5 March 2018
During a routine inspection
When we completed our previous inspection on 12 February 2017, at the previous office address of the service, we identified two breaches of the legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12, (Safe Care and Treatment) as medicines were not consistently managed in a way which ensured people received them in a safe and effective manner with regard for the risks associated with them; Regulation 17, (Good Governance), the provider had failed to operate a robust quality assurance framework. We also made three recommendations for good practice, that; the provider sought guidance from a national source on robust risk assessments; the provider sought guidance on how to implement the MCA 2005 Code of Practice and the provider sought guidance from a national source about the implementation of a person centred care plans.
At this inspection we found that improvements had been made to all identified areas.
Medicines were managed safely and people received them as prescribed. People were supported with medicine management when needed and care workers had received training on how to administer medicines.
Systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service and these were being followed. An electronic system to monitor if staff were staying the allocated times at care calls was now effective.
Individual risk assessments were in place which considered for example, moving and handling, falls and skin integrity. Systems were in place to monitor accidents and incidents.
The provider had appropriately implemented the Mental Capacity Act (2005) Code of Practice. Training schedules confirmed care workers had received training on the Mental Capacity Act (2005). Staff told us how they gained consent from people before delivering care. Consent forms were in place for people to sign to indicate their consent to the package of care and care plan.
Person centred care plans had been put in place when implementing the new electronic system of recording records. People had individual care plans and staff spoke highly of these. Information was available on the person’s personal history and hobbies and interests.
There was a registered manager in post. 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. The registered manager was unavailable on the day of the inspection, and the provider and management team supported the inspection process.
People who received personal care and support from Braeburn Care told us they were happy with the service provided. One person told us, “They (staff) are very good. I cannot complain about anything”. Staff treated people with kindness and respect for their privacy and dignity. Staff knew people well and remembered the things that were important to them so that they received person-centred care. One person told us, “I would recommend Braeburn to anyone. They do not take liberties. They are respectful”.
People receiving support felt safe and well cared for. They were protected from harm because care workers understood the risks they faced and how to reduce these risks. They also knew how to identify and respond to abuse. Staff were vigilant of people’s health care needs and ensured they had access to health care professionals to maintain their health. Staff understood the need to share information about changes in people's health. People were supported to eat and drink enough to meet their needs.
There were enough safely recruited care workers to ensure the care could be provided. Staff told us told us they felt supported in their roles and had received training that provided them with the necessary knowledge and skills to do their job effectively.
People were supported by staff who were passionate about their work. Staff told us they liked working for the organisation and appreciated that the organisation put people first.
People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. The provider ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.
The provider provided good leadership. They checked staff were focused on people experiencing good quality care and support. Staff told us the management team were approachable and responsive to their ideas and suggestions.