Archived: Briars Rest Home

Updated 9 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 14 December 2016 and was unannounced. The inspection team consisted of two adult social care inspectors.

At the time of the inspection visit 13 people lived at the home.

Before our inspection we reviewed the information we held on the service. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people who lived at the home. We also checked to see if any information concerning the care and welfare of people living at the home had been received.

We contacted the commissioning department at the local authority and Healthwatch Blackpool prior to our inspection. Healthwatch Blackpool is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced whilst living at the home.

During our inspection we spoke with a range of people about the service. They included six people who lived at the home, two relatives, the provider, the manager and three members of staff. We spent time observing the care and support being delivered throughout the communal areas of the home. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care and medicine records of three people, the previous four weeks of staff rotas, recruitment records for four staff, and records relating to the management of the home.

Updated 9 February 2017

This inspection took place on 14 December 2016 and was unannounced. This is the first inspection since the service changed from a partnership to an individual provider in December 2015.

The Briars Rest Home is a detached property close to local amenities. The home provides personal care for up to 15 people. All bedroom accommodation is for single occupancy. Communal space consists of a lounge, a separate dining room, and a small conservatory which is also used as a smoking room. At the time of the inspection visit 13 people lived at the home.

There was not a manager registered with the Care Quality Commission (CQC). The previous registered manager left the Briars rest home in December 2015. Although a new manager was appointed in March 2016, they had not applied for registration with CQC when we inspected. Like registered providers, 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 they were happy and well cared for and felt safe living at the home. However this did not always reflect our findings. There were several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which meant the service was not safe, effective, caring, responsive or well-led.

The risk assessments we looked at were basic. Actions to manage risk were not always identified to guide and support staff in keeping people safe. They were not always signed or dated so it was unclear whether they were current.

We looked at a person whose behaviour challenged the service. There were no management strategies to assist staff to defuse situations or distract the person from behaviour that challenged. This put people at risk, particularly when staff were new in post and unfamiliar with the person.

We looked at how medicines were managed. We saw they were not always managed safely. ‘Medication administration records (MAR) were not always completed accurately. Failing to complete medicines records properly placed the health and welfare of people at unnecessary risk.

We looked at the recruitment and selection procedures the provider had in place to ensure people were supported by suitably qualified and experienced staff. We looked at the recruitment records of four members of staff. Suitable arrangements were not in place to ensure safe recruitment practices were followed.

The Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), was not implemented. People had not consented to or been involved in planning and updating their care. Care records seen stated whether people had mental capacity but not how this decision was reached. The manager had not completed applications to request the local authority to undertake (DoLS) assessments for people at risk if they left the home without an escort.

There were no quality assurance measures in place to monitor the quality of the service and people were not given formal opportunities to share their views.

Care records were not always accurate, informative or dated. Care plans and risk assessments were limited. Some information was conflicting; other information had not been recorded, so people’s care needs were not clear. Care files sampled showed no evidence people or their relatives were involved in planning.

Although staff had not received recent safeguarding training, staff spoken with understood their responsibility to report any suspicions of or if they observed any abuse. New staff had not received appropriate training or competency checks.

People told us that staff were caring and kind. They and their relatives said that staff were patient and compassionate. They interacted with people frequently and provided social and leisure activities. People told us they knew how to raise a concern or to make a complaint if they were unhappy with something but had no need to complain.

People were offered a choice of nutritious meals. They were complimentary about the meals and told us they enjoyed them.

People had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems. One person said, “They [staff] are quick off the mark if anyone is ill.”

People, relatives and staff told us they found the manager supportive and approachable. One person told us, “There have been some good changes since [the manager] came.”

We found a number of breaches 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 this report.