Breme Residential Care Home

Updated 18 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an Expert by Experience completed the onsite visit. Another Expert by Experience made phone calls to relatives offsite. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Breme Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Breme Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. Cover had been provided by a regional manager and the new manager started on the day of the inspection. Once they have completed their induction, they will apply for registration.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 person who used the service and 12 relatives about their experience of the care provided. We spoke with 7 members of staff including the regional manager, manager, carers, activity coordinator and the chef. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records, including 3 people's care records. We looked at 3 staff files in relation to recruitment and staff support and a range of records relating to how the service operated and was managed.

Updated 18 March 2023

About the service

Breme Residential Care Home is a residential care home providing personal to up to 60 people. The service provides support to older and younger adults, people living with dementia or a physical or learning disability, sensory impairment or autistic people. At the time of our inspection there were 35 people living in the home.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support:

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. Medicines were managed safely. Staff were recruited in line with the providers policy and procedures. The provider had plans in place to update the environment where needed.

Right Care:

Staff knew people well and understood how to provide care in a person-centred way. Staff ensured their rights and dignity were promoted and protected. Infection, prevention and control was managed well. People said they felt safe and their relatives agreed with this. Staff received training in how to keep people safe.

Right Culture:

The provider had good oversight of the home. The new manager was experienced and committed to improving the culture of the home through speaking to people, relatives and staff about how they felt things needed to improve. Staff said they felt supported by the management team. Staff liaised with a range of professionals to ensure that people’s health and wellbeing needs were being met.

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 23 October 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and the culture in the home. A decision was made to complete a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.