Archived: Brierfield House

Updated 9 November 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector, a specialist advisor (medicines) and an Expert by Experience on the first day and one inspector on the second day. 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

Brierfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority contacts monitoring and safeguarding teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well and any improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and two relatives about their experience of the care provided. We spoke with eleven members of staff including the activity coordinator, cook, kitchen assistant, registered manager, laundry assistant, development managers, regional manager, care workers, a visiting healthcare professional and the health and safety advisor. We observed people receiving support and looked around the premises and grounds. We reviewed a range of records. This included three people’s care records and several medication records. We looked at two staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We had discussions with the area manager and we sent further information, including action plans addressing the issues identified during the inspection.

Updated 9 November 2019

About the service

Brierfield House is purpose built residential care home, providing accommodation and personal care for up to 42 older people and people living with dementia. The home is close to the centre of Brierfield. Accommodation is provided over two floors; all bedrooms were single occupancy. At the time of the inspection 31 people were using the service.

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

Improvements were needed to how people's medicines were managed to ensure they were safe. People told us they felt safe at the service. We observed people were relaxed and content in the company of staff and managers. However, there had been a number of safeguarding incidents, we found action had been taken and was ongoing to make improvements. We made a recommendation about ensuring safe care and treatment. Some risks to people’s well-being and safety were not properly managed. The registered manager acted immediately to rectify matters and clear plans were in place to make improvements.

Although there were enough qualified staff available to provide safe care and support, there had been shortfalls with staffing arrangements. We were assured this matter had been resolved. The provider followed safe processes when recruiting staff. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. The premises were clean and systems were in place to promote good hygiene.

The provider had not given proper attention to overseeing the service and checking people were receiving safe and effective care. We found positive steps were being taken to make improvements, but the shortfalls could have been minimised with earlier interventions. There had been changes in management and leadership which had an influenced on the day to day running of the service. Some staff were positive about the management and ongoing changes at the service, others were discontent. None of the people living at the service expressed any concerns about the management and leadership arrangements.

People’s needs and preferences were assessed before they moved to the service. But we found some matters had not been fully considered. We made a recommendation about assessing and reviewing people’s needs. Improvements had been made with supporting people with their healthcare needs. People said they were satisfied with the variety and quality of the meals provided at the service.

Some parts of the accommodation and outside areas needed improvement. However, the provider had plans in place to develop the service for people's comfort and wellbeing. 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.

People had care plans to support their needs and preferences. However, some lacked information or needed updating to reflect people's current needs. We made a recommendation about planning for people’s needs. There were opportunities for people to engage in a range of group and individual activities. Visiting arrangements were flexible, relatives and friends were made welcome at the service. Processes were in place to support people with making complaints.

People made positive comments about the caring attitude of staff. They said their privacy and dignity was respected. We observed staff interacting with people in a kind, pleasant and friendly manner. Staff were respectful of people's choices and opinions.

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 25 September 2018).

Why we inspected

The inspection was prompted in part due to concerns received about medicines, staffing and general management. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to medicines management and monitoring and oversight of the service.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.