Archived: Brackenthwaite

Updated 9 November 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18 September 2017 and was unannounced.

The inspection team consisted of one adult social care inspector and one expert-by-experience in the care of a family member living with a dementia. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service for older people.

Before the inspection, we had received a completed Provider Information Return (PIR). The PIR asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the service as part of our inspection. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send into the Care Quality Commission within required timescales.

We spoke with ten people who lived at Brackenthwaite and four relatives. We spoke with the registered manager, two senior supervisors, and five care workers, one domestic, two members of catering staff and a visiting healthcare professional.

During this inspection we carried out observations using the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not communicate with us. We undertook observations in communal areas and during mealtimes.

We reviewed a range of records about people’s care and how the home was managed. We looked at care records for six people including their medicines records. We checked recruitment, training and induction records for four staff, staffing rosters, staff meeting minutes, the maintenance book, fire risk assessment and log and quality assurance audits the manager had completed.

We contacted commissioners from the local authorities who contracted people’s care.

Updated 9 November 2017

This was an unannounced comprehensive inspection which we carried out on 18 September 2017.

We last inspected Brackenthwaite on the 17 April 2013. At that inspection we found the service was meeting the legal requirements in force at the time. We found the legal entity for the provider was not correct and the provider was registered under the entity of Cumbria County Council in November 2015. This is the first inspection since this change in registration was made.

Brackenthwaite is a care home registered to provide accommodation for up to 30 people requiring personal care. The property is a three storey building with a passenger lift to assist people to access the accommodation on the upper floors. People live in small units, each with a sitting and dining area. One unit specialises in providing care for people living with a dementia. At the time of our inspection there were 18 people living in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 and associated Regulations about how the service is run.

People’s rights were protected and staff obtained people’s consent before providing care. The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). People made informed choices and were enabled to be involved in decisions. Some of the records in people’s care plans were not clear on the support they needed to make decisions.

We made a recommendation about how people’s capacity was recorded.

People were supported with care and compassion and there was an ethos of care which was person-centred: valuing people as individuals. People told us they felt safe and well cared for. They appeared content and relaxed with the staff who supported them and told us that staff were very kind and caring. Activities and entertainment was available for people that met their diverse needs.

Relatives reported a "warm and welcoming atmosphere" and being updated with any concern about their relative's well-being.

The home was suitably staffed to provide care and support to people when they needed it. Staff were supervised and well supported. Staff in the home had completed training to give them the skills and knowledge to carry out their roles and to ensure people in the home were safe.

People were protected as staff had received training about safeguarding and knew how to respond to any allegations of abuse. Staff were aware of the whistle blowing procedure and knew how to report bad practice. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

People were safe because risks had been identified and managed. Records had been updated and they were regularly reviewed to reflect people’s care and support requirements. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received their medicines in a safe and timely way.

People were supported to eat a well-balanced diet and those who were at risk of malnutrition and/or dehydration had their food and fluid intake monitored. They told us of the good quality and range of the meals provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A complaints procedure was available. People told us they felt confident to speak to staff about any concerns if they needed to. The registered manager acted on feedback in order to ensure improvements were made to the service when required.

Communication was effective, ensuring people, their relatives and relevant agencies were kept up to date about any changes in people's care, support needs and the running of the service.

The service was well organised and managed. The provider undertook a range of audits to check on the quality of care provided. Staff and people who used the service said the manager was supportive and approachable. Both the registered manager and the senior team had high expectations of staff and gave them as much support and training needed to provide a reliable, efficient and compassionate service to people. Staff were proud of their work in supporting people at Brackenthwaite.