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Brandon House Nursing Home Good

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All reports

Inspection report

Date of Inspection: 12 August 2013
Date of Publication: 18 July 2014
Inspection Report published 18 July 2014 PDF

Food and drink should meet people's individual dietary needs (outcome 5)

Not met this standard

We checked that people who use this service

  • Are supported to have adequate nutrition and hydration.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 12 August 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff and talked with commissioners of services.

Our judgement

People were not protected from the risks of inadequate nutrition and dehydration.

Reasons for our judgement

During our visit we observed the lunch service on both floors.

On the first floor lunch was served in the lounge area. Three people sat at a table at the end of the lounge. Other people sat around the edges of the room. The area was cramped with people having to move around the food trolley and mobility aids. Six people required assistance to eat their lunch. This assistance was provided by three care staff and the nurse on duty. We saw that due to the lack of space, staff struggled to seat themselves in a comfortable position when supporting people. One staff member sat on a foot stool and was therefore on a level lower than the person they were assisting. After a while they stood up and continued to assist the person to eat from a standing position. This was not respectful to that person.

We later saw there was a pleasantly furnished dining room available on the first floor where tables could be laid. Staff we spoke with told us they did not use the dining room as there were not enough staff to cover the dining room, lounge and support people who chose to eat in their bedroom.

We observed people eating their lunch in the dining room on the ground floor. Three people were assisted to eat. People did not receive the full attention of staff. Staff talked to each other rather than the person they were supporting.

We saw that people were offered a choice of liver and onions, cheese and onion pastie or an omelette for lunch. The servings looked generous and people were offered second helpings. At 3.00pm we saw people were offered hot drinks with a selection of sandwiches, pastries and cakes.

We identified eight people living in the home who had lost a significant amount of weight in the previous eight weeks. The cook confirmed they were not informed of people who were losing weight, but fortified all meals prepared.

One person who had lost weight had spent most of the night before our visit awake. During our visit they were asleep in bed for much of the time. At lunch time their lunch of a cheese sandwich and a packet of crisps was put by their bed. At 3.30pm it was still there. We looked at their fluid and food intake charts for that day. We saw they had not eaten any food and only taken 60 mls of fluids. We asked the cook if food was available during the night. They told us they were not asked to prepare anything, but food was available in the kitchen for care staff to prepare.

Everybody in the home was on food and fluid charts. One member of staff raised concerns with us about the accuracy of the charts. Another confirmed the charts were not completed immediately the food or fluid was taken. This meant we could not be sure the charts accurately reflected people's food and fluid intake.