Brandon House Nursing Home

Updated 5 May 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a nurse specialist advisor and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Brandon House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brandon House is a care home with nursing care. 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 and sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We carried out observations to assess people's experiences of the care provided as most people were living with dementia and were unable to provide detailed information. We spoke with the registered manager, the deputy manager, a nurse, two care staff, an activities co-ordinator, the chef and a housekeeper. We spoke with two people and five relatives to gather their experiences of the care provided.

We reviewed six people's care records and a selection of daily records for people. We looked at the medicines records for each person living at the home. We looked at a sample of records relating to the management of the service including health and safety checks, training records, accident and incident records, safeguarding records and management audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 5 May 2022

About the service

Brandon House is a residential care home providing personal and nursing care up to a maximum of 35 people. The service provides support to older people living with dementia. At the time of our inspection there were 30 people using the service. Accommodation is spread over two floors.

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

Quality assurance checks had not always identified areas needing improvement. For example, we found improvements were needed in regards to medicine management, including storage as well as environmental risks linked to infection prevention and control. The provider took the necessary steps to address areas of improvement we found either on the day of our inspection visit or immediately following this.

People’s care records were not always sufficiently detailed to show risks associated with people's care were effectively managed and responded to in a timely way to keep people safe. There were sufficient numbers of staff to support people’s needs and staff were recruited safely. Staff felt supported by the management team. People and their relatives spoke positively of their experiences of the service. Relatives spoken with felt their family members were safe living at Brandon House.

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 30 January 2019).

Why we inspected

We received concerns in relation to the management of nutrition and care. As a result, we undertook a focused inspection to review the key questions of Safe and Well led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report. The provider responded to our findings by taking immediate actions to mitigate any immediate risks that could impact on people’s care.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brandon House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to Regulation 17 at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.