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.
Briarwood provides nursing care for up to 29 people with mental health needs. At the time of this inspection there were 24 people living at Briarwood. The bottom floor called ‘Meadows’ provides accommodation for individuals living with dementia and the top floor called ‘Millview’ provides accommodation for individuals diagnosed with mental health conditions. Extensive redecoration work was being carried out to Meadows which meant that some areas were not available for people to use.
This was an unannounced inspection. The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
We last inspected Briarwood in October 2013. At that inspection we found the service was meeting all the essential standards that we inspected.
People and family members told us they felt safe living at Briarwood. People said they felt settled and found it easy to talk with staff. We observed staff supporting people to maintain their safety. For example, we saw that staff assisted one person who used a wheelchair to negotiate around furniture.
On admission to Briarwood people were routinely assessed against a range of potential risks, such as poor nutrition, falls, skin damage and mobility. Where other risks had been identified assessments had been carried out to ensure people received appropriate care.
Staff had a good understanding of how to keep people safe and knew how to respond to safeguarding concerns and behaviours that challenged the service.
Mental Capacity Assessments had been completed in line with the requirements of the Mental Capacity Act 2005 (MCA). We also found the provider acted in accordance with the requirements of the Deprivation of Liberty Safeguards (DoLS). Where required DoLS applications had been made to the local authority.
The provider had systems in place to ensure people received their medication from trained and competent staff. Records showed that people received their medication when it was due. Some people told us they felt the evening medication round was too late and this affected when they could go to bed.
We found that there were enough trained staff to meet people’s needs. Staff we spoke with said they were well supported by the management team and had opportunities to have one to one time with their manager. Staff had completed specialist training to help them support people’s individual needs, such as catheter training, dysphagia (swallowing difficulties), wound management, stroke care and phlebotomy (taking blood).
The provider had systems in place to identify people who were at risk of poor nutrition. We saw that people were actively involved in preparing their own meals. Where people required assistance with eating and drinking they received this support uninterrupted.
People were supported to meet their healthcare needs and had regular access to a range of healthcare professionals, such as the GP, psychologist and the dietitian. Staff supported people to access health appointments when required.
Family members told us that their relative was well cared for. We observed care being delivered and found that people received their care from friendly and respectful staff. People received regular interaction from staff throughout our inspection. People were supported to maintain their independence and their interests. They also had access to a range of activities both inside Briarwood and in the community.
People were asked to give their consent before receiving any care. Care plans were evaluated regularly to ensure they were up to date.
People and family members had opportunities to give their views about the service and we found these views were acted on. We saw the views of family members were largely positive. We found the provider had in place a complaints policy and people told us they knew how to make a complaint.
The provider undertook a range of checks and audits as part of its quality assurance programme to assess the quality of care provided. This included both internal and external checks on the quality of care delivered. The findings from audits were used to make improvements to the service. Records showed that staff regularly logged any incidents and accidents, which included the specific details of the incident or accident and the action taken to deal with the situation. The on-line system used to record incidents had in-built senior management checks to ensure that appropriate action was taken following an incident. Information was analysed to look for trends and patterns and to identify learning to improve the quality of the care provided.