4 October 2017
During a routine inspection
Briardene Care Home is a 59 bed care home that provides personal and nursing care to older people, some of whom are living with a dementia. Accommodation is provided over two floors, with each bedroom having ensuite toilet and wash basin facilities. In addition specialised bathing and showering facilities are available.
At the time of the inspection there were 50 people using the service.
The service had a registered manager but they were currently absent due to a period of planned leave. The deputy manager was managing the home and had been in the position of acting manager since August 2017.
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 provider of Briardene Care Home had recently changed and it had been recognised that there were areas of the Home which required improvements. Ongoing improvements were being made to documentation and an overarching action plan was being developed.
Various quality monitoring systems and audits were being completed which had identified areas that needed to improve. The acting manager had a priority list for ensuring peoples care plans, risk assessments and documents relating to the provision of care were renewed and updated. The acting manager was tracking this to ensure timely completion. Where care documentation had been rewritten the information was detailed and specific to the person. Risks had been appropriately assessed and mitigated however work was ongoing to ensure all records met the required standard.
People, relatives and staff were positive about the approach of the acting manager and everyone made positive comments about the changes and improvements that were being made. People and staff told us the acting manager was approachable, supportive and “got things done.”
Team meetings were in place and there had been a recent introduction of heads of department meetings. The acting manager had plans to work towards comprehensive reviews of clinical procedures within clinical staff meetings.
Staff told us they felt well supported and most of the staff had attended at least one supervision since the new provider had been in place. Plans were in place to ensure supervision meetings were planned for the remainder of the year. Appraisals had not yet been completed. The acting manager was conscious that they needed to get to know the staff first before assessing their performance. Training was provided and the provider was currently assessing the need for a review of some training, including dementia awareness. Some staff had yet to attend refresher training.
Complaints, safeguarding concerns and accidents and incidents were logged. It was evident that improvements had been made following any concerns however lessons learnt were not always clearly recorded and the outcomes of complaints not always logged.
An activities coordinator was in post who was working with people to identify what their interests and hobbies were so activities could be tailored to their needs. They were also meeting with people and families to complete one page profiles and ‘This is Me’ documents so staff could get to know the person and their life history.
People were very complimentary about the approach of staff and said they were treated with care and kindness. One person commented, “They say there is no place like home, well this is the next best thing for me.” Another person had written on a quality assurance survey, ‘My life at Briardene has been some of my happiest.’ We observed people were treated with compassion and respect.
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. Information about capacity and best interest decisions was included in some, but not all, people’s care documentation.
People were appropriately supported with nutrition and hydration. There was access to a range of healthcare professionals and people confirmed they received medical support when needed. Medicines were managed and administered in a safe way.
People and staff told us there were enough staff as agency staff were currently being used whilst a recruitment campaign for permanent staff was ongoing. The acting manager had been proactive with the agencies to ensure the same staff worked at Briardene Care Home to ensure consistency for people.
Safe recruitment practices were followed, and nursing and midwifery council checks were completed on a monthly basis. The provider confirmed that Disclosure and Barring Service checks were completed prior to recruitment.