Bradwell Court Residential Care Home

We found the following examples of good practice.

The atmosphere in the home was sociable and welcoming. People told us that they felt safe and well cared for and made positive comments about the staff including: “I’m only too happy here, extremely well looked after, the staff are lovely and the care excellent” and “ Very good the staff are very nice”.

At the time of the inspection visits inside the home were only allowed in exceptional circumstances such as end of life. At such times special arrangements would be made, sensitive to the needs of the person and their visitors to ensure the safety and wellbeing of all concerned.

All visitors were offered a lateral flow device (LFD) test for Covid-19 and were asked to complete a health screening form, had their temperature checked and were provided with face masks and, visors to wear throughout their visit.

An ultraviolet (UV) lightbox had been installed in the reception area to ensure that staff and visitor hand hygiene is as effective as possible.

People could keep in touch with their relatives by phone, video calls and closed window visits arranged with the home. The provider had acquired a smart TV to support video calls and facilitate virtual tea visits.

Whole home testing was in place for people, and staff and the registered manager maintained detailed records of each test, its reference number and outcome.

Staff had benefited from training, support and guidance on infection control including COVID-19 and demonstrated skill and confidence in the way they carried out their duties and responsibilities.

Staff had access to the personal protective equipment (PPE) and there were PPE ‘stations’ situated at various locations around the home.

The provider had assessed the impact of how PPE may cause fear and anxiety for people and had provided transparent face masks to help improve communication and allay fears where required.

The home was clean and free of malodour throughout. Enhanced cleaning schedules had been introduced and monitored closely by senior staff to reduce the risk of transmission of COVID-19.

Further information is in the detailed findings below.

People's experience of using this service: Everyone we spoke with told us Bradwell Court was a comfortable home to reside in and visit, that staff were kind and caring and that people were treated with respect. Staff showed genuine care and passion to deliver care in a person-centred way, based on what people’s likes and dislikes were. People were observed to have good relationships with the staff team.

The registered manager and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us they were approachable and that they listened to them when they had any concerns or ideas.

Staff had received appropriate training and support to enable them to carry their role out effectively and safely, including the management of medicines. There were enough staff to meet people’s needs and people’s rights, privacy and dignity were maintained at all times.

Staff were recruited using safe recruitment procedures and processes. Staff told us that they were supported by the management and found them to be approachable. and the training they received enabled them to be effective in their roles. Staff received supervisions to ensure a good quality of care was delivered and they received support from the management.

Detailed care plans described the support people needed. These included information from external healthcare professionals. People’s health was well managed and the positive links with professionals promoted wellbeing for them.

Checks and audits were completed by the registered manager and provider to check the quality and safety of the service. We found that some of these checks were missing dates and signatures in some places. These was addressed and rectified by the registered manager.

The service had a robust complaints policy and procedure in place which detailed clearly a log of all complaints received to date. On the day of the inspection we found that one of the complaints was not logged appropriately but this was rectified by the registered manager on the same day. The service had not received many complaints and took pride in learning from feedback including suggestions received from people, staff and relatives .

The service employed an activities co-ordinator who displayed a caring manner towards the people who used the service. The activities co-ordinator explained to us how they researched new activities to ensure innovative and original ideas were used.

The service showed a strong commitment to supporting people with their dementia needs. We observed a staff meeting where discussions took place on how the service could be enhanced further to help meet the wide range of needs of people with dementia. We noted that staff were innovative in trying different methods in engaging people and helping them to get around the service. Staff offered appropriate support which incorporated reflection and consideration of real life practical examples. During our tour of the service we observed sensory walls and aids displayed in the corridors with appropriate signage throughout the service.

More information is in the detailed findings below.

Rating at last inspection: Good (report published 24 February 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained ‘Good’ overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The home provides personal care, support and accommodation for up to 27 older people who may also have dementia. Accommodation is provided on three floors, with lounges available on two floors. A passenger lift and stairs provide access to all floors. The dining area is on the ground floor. Additional quiet seating areas are available around the home. The bedrooms are very spacious and can also accommodate lounge furniture. All bedrooms have their own bathroom with walk in shower. At the time of the inspection there were 25 permanent residents and another permanent resident was in hospital.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Prior to this inspection we received feedback from Healthwatch, the local authority contract monitoring team and a visiting health care professional to seek their views of the service. They did not have any concerns about the care.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions but had not always consistently followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

However, the experiences of people who lived at the home were positive.

People’s needs were assessed and plans were developed to identify what care and support people required to maintain their health and wellbeing and foster their independence where possible.

People were protected from abuse. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s needs and that safe and effective recruitment practices were followed.

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and where shortfalls were identified the manager was using the information to improve the service. This demonstrated that it was a learning organisation.

The service users all commented that the home was clean and they were generally happy living there. All three of the relatives we spoke to told us that they did not have any concerns about the welfare of the service users. We also spoke to one community staff nurse who told us that they did not have any concerns with the home and noted how the staff at the home 'were always quick to call the community nursing team when required'.

During the inspection, we heard from several credible sources that at times, the home did not always have enough qualified, skilled and experienced staff to meet people's needs. Though on the day of our inspection we were not able to demonstrate the full impact that this reported shortfall in staff had on people using the service.

We also saw that the home had procedures in place to monitor, improve and protect the welfare of service users. We were shown some examples of service improvement following learning from incidents, external and internal audits.

People told us that they liked their room and that they enjoyed the range of activities provided. Family members we spoke to were positive regarding the care people received at the home. Comments included: 'Prior to moving here they assessed Mums needs and we meet regularly to discuss her care, they are very supportive' and: 'Excellent care.'

We found that people felt confident to express any concerns. Members of staff had a good understanding of safeguarding procedures and told us they would report any concerns immediately.

We noted that there were procedures in place that were followed to ensure that staff were recruited effectively and records were kept of this process. A comprehensive and documented induction procedure was in place to support newly recruited staff.

We found a complaint system was in place and communicated to family members and people who lived at the home. We saw that the home seeks opinions and comments from people in a variety of ways and these are monitored and responded to in a timely manner.