Braeside home for the Elderly Ltd

Updated 24 February 2022

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic, we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 19 January 2022 and was announced. We gave the service 24 hours’ notice of the inspection. The registered manager was not available on the date of the inspection, so we spoke with the deputy manager. We received further information from the registered manager after the inspection.

Updated 24 February 2022

This inspection took place on 8 and 9 January 2018. The first day of the inspection was unannounced. The service was last inspected in October 2016 when it was rated Requires improvement. This was because six breaches of regulations were identified. These were in relation to the management of medicines, safeguarding people from harm, staffing, records, good governance and notifications.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, responsive and well-led to at least good. This inspection was carried out to check the required improvements had been made.

Braeside Home for the Elderly (HFE) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is a detached property and accommodates up to 24 older people on two floors. At the time of the inspection there were 13 people accommodated in the home.

The home had a registered manager in place. 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. The registered manager had been in post since January 2017.

We found that since the last inspection, the new registered manager had made significant improvements to the way the home was run; this meant all the regulations we reviewed were now met.

People told us they felt safe in Braeside HFE and that staff treated them well. Our observations showed they were cared for by staff that were kind, caring and respectful of their dignity and privacy.

Staff had completed training in safeguarding adults and knew the correct action to take if they witnessed or suspected abuse. Staff told us they would be confident to use the whistleblowing policy that was in place should they witness poor practice in the service.

People told us there were enough staff on duty to meet their needs in a timely manner. During the first day of the inspection we noted staff did not regularly check on people who were sitting in one of the lounges. However, this improved on the second day of the inspection.

Records we reviewed showed all staff had been safely recruited. Improvements had been made to the training, supervision and support provided to staff by the registered manager. Staff spoken with highlighted training as one of the areas which had been vastly improved by the new registered manager.

We found there were appropriate policies and procedures in place for the safe management of people’s medicines and that people received their medicines as prescribed by health care professionals. Improvements had been made to the way medicines were stored to help ensure they were not accessible to people other than trained staff.

Care records we reviewed were personalised and provided a good level of detail for staff to follow. The initial assessment, completed before people were admitted to Braeside HFE, was used to formulate care plans and risk assessments; these records had been regularly reviewed and updated when people’s needs changed. We noted that people who lived in the home and, where appropriate their relatives, had been involved in these care plan reviews.

People’s communication needs were clearly documented within care plans as well as how staff should support them to express their views and wishes. Staff spoken with demonstrated a good understanding of people’s diverse needs and preferences.

Although all areas of the home were clean, we noted some improvements needed to be made so that people were properly protected from the risk of cross infection. A downstairs shower room needed to be refurbished and appropriate arrangements needed to be made to the way personal protective equipment (PPE) was stored in the home.

Staff had received training in fire safety and first aid. However, there was no business continuity plan in place to provide guidance for staff about the correct action to take in the event of an incident which caused disruption to the service.

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. Staff had received training in the Mental Capacity Act (MCA) 2005. The registered manager was aware of their responsibility under the MCA and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected. Six applications had been submitted to authorise the care arrangements for people who were unable to consent to their care in Braeside HFE; one of these applications had been authorised by the local authority.

People were supported to be as independent as possible. Care records reminded staff about the need to encourage people to do as much as possible for themselves.

Systems were in place to help ensure people’s health and nutritional needs were met. People told us they enjoyed most of the meals they received. They were provided with a nutritionally balanced diet that catered for their dietary needs and preferences. Staff worked in cooperation with health professionals to help ensure that people received appropriate care and treatment.

People had the opportunity to engage in a range of activities. Staff told us it was sometimes difficult to engage people in activities; for this reason the registered manager had developed a system of ‘residents of the day’. This meant that staff on duty were asked to spend individual time with two identified individuals to help reduce social isolation and promote people’s sense of well-being.

People who lived in Braeside HFE and their relatives knew about the home’s complaint’s procedure. All said they were confident any complaints would be fully investigated and action taken if necessary to rectify matters.

The registered manager and provider conducted regular checks to make sure people were receiving appropriate care and support. The registered manager took into account the views of people using the service, their relatives and staff through meetings and surveys. Staff said they enjoyed working at the home and considered communication and paperwork had been vastly improved since the new registered manager had started work Braeside HFE.