Brunel House

Updated 2 December 2021

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 team consisted of two inspectors 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.

Service and service type

Brunel House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission. It is a condition of the provider’s registration that there must be a registered manager for this service. 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

Before the inspection we reviewed the information we held about the service and the service provider. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We received feedback from two professionals who have contact with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with two people and one relative to gather their views about the care they received.

We looked at 12 people’s care records. We checked recruitment, training and supervision records for staff and looked at a range of records about how the service was managed. We also spoke with the manager, human resources manager, regional director and six care and nursing staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke to nine relatives and four staff by phone.

Updated 2 December 2021

About the service

Brunel House is a care home providing nursing and personal care to 40 people aged 65 and over at the time of the inspection. The service can support up to 65 people. People live on three floors of the building, one of which specialises in providing care to people living with dementia.

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

The provider did not always ensure there were enough staff working in the home to meet people’s assessed needs. People, their relatives, staff and visiting professionals told us there were not enough staff working in the home at times. The lack of staff impacted on people’s ability to receive care in a timely way. Staff felt they were rushing when providing care for people and were not able to provide person-centred care.

Risks to people were not always effectively assessed and managed. Action was not consistently taken following incidents to reduce the risk of a similar incident happening again.

The provider did not have effective systems in place to assess the quality of the service provided and make improvements where needed. The management team had not completed some of the regular checks and audits that were needed for effective oversight of the service. The systems had not identified some of the shortfalls we found during the inspection.

We made a recommendation that the provider reviews the medicines management practice, to ensure their procedures are followed consistently. There was not always an accurate record of medicines held in the service and one person regularly received time-specific medicine either early or late.

The home had good infection prevention and control procedures in place. Procedures had been reviewed and updated to reflect the COVID-19 pandemic. Systems were in place to prevent visitors catching and spreading infections.

The regional director had identified the need for improvement in the service and had brought in a ‘service support team’. These were additional staff tasked with identifying and implementing improvements to the service.

Staff demonstrated a good understanding of people’s individual needs and a commitment to provide person-centred care. However, they were frustrated at the staffing circumstances which made this difficult.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 January 2020) and there was a breach of regulations. The provider completed an action plan after the last comprehensive inspection to show what they would do and by when to improve. We completed a targeted inspection in February 2021 and the provider had made the improvements necessary. At this inspection we found the service had deteriorated and there were further breaches of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and management of the service. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.