Archived: Brownlow House Residential Care Home

We found the following examples of good practice.

The premises were clean and well maintained. Hand sanitiser and personal protective equipment (PPE) were available at the entrance of the home. Visitors had their temperature taken and recorded, PPE was available, and people were supported to follow the government's guidance on wearing PPE and social distancing. The provider had their own ‘track and trace’ system for visitors to complete before they could enter the premises.

The provider had appropriate arrangements to test people and staff for COVID-19 and was following government guidance on testing. This ensured that people, visitors and staff were tested for COVID-19 in a consistent way in line with national guidance.

The provider ensured that staff received appropriate training and support to help prevent the spread of infection. All staff had received regular training on infection control and the use of PPE. Staff were assigned to work at one location to help minimise the risk of cross infection.

The provider ensured that people using the service could maintain links with family members and friends. Family members and friends could stay in touch with people with phone and video messaging. The provider had a pod with two seats and a window in the garden. The pod window looked into the conservatory window with a speaker and microphone so visitors could communicate with people safely. The pod was completely enclosed and sanitised after each session, to ensure a safe indoor visiting solution.

The provider understood the communication needs of people. For example, the provider used various forms of communication with people who had hearing difficulties.

The provider sought support and advice from external agencies including the local authority, and Public Health England health protection teams and was open to all advice and guidance offered to help keep people safe.

Brownlow House Residential Care home is a residential care home providing personal care to 18 people who have dementia, a mental health condition and older people at the time of the inspection. The service can support up to 24 people.

Brownlow House Residential Care Home has accessible communal areas including bathrooms, a living room, a dining room and a conservatory used as an additional dining space and as an activities room. People’s bedrooms are spread across three floors with washbasin and toilet facilities.

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

People received safe care by suitably recruited staff who knew how to safeguard them from harm and abuse. People’s medicines needs were met safely. People were protected from the risk of infection. People’s health and safety was ensured, and incidents were investigated, and lessons were learnt to minimise their recurrence.

People’s needs were assessed and met by staff who received detailed induction, refresher training and regular supervision. People received effective care by staff who worked well with healthcare agencies to promote good health outcomes. People’s individual dietary needs were identified and met. People’s bedrooms and communal areas were accessible.

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.

People and relatives found staff caring and kind and treated them with respect. People told us staff listened to them and involved the in the care planning process. People received a non-discriminatory service. People’s independence was respected and encouraged.

People told us their personal needs were met by staff who knew them well. People’s care plans were personalised. People were encouraged to partake in activities. People received visits from family and friends. People and relatives knew the complaints process. People’s end of life care wishes were explored and recorded.

People and relatives were happy with the home. The manager promoted a positive culture where staff felt supported and this helped achieve good outcomes for people. There were effective quality assurance systems in place to ensure the quality of the service. The manager worked with other organisations to improve care.

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 9 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Brownlow House Residential Care Home is a care home registered to provide accommodation, personal care and support for up to 24 people with dementia, mental health illness and older people. At the time of our inspection, 20 people were living in the home.

Brownlow House Residential Care Home has a dining and lounge room on the ground floor with a conservatory used as additional dining and lounge space. The conservatory opens up to an accessible garden with a patio area. The home has 22 bedrooms with one double bedroom, spread across three floors with bathroom and shower facilities. All bedrooms are with washbasin and toilet facilities. The first two floors are accessible via lift. The home has kitchen and laundry facilities.

The service had a manager who was going through registration process with the Care Quality Commission (CQC). A registered manager is a person who has registered with CQC 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.

People using the service told us they felt safe at the service and enjoyed living there.

People were protected against abuse and poor care by staff that were trained in safeguarding adults. The service had good systems to identify and manage risks. Risks to people were assessed and regularly reviewed. Care plans and risk assessments supported the safe management of people’s medicines. The service kept accurate records of medicines administered by staff that were well trained. The service was clean and had effective measures to prevent cross contamination.

People’s nutrition and hydration needs were met and staff kept detailed daily care records on how people were supported and what they had for meals. People and their relatives were very happy with the quality of food and the choices they were offered.

The service had sufficient numbers of staffing to meet people’s individual health and social care needs. People and their relatives told us staff were always available and easy to get hold of. The service worked closely with various health and care professionals to support people with their needs and wishes. People received weekly GP visits.

The service followed appropriate recruitment practices. Staff received induction and regular training, and records confirmed this. Staff received regular one-to-one supervisions and yearly appraisal.

The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People told us staff asked their consent before supporting them. The manager and staff demonstrated a good understanding of the procedures under MCA and DoLS.

People told us they had good relationship with the staff and found them kind and caring. Staff knew people well, treated them like individuals and provided person-centred care. Staff recognised people’s need to remain independent, and enabled and supported them wherever possible to remain independent.

The care plans were personalised and people’s individual needs and likes and dislikes were recorded. People and their relatives were involved in planning their care and were asked about their views. The service offered people with a range of activities. People and their relatives told us they were asked for their feedback and their complaints were acted upon promptly.

People, their relatives, staff and health and care professionals told us the service was very well run and the manager was knowledgeable. The manager worked with health and social care professionals to ensure the service supported people to maintain healthy lifestyle.

The service had records of audits and monitoring checks of various aspects of the service ensuring efficient systems were maintained to improve the quality of care delivery. The manager involved people, their relatives, staff and health and care professionals in improving the quality of the service delivered.

We observed staff being kind and caring during our early morning visit to this home. There were 19 people residing at the home, although one was in hospital. The provider had reduced the number of people staying there as double rooms were being converted to single rooms as people moved on. Staff were very familiar with the needs of people who used the service and when we pointed out that there was an insufficient number of staff to support people who were early risers, the provider said an additional member of staff would be available from 6.30am from 1st April 2014.

There was a high standard of record keeping and the 'Resident of the Day' system meant care plans and risk assessments were regularly reviewed with input from the person themselves whenever possible. We asked the manager to ensure that the lift remained accessible to people at all times and they undertook to ensure this was the case.

Most staff members were up-to-date with most of their mandatory training. This included sessions on dementia and mental health awareness.

The home assessed people's capacity to make decisions on admission to the home and kept this, their care plan and their risk assessments under review. There was a choice of food available and people's dietary needs and choices were taken into account. Staff received appropriate training for their role and there was an emergency on call sytem to assist them in the event of an emergency.

We noted that there was a rolling refurbishment underway to update the building, but we were concerned that certain aspects of lift maintenance had not been attended to and that information about the fire action plan was not available. The home had not notified the Care Quality Commission of all the events it is required to in order to comply with the regulations.

People were very positive about the home. They told us 'There's enough to do,' 'I can go out when I want to,' 'It's very relaxing here,' 'Staff are brilliant,' 'I love my room,' and 'My room's alright.'

We observed staff supporting people in a positive manner that respected their dignity. People indicated that they received sufficient support from staff, and had choices about their living arrangements, had opportunities to develop independence skills, and that they were able to go out as much as they wished. A number of improvements had been made to the home environment including refurbishing some people's bedrooms.