You are here

Branksome House Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 15 September 2020

During an inspection looking at part of the service

About the service

Branksome House is a residential care home providing personal care for up to nine adults with learning disabilities and/or autistic spectrum disorder needs. At the time of the inspection seven people were living there and receiving care.

The service was developed and designed before Registering the Right Support came into existence. Despite this, the service was managed 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

The provider’s quality assurance processes had improved and were effective in driving in improvements across the service. This was evident in the premises, fire safety and review of incidents and accidents, to ensure people received a safe service. People received their medicines as prescribed. Some improvement to people’s records was still needed and the provider had started making these improvements during the inspection.

The registered manager provided good support for staff to be able to do their job effectively. Staff knew people well and the support they required. People, relatives and staff were positive about the provider and the support people received from staff.

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.

Following our previous inspection the outcomes for people using the service had improved and reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible and staying in contact with loved ones. The service was a hub of activity with friendly staff providing care and support in a way people liked and enjoyed. Positive interactions took place between people, staff and each other throughout our visit.

There were effective infection prevention and control systems in place to ensure the risk of infection was managed. Staff followed appropriate infection control procedures, during the COVID-19 pandemic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Requires Improvement (published 7 February 2020) and there were four breaches of regulation in Regulation 9 (Person centred care), Regulation 15 (Premises and Equipment), regulation 12 (Safe care and Treatment) and Regulation 17 (Good Governance).

Following our last inspection, we served two Warning Notices on the provider. We required them to be compliant with Regulation 12 (Safe care and treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by 25 March 2020. We issued requirement notices for Regulation 9 (Person Centred Care) and Regulation 15 (Premises and Equipment).

The provider completed an action plan after the last inspection to show what they would do to improve and by when.

At this inspection we found significant improvements had been made and the provider was no longer in breach of the regulations we found at the previous inspection.

We did however find a new breach of Regulation 17 (2) (c) (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to people’s records.

The service remains rated Requires Improvement.

Why we

Inspection carried out on 19 November 2019

During a routine inspection

About the service

Branksome House is a residential care home providing personal care for up to to nine adults with learning disabilities and/or autistic spectrum disorder needs. At the time of the inspection seven people were receiving care.

People’s experience of using this service and what we found

The new provider’s quality assurance systems to assess, monitor and improve the quality and safety of the service were not operated effectively. Shortfalls in the service had therefore not always been promptly identified and addressed.

At the time of the inspection the local authority was working closely with the provider to make the required improvements. The provider kept us updated of the action they were taking to address the risk and quality concerns.

The service did not always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons:

People were supported by staff who had been recruited safely. People received their medicines as prescribed. However, not all practices were safe enough.

Risks associated with people's care needs were not always appropriately assessed and information for staff on how to provide safe support to people were not always documented or reviewed following safety incidents.

People were not always adequately supported to keep their homes well maintained and cleaned.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The service had not always maintained a current record of people’s capacity to make decisions.

Sufficient numbers of staff were available during the inspection to keep people safe. The provider was taking action to improve the support to staff to enable them to meet the needs of people living at Branksome House.

People did not always receive person centred care that reflected their personal preferences and met their social needs. Care records did not always show the support people required and had received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This was the first inspection of the service under the new legal entity. The service was last inspected under the old provider and was rated Good.

At this inspection, we found the service had deteriorated to be Requires Improvement. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well-led sections of this full report.

Why we inspected

The inspection was prompted in part due to concerns received from local authority commissioners about areas of concern such as the management of people’s medicines, infection control, staffing and risk assessments. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to Regulations 9, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have told the provider to take at the end of this report. We issued two warning notices to the provider informing them they must be compliant with both regulations.

Follow up

The provider started taking immediate action during our inspection to address the shortfalls we found and to mitigate the risks.

We will request to meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan for the provider to understand what they wi