. People told us there were enough staff on duty to meet their needs in a timely manner but we on the second day of the inspection we found improvements could be made to the deployment of staff in the dining room during the busy morning period.

We saw there were risk assessments in place for the safety of the premises. All areas of the home were clean and well maintained, although we noted there was limited space available for the storage of equipment people needed. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply to the premises.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA) 20015; this legislation provides legal safeguards for people who may be unable to make their own decisions. The registered manager had assessed the capacity of people who used the service to consent to the care and treatment they required. Where necessary, applications had been made to the local authority to ensure any restrictions in place were legally authorised under the Deprivation of Liberty Safeguards (DoLS). Staff we spoke with were aware of their duties when these restrictions were in place.

Although care records were personalised and provided good information about the care people required, we found care plans had not always been reviewed and updated. Our observations showed that staff did not always provide support in accordance with the care plans for people who used the service

People gave positive feedback regarding the quality of the food provided in Branch Court. Systems were in place to ensure people’s nutritional and health needs were met. We saw that staff would contact relevant professionals, if they had any concerns regarding the health of a person who used the service.

Systems were in place to help ensure people received the care they wanted at the end of their life. One of the professional visitors we spoke with spoke highly about the quality of end of life care provided by staff in Branch Court.

A timetable of activities was in place to help promote the health and well-being of people who used the service. We saw that people were supported to access local facilities and resources but not all people who used the service felt the activities on offer in Branch Court met their individual needs.

The registered manager had introduced a system to involve the relatives of people who used the service in reviewing the care provided in Branch Court. However, we noted it was not always evident that people who used the service had regular opportunities to provide feedback on the care they received.

People we spoke with told us they would be confident to raise any concerns with the managers or staff in the service. Relatives/friends we spoke with told us they found the managers to be approachable.

All the staff we spoke with told us they enjoyed working in Branch Court and considered they received the training and support they required for their role. Records we looked at showed regular staff meetings took place and were used as a forum to discuss required standards of care and improvements which could be made to the service.

There were a number of quality assurance measures in place in the service, including audits relating to care plans and medication records. The absence of the registered manager due to sick leave had led shortfalls in these audits. However a plan was in place to ensure all records were brought up to date following the registered manager’s return to work.

Inspection areas

Safe

Requires improvement

Updated 12 August 2015

The service was not always safe.

The systems for managing medicines required improvement to ensure people always received their medicines as prescribed.

The system for reviewing and updating risk assessments needed to be improved to help ensure people were protected from the risk of unsafe or inappropriate care.

People told us they felt safe in Branch Court and that there were enough staff to meet their needs. Staff had been safely recruited.

Effective

Good

Updated 12 August 2015

The service was effective.

Systems were in place to ensure staff received the training and support they required to deliver effective care. Staff were able to demonstrate their understanding of the Mental Capacity Act (MCA) and DoLS and their responsibility to support people to make their own decisions wherever possible.

People were able to access professionals and specialists to ensure their health needs were met.

People who used the service told us food was good and they were given sufficient food and drink to meet their nutritional needs.

Caring

Good

Updated 12 August 2015

The service was caring.

People who used the service spoke positively about the attitude and approach of staff. We observed staff to be kind, caring and thoughtful in their interactions with people.

People were supported to receive the care they wanted at the end of their life.

Responsive

Requires improvement

Updated 12 August 2015

The service was not always responsive to people’s needs.

Although people told us they always received the care they needed, we observed staff did not always follow the information contained within care plans.

Systems to involve people who used the service in commenting on the care they received needed to be improved.

A programme of activities was in place but people we spoke with did not feel the activities on offer always interested them.

Well-led

Good

Updated 12 August 2015

The service was well-led. The service had a manager who was registered with the Care Quality Commission and was qualified to undertake the role.

People we spoke with gave positive feedback about the leadership of the service.

Staff told us they enjoyed working at Branch Court and received good support from the managers in the service.