We carried out a review of the data available to us about St Brannocks on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about St Brannocks, you can give feedback on this service.
St Brannocks is a residential care home providing personal care for up to six people. At the time of the inspection four people were using the service. The service is registered to provide support to people living with learning disabilities and autism.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People told us they were happy living at the service. One person told us, “ I am very happy, the staff are nice and kind.” Another person commented, “Best house in the world, it’s a very happy house.”
People continued to be supported to remain safe. Risks to health and safety were well managed. Staff knew how to protect people from abuse and when and how to raise concerns. Medicines were managed safely and people received these on time and as prescribed. Incidents and accidents continued to be reported appropriately and were used as learning opportunities to improve people’s support.
People’s needs continued to be assessed before they moved into the service. The assessment was used to plan people’s support, staff training and staffing levels. Staff were well supported and supervised, they had the skills and training needed to support people. Staff were motivated and said they enjoyed their roles. Staff continued to be recruited safely to make sure they were suitable to work with vulnerable people.
People were supported to access healthcare services, including dental care and specialised support for specific conditions. People had enough to eat and drink, they were encouraged to use the kitchen to prepare meals with staff support where needed.
People were involved in decisions about their care and were supported to make choices. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were kind and caring and offered people emotional support when this was needed. People were encouraged to express their views about their care and support. People said they were listened to by staff. Staff respected people’s privacy and people were treated in a dignified manner.
People had the opportunity to feedback about their support or any concerns through surveys, house meetings and one to one meetings. People knew the registered manager and staff well and interacted readily with them throughout the day. People and their relatives knew how to complain if they chose to do so. Care plans and support was person-centred and staff knew people well.
There were systems in place to check and maintain the quality of the service to ensure people received a good standard of care. The service continued to work in partnership with other service to improve outcomes for people.
The service applied the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes which include control, choice and independence.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published on 27 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People were safe at the service. Staff knew about abuse and to report any concerns that they had. Risks to people were well-managed and staffing levels were sufficient to ensure people received the care they needed. People's medicines were administered by the service and there were systems in place to ensure that this was done safely.
Staff had the training and support they needed for their roles. 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. Nutritional needs were being met and people were supported to attend appointments with healthcare professionals.
There were positive relationships between people and members of staff. Staff adapted their communication and involved people and their families in decisions about their care. People's privacy and dignity was maintained by members of staff.
Care was person-centred. People had individual care plans in place which provided staff with information about specific goals, preferences, needs and abilities. Activities were provided in the service and local community and the feedback of people and their family members, including complaints, was welcomed.
There was a positive culture at the service and staff members were motivated by their roles. The registered manager had a visible presence and was known to people, relatives and staff. There were quality assurance processes in place to monitor and review the care being provided.
The leadership of the service had changed since the last inspection; we found that staff morale had improved and staff felt opportunities to express their views had improved. Staff told us they felt valued and listened to.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
We inspected St Brannocks on 13 August 2014. This was an unannounced inspection which meant the staff and the provider did not know we would be visiting. Our previous inspection was on 22 April 2013, and the home was meeting the regulations assessed.
This home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home and has the legal responsibility for meeting the requirements of the law; as does the provider.
St Brannocks can provide care and support to seven people with learning disabilities. At the time of the inspection six people were living at the service. There was a low staff turnover and many staff had worked with the same people for a number of years. We saw that staff understood people’s needs, and care was provided with kindness and compassion. Staff actively supported people to make everyday decisions for themselves. Some people also undertook their own administration of medicines and there were appropriate arrangements in place for the safe management of medicines. People were enabled to lead a busy lifestyle doing the things that they wanted to do.
Although systems were in place to provide staff with opportunities to express their views through staff meetings and one to one supervisions, staff said they did not particularly value these. This was due to past experiences when they did not feel they had been listened to, and for them many issues remained unresolved. As a result staff morale was low, but we found staff demonstrated a commitment towards the people they supported to provide a good level of support that was unaffected by how they were feeling. We found that whilst the provider had made progress in providing appropriate training to staff, further team and skill building was needed.
Thorough recruitment practices were in place to ensure that appropriate checks of new staff were undertaken. New staff received an induction when they started work at the home. Interviews with staff and records viewed showed that they were appropriately trained and skilled to provide care in a safe environment. Staff understood their roles and responsibilities but some felt that sometimes other staff could be inconsistent in the messages they gave to people and that the overall flow of communication in the home could be improved.
Discussions with staff and our observations showed us that there were enough staff to support people. Throughout our inspection we saw that staff treated people with kindness, patience and respect, and that staff consulted with them about all aspects of their support. We saw that the home was mindful of the need for some people to have space away from others and had re-arranged furniture in shared areas to help this.
An in-depth quality assurance process was in place that involved ongoing monitoring by the registered and area managers, with further monitoring undertaken by an internal compliance team. We saw that where issues were highlighted, action plans were drawn up and timescales for improvement set.
People were supported to consent to their care and treatment. There was written guidance available to staff around the Mental Capacity Act 2005 and staff had undertaken training in the subject. Staff were able to demonstrate their knowledge related to safeguarding and the procedure to follow.
People received care that met their needs and promoted their rights. People's care was reviewed regularly and service delivery was amended accordingly. Advice and guidance was sought from health and social care professionals to be able to meet people's needs effectively and promote their welfare and safety.
There were enough staff on duty to be able to meet people's needs effectively. Staffing levels were adjusted to reflect people's needs. One person had one to one support to assist in reducing behaviour that could be described as challenging.
Information about how to make a complaint was available to people in an accessible format. Complaints were investigated and action was taken to address the issues identified.
During the inspection we spoke with people using the service and they told us they liked living there. People told us they felt safe and supported by the staff. A person told us the staff 'make sure I am alright,' adding 'they give me support to write letters, help cook dinners and take me out to the cinema. They take good care of me'.
A relative told us that their relative 'seems to like it there'. Another relative told us the manager was a 'breath of fresh air' and that their relative always looked forward to returning to the service after visiting family. During the inspection we observed positive interactions between people and staff and saw they were able to meet the needs of the people at the service.
However, we spoke with staff who told us they did not always feel supported in their role; they did not always receive supervision frequently. Staff were not always able to share information about practice and service delivery because team meetings were not always held frequently.
We looked at records and saw that care plans did not always contain up to date risk assessments to reflect the current needs of people who lived at the service. Complaints were not always logged to enable them to be responded to and inform service delivery.