Branch Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety, mainly in relation to records and how staff were supported. This meant there was an increased risk that people could be harmed, though we did find some examples of good care being provided.

The service was in breach of legal regulation in relation to good governance and staffing.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People’s relatives seemed to suggest there was an open dialogue of communication with the registered manager. One relative told us, “Theres an open-door policy, we can speak to anyone at any time.” Staff were knowledgeable about how to report accidents and incidents. We were able to review examples of lessons learned which took place following incidents.

We have been able to gather limited feedback from external professionals despite our requests. However, one professional told us the staff follow instructions that they leave and provides them with updates if they request this.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People felt the staff team worked well together to ensure they received the care and support they needed. One relative told us, “My grandmother is a lot safer here. There was a lot of problems at the last place. She was dehydrated and ended up in hospital. The manager has been amazing. It was an emergency admission, and we could not ask for anything more.”

Staff spoke about how they got to know people who were new to the service by looking at care plans, and people their relatives and management were involved in creating care plans. One staff member said, "People and their relatives are involved (in creating care plans), the deputy writes care plans." Handover sheets were in place and all staff on shift attended handover. We were able to see examples where appropriate referrals had been made when people needed specific support.

We have been able to gather limited feedback from external professionals despite our requests. However, one professional told us the home was prompt at identifying potential concerns and made referrals to them quickly.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

People told us they felt safe, one person said, “I feel safe here, it’s ok as far as it goes.” Staff told us they had access to safeguarding policies and safeguarding training. They gave examples of things they may report as a safeguarding, one staff member told us they would report, "Abuse, ill treatment and if staff abused people."

Staff told us they had received training about mental capacity. The registered manager confirmed people had access to advocates if they needed this support. We also spoke to an advocate who had no concerns about the service. During our assessment we witnessed interactions between staff and people, which seemed calm, kind and considerate. On arrival, guests (including inspectors) were allowed access through keypad coded and locked doors. We were asked for our identity badges and were asked to sign into the home to make sure the home had a record of any visitors, which helped keep people safe.

Appropriate safeguarding’s were mostly being made. We did find an example where a safeguarding should have been raised following a discussion with the local safeguarding team and it had not been, though no harm came to the person as a result. The service had a safeguarding policy in place which detailed necessary information. At our last inspection we made a recommendation around mental capacity assessments, and we found improvements had been made in this area. People’s capacity had been assessed, and necessary Deprivation of Liberty Safeguards (DoLS) applications were in place to deprive people of their liberty. At our last inspection we made a recommendation around mental capacity assessments, and we found improvements had been made in this area.

The service did not always work well with people to understand and manage risks. Although they provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them, records in this area did not meet the required standard.

Necessary risk assessments/information was not always in place or as detailed as they should have been in relation to people’s health conditions. For example, one person who was living with diabetes did not have details around signs/symptoms or risks in their care plan. This meant staff may not always be aware of how to manage risk appropriately. We reviewed two peoples care plans who were living with epilepsy, and these did not detail all the risks involved, symptoms or what staff were to look out for in event of a seizure or leading up to a seizure. One person’s falls risk assessment had not been updated since August 2024 in their paper file. This lapse occurred during a transition onto electronic care planning. The registered manager ensured the falls risk assessment was updated during our assessment.

Although the home had various risk assessments in place some areas would benefit from further consideration such as communal living spaces. We found the personal emergency evacuation record (PEEP) was not fully up to date. The PEEPs register contained information for one person who no longer resided at the property. People who were able and wished to self-administer medicines were supported to do so. The person we spoke with was happy with the arrangements made for medicines self-administration, but we could not find a supporting care plan or risk assessment. At our last inspection we identified similar concerns relating to risk management, though during this assessment, we found no impact from this and felt these were more of a governance issue. Based on this information, we have made the decision to close the previous regulation 12 breach of safe care and treatment and move the concerns we found to a regulation 17 breach of good governance.

People told us they were able to do what they wanted. One person who had capacity told us how they had a key card, which allowed them to leave and return to the home when they wanted, this showed how the home involved people in managing their own risk. Staff spoke about how they managed risks. One staff member said, "The deputy manager writes them (risk assessments) and involves people and their family. Night staff and day staff also input." Staff told us how they supported people with their healthcare needs. During our walk arounds we found no environmental concerns that posed immediate risk to people.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

At our last inspection we made a recommendation around the environment and at this assessment we found improvements had been made. The registered manager told us, "I think I have improved the environment a lot since I started.” The environment was safe and significant improvements had been made to areas of the home since our last visit. We found wardrobes were secured to the walls, radiators had necessary covers in place, windows had necessary restrictor in place and there was adequate signage around the home. Some improvements could be made to make the environment more dementia friendly as the home supported a high number of people living with dementia. Improvements such as making peoples doors more recognisable and adding contrasting toilet seats could benefit some of the people living at the service. The registered manager acknowledged this and advised they would look into this further.

People and their relatives felt their loved one was in a safe environment. One person said, “I have my buzzer in my room and I feel safe, I was alright in my own flat, but here is better, I have company and I am a chatty person and I feel safer around people.” Staff told us they attended fire drills. One staff member said, "I think it the last fire drill was about a month ago." Staff told us they had no concerns about the safety of the people living at Branch Court Care Home.

Necessary safety certificates were in place to support safe environments including gas safety, electrical a safety, waste contracts and a fire safety risk assessment.

The provider did not always make sure staff had completed appropriate training to ensure staff were always skilled and experienced members of staff. They did not make sure staff received effective support, supervision and development. Though staff did work together well to provide safe care that met people’s individual needs.

Staff supervisions and appraisals were not regularly taking place. Staff told us they did not receive regular supervisions, one staff member said, "No I haven't (had a supervision or appraisal in the last 12 months). I don’t think I have had one since I started". The registered manager said, “I think I need to improve supervisions." The registered manager told us they would look to make improvements in this area. Staff training was not always up to date. Some staff had not completed a number of courses. The registered manager spoke about how they would address this following the assessment. Competency checks for moving and handling had lapsed for all staff. The registered manager booked the necessary competency checks in following our site visit. Safe recruitment practices were in place and had been mostly followed, though we did find some gaps in employment history for some staff that had not been addressed. The operations director looked to gather this information during the assessment.

People felt supported by staff and family members echoed this. One family said, “We are very confident there is always enough staff, and they are all good at their job. It’s like a big family.” Staff told us they completed an induction when they started and they felt they had the appropriate training for their role. Staff told us they felt the staffing levels in the home were appropriate though one staff member did feel they would benefit from an extra staff member in a morning. We observed staffing in place that was in line with the rotas provided.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Relatives felt the home was clean. One relative said, “You don’t get that horrible smell like you do at some care homes.” Staff were able to tell us how they tried to minimise the spread of infection through appropriate use of PPE. One staff member said, “I wash my hands and wear PPE." The home was clean and tidy and there was a dedicated area for laundry. Appropriate PPE was in place. Cleaning records were in place, signed and up to date.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did not always involve people in planning.

Regular medicines audits were carried out so that should any shortfalls be identified; they could be promptly addressed. For example, we saw action was being taken to improve records about the use of a ‘when required’ medicine to support management of agitation or distress. However, the issues relating to medicines storage at the home’s previous audit had not yet been resolved. Medicines were securely stored but the maximum and minimum temperature range was not recorded to show that safe storage temperatures were maintained. Additionally, homely remedies were available for the prompt treatment of minor ailments, but some of these had not been needed for a long time and were expired. These were removed by staff during the assessment. People were supported to receive their medicines in a way which met their individual needs. Care was taken to help ensure that time sensitive medicines such as those for Parkinson’s disease were given on time. Appropriate arrangements were usually in place for the covert (hidden) administration of medicines if needed, although a recent change had not been promptly followed-up for one person. We raised this with staff and arrangements were made for a review to consider this. The local GP practice carried out a ‘ward round’ at the home every week where people’s health needs and medicines could be reviewed. The staff member administering medicines spoke positively about the medicines training and assessment provided at the home.