Background to this inspection
Updated
11 July 2018
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 24 April 2018 and was unannounced.
The inspection was carried out by one 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.
Before the inspection we reviewed the information about the service the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service including previous inspection reports. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.
We spoke with eight people and observed staff interactions with people. We also spoke with three relatives and a visitor. We spoke with five staff and the registered manager who was also the owner.
We requested information by email from local authority care managers and commissioners and other health and social care professionals involved in the service. We also contacted Healthwatch to obtain feedback about their experience of the service. There is a local Healthwatch in every area of England. They are independent organisations who listen to people’s views and share them with those with the power to make local services better. We received feedback from a community matron, a practice nurse, a GP and a commissioning officer from the local authority.
We looked at the provider’s records. These included three people’s care records, which included care plans, health records, risk assessments, daily care records and medicines records. We looked at two staff files, a sample of audits, satisfaction surveys, staff rotas, accidents and incidents and policies and procedures.
We asked the registered manager to send additional information after the inspection visit, including staff training records and policies. The information we requested was sent to us in a timely manner.
Updated
11 July 2018
The inspection took place on 24 April 2018. The inspection was unannounced.
Bromfield House Residential home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Bromfield House Residential Home accommodates up to 10 older people. There were two floors, the first floor was accessible by passenger lift. There were nine people living at the service when we inspected.
At our last inspection on 12 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
The service had 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.
Risks were appropriately assessed and mitigated to ensure people were safe. Medicines were managed safely. Records evidenced that people had received their medicines as prescribed.
Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. Accident and incident records were closely monitored, actions were taken in a timely manner to ensure lessons were learnt.
People were happy with their care and support. Staff had built up good relationships with people. Relatives confirmed that their family members were happy living at the service.
The service provided good quality care and support to people enabling them to live as fulfilled and meaningful lives as possible.
Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the service was calm and relaxed. Staff treated people with dignity and respect. People’s privacy was respected. The service was homely, clean and tidy.
People were supported to maintain their relationships with people who mattered to them. Relatives told us they were able to visit at any time.
There were enough staff deployed to meet people’s needs. The provider continued to operate a safe and robust recruitment and selection procedure to make sure staff were suitable and safe to work with people. Staff received training, support and supervision to enable them to carry out their roles safely.
Staff knew what they should do to identify and raise safeguarding concerns. The registered manager knew their responsibilities in relation to keeping people safe from harm.
People were encouraged to make their own choices about everyday matters. People’s decisions and choices were respected.
People's care plans clearly detailed their care and support needs. People and their relatives were fully involved with the care planning process. The service had developed care plans which clearly detailed people’s likes, dislikes and preferences. Care had been delivered in line with people’s choices. The registered manager reviewed each person’s care with each person on a monthly basis. People were encouraged and supported to engage with activities that met their needs.
People had choices of food at each meal time. People were supported and encouraged to have a varied and healthy diet which met their health needs.
People were supported and helped to maintain their health and to access health services when they needed them. The registered manager and staff maintained good communication with other organisations such as the community nursing service, GP and other healthcare services. Relatives were kept well informed about their family member’s health needs.
People and their relatives were given information about how to complain. People and their relatives were actively involved in improving the service, they completed feedback surveys and had meetings.
Staff were positive about the support they received from the management team. They felt they could raise concerns and they would be listened to.
The registered manager had built strong links with other local registered managers and providers who they gained support and advice from. The registered manager had signed up to conferences and events in the local area to help them continuously learn and improve.