The inspection of Brough Manor took place on 15 May 2015 and was unannounced. At the previous inspection on 30 July 2013 the regulations we assessed were all being complied with.
Brough Manor provides care and accommodation for up to 26 older people some of whom may be living with dementia. The service offers support with personal care, and provides activities and pastimes to help enable people to remain as independent as possible. Rooms are mainly single occupancy with en-suite toilets but there is provision for shared use as well. There are two lounges, a dining room and a garden courtyard for people to use. There is access to local train and bus transport close by. At the time of our inspection there were 23 people using the service and approximately 10 people were living with dementia.
There was a registered manager in post who had been managing the service for the past three years. 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.
We found that people were protected from the risks of harm or abuse because the provider had effective systems in place to manage issues of a safeguarding nature. Staff were trained in safeguarding adults from abuse and understood their responsibilities.
People that required support with mobility, transferring and postural changes were safely cared for by staff that followed good practice guidelines and were trained in moving and handling techniques and the use of hoists. All safety issues were covered by risk assessments that were regularly reviewed.
We found the premises to be safe and well maintained. Contingency plans and risk assessments were in place for emergency events such as utility failures or inclement weather.
There were sufficient numbers of trained, skilled and competent staff on duty and staff had been safely recruited following effective use of recruitment procedures, which ensured staff were vetted for their suitability to work with vulnerable people.
We found that the management of medicines was safely carried out and while there was a need to improve the infection control equipment in the service, the overall infection control and food hygiene practices were safely carried out and managed.
People told us they were happy with the effectiveness of the service. Staff were appropriately inducted, trained, skilled and supervised to carry out their roles.
Staff use of equipment was seen to be effective, for example, in assisting people to transfer and there was good communication when doing so. The service effectively used the Mental Capacity Act and Deprivation of Liberty Safeguards legislation to ensure people’s rights were adhered to and consent in all things was obtained.
Nutrition and hydration for people was adequately provided and people’s choice/preferences played a part in this. The service was proactive in accessing health care professional’s support.
The environment was suitable for older people, but not entirely suitable for meeting the needs of people living with a diagnosis of dementia.
People we spoke with said the staff were kind, considerate and caring and we observed a caring approach from all staff. Relationships between people and staff were seen to be good. Activities were appropriate to people’s needs and preferences and they made for eventful days.
We were told by people that their privacy and dignity was respected and we saw for ourselves that staff were discreet. People’s physical and emotional well-being was considered and they were supported to achieve good outcomes.
We found that a different approach to supporting people living with dementia at the end of their lives had been discovered and used to ensure their last days were as comfortable and stress free as possible.
We found there were well written care plans in place to reflect people’s needs and to show staff how best to support pole. The complaint system in place showed issues were responded to appropriately and resolved as quickly as possible.
There was a variety of activities provided for everyone. People’s choice and preferences were respected as much as possible.
There was consistency in the running of the service because the registered manager had been registered for the last three years. They were open, transparent, focussed and inclusive in their management style. We found there was a strong and effective system of quality assuring in place: auditing and surveying, which provided feedback to people and their relatives. Records were well maintained throughout the service.