This inspection took place on 14 March 2017 and was unannounced. At our last inspection on 8 March 2016, the service had one breach of the Health and Social Care Act 2008. This was in relation to being able to locate employment records. At this inspection, we found improvements had been made. The provider had also made improvements to infection prevention and control practices. There is a requirement for Briar Close House Care Home to have a registered manager and a registered manager was in place. 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 service is registered to provide residential care for up to 40 older people, some who are living with dementia. At the time of our inspection 35 people were using the service.
Care plans and risk assessments for people with behaviour that challenged did not identify current risks and control measures to sufficiently reduce risks of harm to people and staff. Staff practice when caring for people with behaviour that challenged was not always consistent as care plans did not reflect current care needs and risks. Care plans and risk assessments for other areas of people’s care and treatment reflected people’s current needs.
Incident reporting and behaviour monitoring records were not always completed to enable the quality and safety of services to be assessed, monitored and improved, and in addition reduce risks relating to health, safety and welfare of people and staff. Other systems and processes to ensure good practice were in place, for example kitchen standards and fire prevention checks.
Procedures designed to uphold people’s rights, in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) had not always been considered when people, who lacked the mental capacity to consent to their care, were resistant to their care and treatment.
Not all staff had completed training to the timescales identified as required by the provider for them to complete their role.
Medicines administration records did not always show people had been offered creams as prescribed. Medicines were stored securely, administered and records kept in line with the provider’s policy. Other risks to people’s health, for example from falls, were identified and actions taken to reduce those risks.
People told us most staff were caring, however they commented some staff were better with people than others. Some people experienced loneliness and not all staff took opportunities to reduce this.
People told us they felt safe and were able to raise any worries or concerns. Staff had been trained and had an understanding of safeguarding and how to keep people safe from potential abuse. Staff were recruited in line with the provider’s policy and procedures, and checks were completed to ensure staff employed were suitable to work at the service. Staffing levels were based on meeting people’s needs and enough staff were deployed to do so.
People were happy with the meals they received. We saw people’s special dietary requirements were catered for and people had access to snacks and drinks throughout the day.
Other healthcare professionals were involved in supporting people’s health care needs when needed. For example, people had access to district nurses and doctors when needed.
Most, but not all staff felt supported by their managers and found meetings with their managers useful.
Families were welcomed when they visited. Care plans were developed to include people and their relatives’ views. Staff provided care that respected people’s privacy and dignity.
Staff supported people with personalised and responsive care. People were supported to enjoy activities and events. People who needed help to orientate around the building, or needed help with communication received this personalised support.
At this inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.