Archived: Briardene Care Home

Updated 6 December 2016

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.

This inspection took place between 11 and 26 October 2016 and was unannounced. We visited the service on 11 and 13 October 2016 and spoke with an external professional via phone on 26 October 2016. This inspection was undertaken by one adult social care inspector 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.

Before the inspection we reviewed the notifications we had received from the provider about significant issues such as safeguarding, deaths and serious injuries, which the provider is legally obliged to send us within required timescales. We also contacted other agencies such as local authorities and Healthwatch to gain their experiences of the service.

During the inspection we toured the building and talked with six people who lived in the home and eight visitors. We also spoke with staff including the deputy manager, rapid response manager, two nurses, two senior carers, two care workers, the activities co-ordinator and three members of ancillary staff. We reviewed a sample of seven people’s care records, five staff personnel files and other records relating to the management of the service. We also undertook general observations in communal areas and during mealtimes.

Updated 6 December 2016

This inspection took place on 11 and 13 October 2016 and the first day was unannounced. This means the provider did not know we were coming. We also contacted an external healthcare professional for feedback about the home on 26 October 2016. We last inspected Briardene in May 2016. At that inspection we were following up on three breaches of regulations which had been found in our previous inspection in September 2015.

Briardene is a care home which provides nursing and residential care for older people, including people living with dementia. There were 49 people living at the home at the time of this inspection.

The service had a registered manager however they had resigned in the week prior to our inspection. The regional manager and a rapid response manager were supporting the deputy manager to run the home following the registered manager’s resignation. A registered manager is a person who had registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People living in the home were kept safe from harm. Staff had received safeguarding training and were aware of the different types of abuse people may suffer and their responsibility for reporting any potential signs of abuse.

Systems were in place to identify and minimise possible risks to the health and safety of people using the service.

Robust recruitment systems were in place to ensure staff employed by the service were suitable to work with vulnerable people.

Topical medication records for people using the service were incomplete. We found these did not contain body maps or specific instructions for staff about the application of these medications. We were unable to establish from the records we reviewed whether people using the service had received their topical medication as prescribed. We found records held of oral medication administration were completed. We observed part of a medication round during the inspection and observed good practice throughout.

Feedback received from people and their relatives indicated that staffing levels were not sufficient to meet their needs. Staff members confirmed staffing levels were not always consistently maintained at the appropriate level. Our observations during the inspection were that call bells were not always answered promptly.

Staff were provided with an induction when they first commenced their employment. They were then provided with support through the provision of on-going training relevant to their roles.

Staff had not been provided with the support they required in terms of regular supervisions and appraisals to enable them to perform their roles effectively.

Care plans we viewed were evaluated on a regular basis. However there was limited evidence of people and their family members being involved in care planning. People and their relatives had also not been provided with the opportunity to be involved in regular reviews of their care and treatment to ensure it continued to meet their needs. Despite this people told us they were happy with the care they were receiving and should they have any concerns or problems they would feel confident speaking to a member of staff.

The home had a stable staff team, many of whom had worked at the home for a number of years. This meant people had been able to develop strong relationships with the staff who cared for them. People and their relatives spoke highly of the caring nature of staff.

People and their relatives were provided with the opportunity to be involved in the running of the home through regular resident and relatives meetings.

Complaints records we reviewed were incomplete. Copies of outcome letters were retained but details of internal investigations were missing. It was not possible to tell from the records available whether complaints had been resolved to the complainant’s satisfaction. In addition to this, some of the relatives we spoke with told us their complaints had not been responded to.

The service had an activities programme in place to help prevent people from becoming socially isolated. People and relatives we spoke with felt the programme had declined recently. We found the service’s activities co-ordinators had been off work for a few months and that a member of staff had just been appointed to undertake this work in their absence.

The provider had a range of systems in place for monitoring and reviewing the effectiveness of the service. However, we found in the months prior to the inspection these had not been used. The homes overall action plan which recorded all areas where improvement was required was also incomplete and had not been updated on a regular basis. This meant it was not possible to determine whether or not action was being taken to improve the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to staffing; complaints; and governance. You can see what action we told the provider to take at the back of the full version of the report.