Archived: Brendoncare The Old Parsonage

Updated 28 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 27, 30 July and 1 August 2018. The inspection team consisted of one inspector, a Specialist Advisor 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. The specialist advisor for this inspection was a nurse and the expert by experienced had professional experience working within the care industry.

Before the inspection, we reviewed the information we held about the service. This included notifications about important events, which the service is required to send us by law. The registered manager completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also received written feedback from a healthcare professional.

During the inspection, we spoke with 16 people, three visitors and seven members of staff. We also spoke with the registered manager and three other members of the provider’s management team. We used a range of different methods to help us understand the experiences of people using the service who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process, which enables us to look in detail at the care received by an individual using the service. We pathway tracked the care and support of three people. We also looked at a range of records, including three care plans, two staff recruitment files and quality assurance audits.

Updated 28 September 2018

This inspection took place on 27, 30 July and 1 August 2018 and was unannounced.

At the last inspection January 2017, we found a breach of regulations 12 and 15 of the Health and Social Care Act (Regulated Activities) Regulations 2014. During this inspection we found improvements had been made and the service had met the requirements of these regulations.

Brendoncare The Old Parsonage 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.

Incestuous

Brendoncare The Old Parsonage provides accommodation and personal care for up to 28 people who may be living with dementia. The accommodation is provided over two floors accessed by a passenger lift which was out of service at the time of inspection. The provider had made arrangements for people to access both floors in the absence of the passenger lift. There were a number of communal areas where people could sit together or alone if they wished. There was also a garden which was safe for people to access independently. At the time of inspection, the provider was in the process of closing the home and was working with people to transition to one of their other homes. There were 23 people living at the home at the time of inspection.

There was a registered manager 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 was rated Requires Improvement at our last inspection in January 2017 and had breached two regulations in relation to safe care, and premises and equipment. Following the last inspection, we asked the provider to complete an action plan to show what they would do to meet the breach and improve the key questions of Safe and Well Led to at least Good.

At this inspection, we found that the provider had made sustained improvements to its medicines management system to ensure the safe ordering, storage, administration, recording and disposal of medicines. We also found the provider had robust systems to monitor the safety of the environment and equipment within the home.

The registered manager had taken on feedback from the last inspection to ensure they took appropriate action to ensure the service made the improvements required. They were open and transparent in their approach and people told us their feedback and complaints were dealt with in a professional and reasonable manner.

The registered manager was well liked and respected by people, relatives and staff. They had sustained improvements made since the last inspection and carried out a series of audits and checks, which helped them monitor the quality and safety of the service. The registered manager was supportive of staff and understood people’s needs.

There was a friendly, caring and relaxed environment at the service. People told us staff were caring and attentive, treating them with dignity and respect. Staff were very knowledgeable about people’s needs and approached their role with enthusiasm and confidence.

There were sufficient numbers of staff in place to meet people’s needs. The provider had safe and effective systems around recruitment, training, induction and supervision to support their staff in their role.

The provider had established very close links to the local community. This relationship helped to provide support, activities and comfort to people. The service had many volunteers who would regularly visit to offer people company and support. People told us they felt at home living at the service and that they were supported to maintain links with the local community and loved ones.

People received personalised care. Staff were aware of people’s preferences and routines and care was provided to reflect this. There were a wide range of activities in place for people to join in with. People were involved in developing the service, this included influencing menu choices and new activities they wished to try.

Risks to people’s health and wellbeing were assessed and monitored. The service had a proven track record in providing highly effective care for people at risk of developing pressure injuries.

The support people required around their eating and drinking was identified in their care plans. People had access to healthcare services as required and people’s care plans were updated with their changing needs. The registered manager had developed positive working relationships with other stakeholders to help provide positive outcomes for people. The home was a clean and hygienic environment and there were systems in place to protect against the risk of infections spreading.

The provider was in the process of closing the home. People had been consulted about the changes and offered alternative accommodation at one of the provider’s other services. People told us they were made to feel involved in the process through visits, updates and contributing to choices around decoration and décor. The registered manager carefully considered how to minimise any disruption during the move and had worked with people to formulate individualised transition plans which were designed with their needs in mind.

The environment at the home met people’s needs, although the registered manager had recently needed to make adaptations considering the passenger lift being out of service. With the impending closure in mind, people and relatives agreed for the adaptation of existing space to meet the needs of people living on the first floor as opposed to repair of the lift. The registered manager appreciated these were only effective short-term measures until the home closed.

The provider had a caring and compassionate ethos. The senior management were a visible presence within the home and the provider had systems in place to support people financially if they were unable to meet the cost of their care.

There were systems in place to protect people from abuse and harm. Staff had all received training to help them identify abuse and actions to take to protect people.

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 support this practice.