Brindley Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider had effective systems in place to promote a learning culture. The provider worked with people and partner agencies to establish and maintain safe systems of care, in which safety is managed, monitored and assured. Procedures in place to ensure people were protected from abuse were not always effective. Overall, risk assessments were up to date and guided staff to support people effectively. There were effective systems in place to ensure the environment was kept safe. While staff had received the required training to carry out their roles, improvements were required to ensure people received person-centred care. While there were systems in place to minimise the risk of spreading infection, such as checks, audits, staff training and the provision of personal protective equipment, staff did not always follow safe hygiene practice. Medicines were stored safely however improvements were required in the recording of medicines.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People gave mixed feedback about how much they were involved in improving the service. One person told us, “We have resident meetings which are good, and I can say what I want but nothing changes. I haven’t completed any questionnaires.” Another person told us, “I feel very involved here. I’ve seen the manager coming around and talking with people.”

Staff told us there was a good learning culture at the care home. One staff member told us, “We now do weekly skin care audits and have really improved in managing people’s skin conditions.” Another staff member told us, “The clinical lead is always working with us. We learn from things and address any issues.”

The provider had systems in place to promote a learning culture. Staff were able to make suggestions on improving care through team and one-to-one meetings and suggestion notes; and residents and relatives could raise any concerns or make suggestions through resident and relative meetings. The provider held learning forums internally and attended meetings with partners to learn lessons and share good practice.

People told us they received safe care. One person told us, “I feel safe here. I would tell staff if I was unhappy.” Another person told us, “I like living here with company. I feel safe.”

Staff told us people received safe care. One staff member told us, “We are monitoring people all day and people are telling us they receive safe care.” Another staff member told us, “We work through things with residents and try to give safe care. For example, a resident would like staff to lift them manually as they don’t like using the hoist, however this would be unsafe and therefore we are working with the physio to find the best way of supporting them.” Another staff member told us, “We have procedures in place to ensure people receive safe care. For example, where needed, people have a MUST (Malnutrition Universal Screening Tool) assessment, we monitor people’s weights and BMIs (Body Mass Index) to check for trends and refer to the GP or dietician if there are any issues.”

Professionals supporting people living at Brindley Court told us the provider worked well with them to keep people safe. One professional working with the service told us, “Referrals received over the last few months have a good amount of detail and account of the patient’s needs.” Another professional working with the service told us, “Professionals who visit the home are particularly complimentary and feel that any requests from the care home staff are appropriate.”

The provider worked with people and partner agencies to establish and maintain safe systems of care, in which safety was managed, monitored and assured. Overall, care plans were up to date and guided staff to support people effectively. We did however identify an instance where a person or their relative had not been involved in their advanced care plan and it did not contain person-centred information. Where the person’s care plan indicated they required support to be weighed weekly, they were only being weighed monthly. However, we observed no impact on their health outcomes and there was regular contact with health professionals. When we told the management team about this, they put a plan in place straight away to update the care plan and to ensure the person was supported to weigh weekly. The provider ensured continuity of care. For example, where a person required oxygen care, they had been reviewed by an oxygen nurse and their recommendations to refer them to a partner agency regarding another health need had been followed up by staff. Where referrals to external agencies were required to meet people’s needs and risks, these were made in a timely way. For example, where a person required emergency medical support, this was requested straight away, and a risk assessment was put in place immediately to manage their new risks. Flash meetings took place daily to ensure staff were kept up to date with people’s needs.

Although the people we spoke to had not felt the need to raise safeguarding issues, they reported they felt safe and would be able to raise any concerns. One person told us, “I am safe. If I had any problems, I would speak with my [relative].” Another person told us, “I feel safe here, any problems I would speak to the [registered] manager. They’ve been this morning to ask if everything was okay.”

Staff told us they followed the safeguarding policy and knew how to safeguard people. One staff member told us, “We are improving in safeguarding people. There is a safeguarding coach in the team, and I have had my safeguarding training.” Another staff member told us, “I know how to recognise abuse. If I see abuse, I know to record what I have seen, and report to the management team. I can report abuse to the local authority if I need to.” While staff told us they knew how to recognise and report abuse, we found staff did not always escalate safeguarding concerns in a timely way or did not always consider whether an incident required a safeguarding referral to be made to the relevant authority.

While we did not observe any incidents requiring a safeguarding response, we observed staff communicating with people with kindness.

Procedures in place to ensure people were protected from abuse were not always effective. For example, where an allegation of abuse had been made, it had not been escalated to an appropriate colleague in a timely way so there was a delay in this being investigated. At the time of our inspection, although the incident was being investigated and the relevant authorities had been notified, the internal investigation outcome or provider’s safeguarding plan had not been recorded. When we informed the management team, they ensured their safeguarding outcome was recorded and a safeguarding plan was put in place while investigations from partner agencies took place. Where a complaint included potential safeguarding concerns, the provider was investigating the incident. However, they had not considered whether the relevant safeguarding authorities needed to be informed. When we informed the management team, they ensured the relevant safeguarding authority was informed. Although the provider had not followed safeguarding procedures effectively, lessons learned from their ongoing investigations had been shared with the staff team in a timely way. There was an up-to-date safeguarding policy in place. However, this did not contain information about local safeguarding authorities. Overall, the provider ensured appropriate decision specific mental capacity assessments were carried out. However, we found one instance where a relative, who did not have the legal authorisation to do so, had signed a document for a person who lacked mental capacity. When we informed the management team, they ensured a mental capacity assessment and best interest decision were carried out straight away. Applications were being submitted appropriately when DoLS authorisations were needed.

People gave mixed feedback about how their risks were managed. One person told us, “Staff support me with my personal care. If I wasn’t happy, I would tell the carers.” One relative told us, “My [relative] is cared for in bed and nothing is too much trouble for staff. They always seem well looked after.” Another person told us, “I require support with [a health need] but not all staff help me with this.”

Staff told us they supported people to manage their risks safely. One staff member told us, “I have had specialist training to support people with their clinical needs. We support people with diabetes and ensure we monitor their blood sugars and that we administer their medication where required and they eat and drink the right things. We ensure safety incidents are recorded and escalated when needed.” Another staff member told us, “For people with skin conditions, we ensure we record the condition of their skin, apply creams when required and help people to reposition by following their care plans. We let the nurses know about any issues and they do a good job.”

We observed staff supporting people safely to manage their risks such as their mobility, skin and eating and drinking.

Overall, risk assessments were up to date and guided staff to support people effectively. We did however identify an instance where risks assessments had not been updated to reflect individual needs and to guide staff how to manage a person’s distressed behaviours. When we told the management team about this, they put a plan in place straight away to update the risk assessments. Where people had been assessed to have mobility and falls risks, they had the required equipment and support in place to support them with their mobility and for staff to be able to monitor their falls risks. For example, people had crash mats, bed sensors and mobility aids, and checks were carried out in line with their risk assessments. Where people required support with managing their skin conditions, staff supported them to reposition regularly, and they had pressure relieving equipment in place where needed. Staff recorded people’s skin conditions where appropriate and escalated any concerns to the nursing team or to partner agencies where additional support was required.

People told us they felt safe in the care home environment. One person told us, “I like it here and I feel safe.”

Staff told us the care home environment was clean and safe. One staff member told us, “We are updating the home environment gradually. We practise fire evacuations and when we had an issue with the fire panel, it was fixed straight away. The management arrange for replacement items to be sorted straight away.”

The care home environment was safe. People’s rooms and communal areas were clean, tidy and free from obstacles. The care home had adaptations to support people with their mobility. Equipment used to support people was safe and used by trained staff where required. Substances harmful to health were stored securely in locked storage rooms.

There were effective systems in place to ensure the environment was kept safe. Routine testing took place for fire alarms and evacuation procedures. Environmental risk assessments were in place such as fire safety, gas safety and water safety. These were up to date and where there were issues identified, these had been addressed or there was a plan in place to address them. Environmental audits took place to monitor the safety of the premises and equipment. People were provided with specialist beds, hoists, and other equipment. There were coded doors to help restrict access to stairways. At the time of our inspection, the lift was out of service and due to be replaced. Where required, people were able to use a stair lift or stair climber to mobilise between the first and second floors. Although this took longer than using the lift, the stair lift was safe and comfortable.

People gave mixed feedback about staff. One person told us, “Staff have a lot of patience although some can be a bit sharp in how they speak.” Another person told us, “You can’t expect staff to be good all the time. Staff are busy and don’t have much time to spend with you.”

Staff told us people received safe care. However, there were some issues in the staff team which could be witnessed by people living at the care home. One staff member told us, “There is a lot of staff conflict however I do not believe this has been witnessed by residents.” The registered manager told us there was a risk people living at Brindley Court had witnessed conflicts between staff. However, they were confident they had not been adversely affected by this. The registered manager had been working with some staff to resolve conflicts and to improve their practice.

While we observed enough staff supporting people safely, staff did not always interact with them when delivering care. For example, some staff did not communicate with people while serving meals.

While staff had received the required training to carry out their roles, improvements were required to ensure people received person-centred care. The provider was working with staff to improve how they interact with people and to make people’s care experience more personalised. Team meetings, one-to-one meetings and daily handovers were in place to support staff to provide safe care to people. Staff were safely recruited. New staff were subject to pre-employment checks such as reviewing their employment history, references from previous employers and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. There were enough staff on duty to meet people's needs. The provider used a dependency tool to calculate the numbers of staff they needed. The provider had identified the need for clinical oversight and had an interim clinical lead in place to support nursing staff until permanent clinical staff were settled.

People told us regular cleaning took place and the care home environment was clean. One person told us, “The home is clean. My room and bathroom are cleaned every day.” Another person told us, “When I am resident of the day, my room is deep cleaned. My room was cleaned yesterday.”

While staff told us there were infection prevention and control systems in place, we observed instances where safe hygiene practice was not followed.

While staff had received infection prevention and control training and wore personal protective equipment such as aprons, hats and face masks, not all staff wore gloves during mealtimes. We observed some instances where staff had not followed safe hygiene practice. For example, where a person told staff they did not ask for a food item on their plate, a staff member removed the food directly from the plate without wearing gloves or having washed their hands first; and not all staff washed their hands between supporting people with moving and handling and serving food. However, we found no evidence people had experienced infections due to unsafe hygiene practice. We observed domestic staff following infection prevention and control procedures during our inspection and people’s rooms and communal areas were clean with no evidence of malodours.

The provider had systems in place to mitigate the risk of spreading infection. While there were systems in place to minimise the risk of spreading infection, such as checks, audits, staff training and the provision of personal protective equipment, staff did not always follow safe hygiene practice. However, we found no evidence people had experienced infections due to unsafe hygiene practice. When we informed the management team, they spoke with staff straight away about the importance of following safe infection prevention and control practice. Refrigerator and freezer temperatures were recorded routinely, and temperatures were in the safe range. Legionella assessments were carried out in line with requirements and remedial action was taken where required. There was an up-to-date infection prevention control policy in place.

People did not share any feedback with us about how they were supported with their medicines. However, we found concerns with some medicines which could have put people at risk.

Staff told us there were systems in place to ensure people received their medicines safely. One staff member told us, “Staff responsible for giving medication have had online training however we would like more face-to-face training for the medicines recording system.” Another staff member told us, “I’ve had all my medicines training and there are no issues regarding medication.” While staff told us they had received their medicines training and people received their medicines safely, we found improvements were required in the recording of stock levels, reasons for giving as required medicines, and positioning of transdermal patches.

Overall, medicines were stored safely, and people were supported to receive their medicines safely. However, improvements were required in the recording of medicines. For example, where a person was given as required medication to manage distressed behaviours, the reasons for giving it were not detailed enough and there were no records to indicate how the person responded to the medication. Where a person required transdermal patches to be rotated to manage their pain, staff had not always recorded where they were applied. Their transdermal patch location needed rotating for at least 3 weeks to reduce the risk of skin irritation or thinning of the skin. As staff were not recording where it was being applied, it could not be determined if the patch was ever being applied in the same place again. When we informed the management team, they put a plan in place to improve the recording of medicines. The provider was working with staff responsible for administering medicines to ensure stock counts were recorded accurately on their medicines system. Staff involved in handling medicines had received medicines training. There was an up-to-date medicines policy in place.