St Brendan's Care Home

St Brendan’s Care Home is a residential care home providing personal care. St Brendan’s Care Home accommodates 62 people across three separate wings, each of which has separate adapted facilities. One of the wings specialises in providing care to people living with advanced dementia. The service provides support to older people who may also have dementia. At the time of our inspection there were 51 people using the service.

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

The home ensured infection prevention and control guidance was followed to keep people and staff safe. People reported to feeling safe living at the service. Risk assessments were personalised and included detailed information of how to mitigate the risk.

The service had an open and transparent way of working to ensure the safety of the people living at the service. The provider was able to demonstrate that quality assurance systems ensured the quality of the service was maintained. There was a positive culture amongst staff at the service. Staff knew people they supported well and cared about their wellbeing. The provider was able to demonstrate their compliance with legal obligations and any learning from incidents or accidents was undertaken effectively. People reported that the management team were approachable and willing to listen.

Meetings for residents, relatives and staff had taken place and improvements to the service had been made based on the comments made.

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 23 October 2018).

Why we inspected

We received concerns in relation to staffing levels within the care home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

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 remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Brendan’s Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had acted to make sure people could have visitors safely. Accurate temperature and symptom checks were made prior to entry. Family visits had been facilitated through a separate room with its own access from outside using screens. When unable to have visits, the provider supported people with video or telephone calls to keep in touch with family.

Personal protective equipment (PPE) guidance and practice followed government guidance. The manager had put detailed processes in place around infection prevention and control (IPC) and PPE for staff to follow.

Frequent training on IPC and PPE was provided by the provider, via a roadshow with the infection control lead, and from the clinical commissioning group (CCG).

The provider used regular testing in line with government guidance which was well recorded. Agency staff were also tested by the provider.

Staff changed their clothes before and after each shift to help prevent infections being transferred to people.

The manager had put in place a colour coding system to make it easier to tell the COVID-19 status of each person. This enabled better isolation of people and allocation of staff.

Night staff undertook deep cleaning using approved cleaning and disinfection products.

The provider had a thorough policy for admissions including COVID-19 testing and a zoned area for 14 days to isolate people on admission from other residents in the home.

The service provides accommodation for a maximum of 62 people across four floors. At the time of the inspection the service was supporting 45 people with a range of physical support needs. Each floor is adapted to meet people’s specific needs. For example, the ground floor is designed to meet the needs of people living with dementia. Reminiscence areas were developed, with themed corridors. Signage was used, as were memory boxes to help direct people to areas.

The service was registered on 20 September 2017 and this was the first inspection.

The service was exceptionally responsive and strove to meet people’s needs, wishes and lifestyle choices. It was flexible and quickly adapted to meet people’s changing, diverse needs. It was particularly person-centred and people were seen and responded to as individuals. Activity programmes were creative and designed to meet people’s preferences and choices. Where possible, they were encouraged to take a lead role in these. Menus were created to offer diverse foods that were healthy. Care planning was individualised and regularly reviewed ensuring people’s current needs were met. Where possible, these were completed with people and / or their representatives, with nothing being finalised until the person gave consent.

The registered manager was experienced, respected and thought of highly by staff, people and families. She and the management team ensured the service was well-led. The registered manager and the staff team were committed to ensuring they offered people the very best care possible and that people were as involved as possible in running the service. The quality of care the service provided was constantly assessed, reviewed and improved. The registered manager strived to create a service that offered outstanding experiences for people.

People were protected from abuse by trained and knowledgeable staff. They were trained in safeguarding people and knew what action to take if they identified any concerns. The service continued to identify individual and environmental risks. Action was taken to reduce these risks, although a comprehensive written account was not always documented.

People continued to be supported by good staffing ratios, which were reviewed and increased as needed. The management supported staff and assisted people on a daily basis where the need arose. Staff were able to meet people’s specific needs safely. Robust recruitment systems were implemented to ensure as far as possible, that staff were safe and suitable to work with people. The service worked well with community schemes, including volunteers, who went through the same robust recruitment process as staff.

People were supported to take their medicines correctly by trained and competent staff. Where people were able to self - medicate, they were appropriately assessed and assisted to remain independent. Medicine records were not always accurate. This was identified in audits, and the management team were developing a new method to manage errors in documentation moving forward.

A well-trained staff team were able to offer people effective care. They met people’s diverse needs. Care plans were kept up to date ensuring people’s current and changing health and emotional well-being needs were met. The service worked closely with health and other professionals to ensure they offered individuals the best care in the most effective manner. A comprehensive care document was always available and kept up to date should the person need to transition from one provision type to another quickly.

People continued to be 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.

The caring, committed and enthusiastic staff team met people’s needs with compassion, kindness and respect. They ensured they promoted people’s privacy and dignity and communicated with them effectively. Measures were taken to ensure records were maintained confidentially, with a comprehensive and fully secure IT system used by the service.