Background to this inspection
Updated
21 December 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.
The inspection took place on 13 November 2017 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is a community service and we needed to be sure that the registered manager would be available.
The inspection was carried out by one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. There area of expertise was with regards to older people.
Prior to our inspection visit we reviewed the information we held about the service. This included notifications; (Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales).
We planned our inspection using this information.
Throughout the inspection we observed staff interacting with people who used the service, in the communal areas and lounges.
We spoke to 15 of the people who used the service, received comments from five relatives and spoke to four members of the staff team, including the registered manager. We also contacted health and social care professionals for their views on the services.
During our visit to the offices we reviewed the care records of four people who used the, service including a sample of medication administration records that people kept in their own flat. We reviewed the recruitment, training and supervision records (in detail) of two members of staff. We also reviewed the training records of all the staff employed by the service.
We reviewed a sample of the policies and procedures in place at the service including safeguarding, the Mental Capacity Act 2005, lone working, complaints and compliments and medications.
We looked at the systems in place for the management and oversight of quality improvement and auditing of the service.
Updated
21 December 2017
The inspection took place on 13 November 2017 and was announced. The provider was given 48 hours’ notice of the inspection because they provide community services and we needed to be sure that someone would be in.
This was the first inspection of the service since their registration with CQC.
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
People who used this service lived in their own flats with access to communal areas, for example a lounge and two large bathrooms, one of which was fitted with a specialised bath. There were 38 self-contained, one and two bedroomed flats at the service.
The registered manager and care staff had access to an office on site, shared with the housing provider.
Not everyone living at Bramble Court received the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; for example, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection there were 18 people receiving the personal care service.
There was a registered manager at the service. 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 who used this service told us that they felt safe, secure and protected from harm. There were risk assessments in place to help ensure staff worked safely and supported people with their care needs in a safe way. The staff that we spoke with during our inspection knew about safeguarding processes and how to report any concerns they might have. They were aware of people’s rights to make decisions and choices with regards their lifestyle and support needs. The provider had policies and procedures in place to help protect people from harm and abuse. People who lived at Bramble Court told us that they knew who to raise concerns and issues with. They were confident that they would be listened to and appropriate actions would be taken.
We found that staff had been recruited safely with thorough checks about their suitability being carried out prior to them taking up their post. Staff told us that they were provided with training and received support in order to carry out their roles effectively. The staff records we reviewed confirmed this to be the case. 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 supported with eating and drinking where this had been assessed as part of their care and support needs.
The people we spoke to during our visit to this service had nothing but huge praise and very positive comments about the care and support provided. They spoke extremely highly of the staff and managers, who assisted them or their family member. Staff were described as “wonderful”, “friendly” and “brilliant.” We were told by people using this service that staff always made time for anything needed. We observed that people were treated with respect and dignity and were provided with information and explanations to help them make informed choices about their day to day lives.
The care records that we reviewed had been developed around each individual person’s assessed needs. Personal preferences, choices and interests had been included in the support plan. This helped to make sure people received the support they wanted. The people we spoke with all commented on the social aspects of living at Bramble Court. They told us that there were plenty of activities available at the service or the nearby community centre if they chose to join in. It was evident that people who used this service were supported and encouraged to maintain their contact with the local community.
People who used this service had been involved in and consulted about the quality and standard of the service provided. People knew who the managers were, although some people were not clear about the managers’ roles. The service operated as an extra care housing complex and there are separate managers for the building and for care. However, although there was some confusion everyone we spoke to confirmed that they were confident to speak to any of the managers and were confident that their comments would be listened to and acted upon.
The registered manager had some auditing and governance systems in place to help ensure the service operated safely. The provider’s quality lead person was also at the service during our inspection. They were able to speak to us about the plans for developing the auditing and governance systems, not only for Bramble Court but for the organisation in general.