Archived: Brambles Care Home

We looked at the answers to five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Is the service safe?

We saw that the premises were visibly clean in all areas and were well maintained. The front and rear gardens were attractively presented.

We inspected medicines management and found that appropriate procedures were in place to ensure that people received the right medicines at the right time, with the support of appropriately trained staff. Some people were able to manage their own medicines, and had been risk assessed as able to carry this out effectively.

We found that the management had suitable procedures in place to ensure that people consented to the care and support provided for them. None of the people in the home were deemed as lacking the mental capacity to make day to day decisions, and most were able to make complex decisions. The manager and assistant manager were currently reviewing the home's responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) for two people, for whom DoLS applications could be needed. This applied to people who might be assessed as needing their liberty restricted for their own safety.

We saw there were reliable systems in place for the safe storage and management of people's own pocket monies. This prevented people from possible financial abuse.

Is the service effective?

We found that people's needs had been discussed and assessed prior to their admission, and were reviewed again as part of the admission procedures. A care plan was implemented from this, and was reviewed monthly, or more frequently if changes were needed. We saw that people or their next of kin (as preferred) had been involved in all aspects of their care planning. The staff liaised appropriately with other health and social care professionals to provide people with additional care or treatment.

The home provided people with a variety of food and drinks to meet their different nutritional needs. People said that the food was good, and they had plenty of choice.

Staff had been trained in required subjects such as health and safety, moving and handling, infection control and fire safety. We saw that this training was kept up to date. Other relevant training courses were provided so that staff could develop their knowledge in line with people's needs.

Is the service caring?

We saw that the home had a relaxed atmosphere, and people were supported to sit where they wanted to, and to take part in the activities that they preferred. Everyone that we talked with made very positive comments about the service, with remarks such as 'The staff are very kind, very good. They are always there if I want someone;' and 'We are looked after very well, I would recommend this home to anyone.'

The home provided a range of activities throughout the week, with a planned activity each morning and afternoon. These were led each day by an allocated member of care staff for each shift, and this enabled staff to be informed about people's interests and hobbies. We saw that the activities were flexible in line with people's preferences.

We saw that staff took time to engage people in conversation, and did not appear rushed. Staff said that they usually chatted with people while assisting them with personal care, but did not have much time for conversation apart from this. All of the people that we talked with spoke highly of the staff's attitude and caring natures.

We viewed responses that people had given to questions in a recent questionnaire. One of the questions was 'Are you happy that staff are always polite and respectful?', to which 100% of people who had responded had replied 'Yes.'

Is the service responsive?

The service had an arrangement with the local GP surgery for routine weekly visits to the home. The staff recognised when people appeared unwell and ensured that they were referred to see the doctor. Other people requested to see the doctor and staff added these to the weekly list.

The service liaised with other health services to maintain people's health needs, such as a visiting dentist, optician, and chiropodist; and made referrals for services such as dietician, community nurses and occupational therapy.

People were enabled to stay in their rooms, go to the lounges, or go out of the home as they wished. Some people said they would not go out of the home without the support of a staff member.

We saw that there were systems in place to ensure that people's care had been given in accordance with their wishes, and to check that their rooms were clean and tidy. A keyworker system was in place so that staff could get to know a few people in more detail, and could assist them with day to day needs such as obtaining toiletries or shopping, or tidying wardrobes.

People that we talked with said that if they had any worries or concerns they would talk to their keyworker or any of the staff; or would ask to speak to the manager or assistant manager. They were confident that the staff would take appropriate action to deal with their concerns. The manager or assistant manager had a visible presence in the home every day, and usually spoke to each person each day. This enabled them to deal with any minor concerns immediately.

Is the service well-led?

We saw that people in the home knew the manager and assistant manager well, and had confidence in them to deal with any issues.

Staff had individual supervision sessions on a regular basis, and staff meetings. This enabled them to discuss ideas and any matters of concern. Staff said that they could ask the management about anything at any time.

People who lived in the home were encouraged to share their views on a daily basis, and had the opportunity to do this when the manager or assistant manager spoke to them. They were provided with a monthly newsletter which identified any changes taking place in the home, and had a list of the planned activities for the month. People were also invited to share their views at residents and relatives meetings; through a separate forum; and using questionnaires. We saw that their views were collated, and action was taken in response to people's comments.

The home had monitoring procedures in place. This included regular checks for maintenance and safety, such as checking water temperatures, checking the nurse call bell system, and checking fire alarms and fire equipment. Medicines were checked every month to see that they were all in date; and the pharmacist visited twice per year to check medicines management.

People told us they were treated with dignity and respect by staff. One person told us "I would not be here if it was otherwise, I have company and have made friends here"

People said that the care they received was "Very good, very pleasant" and that they were involved in their care planning and their care plans had regular month reviews.

People told us that the "Food is excellent" and that the staff accommodated people's food preferences.

People said there were enough staff to meet their needs. One person told us "the buzzer is answered quickly" and another person said that they "Didn't have to wait long for their care needs to be met".

People were invited to express their views and opinions about the service through "resident meetings" and regular surveys.

People said they were involved in their care; they had copies of their care plan and were asked regularly if they wanted changes. One person said 'they do their very best' it is like living in a hotel where everyone looks out for everyone else. The staff responded with care and compassion when people were unwell and ensured prompt medical assistance was provided.

The people we talked to spoke positively about the care and support they received. One person said "I feel very safe living here, I always have. If I had any concerns what so ever all I would have to do is to tell the manager". Other people said that "if they had any concerns they felt confident to tell staff" however they have never had to do this.

The environment was clean, modern and tidy. One person stated 'I love everything about it'. There was an internal courtyard with seating and large well maintained garden, which people told us they enjoyed using in the better weather.

People were positive about the staff and told us they were supportive, kind and polite.