Background to this inspection
Updated
16 January 2020
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
One inspector, an assistant inspector and an Expert by Experience carried out this inspection. 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
Old Rectory (Bramshall) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 had a recently recruited manager in post who was about to commence the registration process with the CQC to become a registered manager. This means they will, along with the provider, be 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
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 asked the local authority and Healthwatch for any information they had which would aid our inspection. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and one relative. 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.
We spoke with six members of staff including, the manager, cook, one senior and two care staff members and one domestic support.
We reviewed a range of records. These included two people’s care and support plans. We also looked at people’s records of medicines administration. We had sight of two staff member’s files in relation to recruitment. In addition, we looked at a variety of records relating to the management of the service, including quality monitoring checks, maintenance, incident and accident records.
Updated
16 January 2020
About the service
Old Rectory (Bramshall) provides accommodation and nursing or personal care for up to 30 people. On the day of our inspection, 20 people were living there, some of whom were living with dementia.
People’s experience of using this service and what we found
People did not always receive safe care and support as staff members did not always follow the guidelines in place to safely support people with their mobility.
The physical environment was not always maintained to a standard which was safe for people to live in.
Despite staff members following infection prevention and control procedures the maintenance of some areas prevented this from being effective.
The provider could not demonstrate people received their prescribed topical creams as directed. This was because the recording charts were not completed as expected.
The provider’s quality checks were not always effective in identifying improvements which were needed to drive good and safe care.
The provider was not meeting the requirements of their registration as they did not have a registered manager in post. Although a manager had been appointed they had yet to complete the registration process.
Staff members had been provided with the training they needed to support people.
People’s care and support plans gave staff the necessary information to effectively respond to their needs and preferences.
People were protected from the risks of harm and abuse as the staff team had been trained to recognise potential signs and understood what to do to safely support people.
Staff members were aware of the necessary actions they should take in the event of an emergency.
Staff members had access to, and used, appropriate personal protection equipment.
The provider supported staff members through structured one-on-one supervision sessions.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems at the Old Rectory (Bramshall) supported this practice.
People had access to additional healthcare services when required.
People were supported to maintain a healthy diet by a staff team which knew their individual preferences.
People received help and support from a kind and compassionate staff team with whom they had developed positive relationships.
People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability.
The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.
The provider, and management team, had good links with the local communities within which people lived.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was ‘Good’ (published 23 June 2017).
Enforcement
We have identified one breach or regulations in relation to people not being safely supported.
Please see the action we have told the provider to take at the end of this report.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.