We carried out a review of the data available to us about St Brendans Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about St Brendans Residential Home, you can give feedback on this service.
We found the following examples of good practice.
The provider told us they had increased staffing levels to support provision of social stimulation where people were in isolation.
The provider had implemented additional quality checks to ensure staff were following the correct Infection control and prevention practices in the home.
The provider had policies, procedures and contingency plans in place to support the staff in taking prompt actions should there be a COVID-19 outbreak in the service.
At the time of the inspection the service was closed to visitors. The provider had written guidance for visitors to follow to mitigate risk of infection when the home re-opened.This included a booking system for visitors, provision of Personal Protective Equipment and a clean of the visiting area at the end of each visit.
St Brendan’s is a residential care home providing personal care to 26 people aged 65 and over at the time of the inspection. The service can support up to 26 people.
People’s experience of using this service and what we found
People said they liked living at the home and they enjoyed the company of the staff who supported them. We saw that people were relaxed and chatty with the staff and the registered manager. There was a friendly atmosphere at the home with people enjoying each-others company.
People were safe at St Brendans. People had clear risk assessments and plans in place which identified their needs and told staff how to respond to these, in order to promote people’s safety. Staff were mindful about what potential harm or abuse could look like. They understood their responsibilities in responding to any concerns identified. Various safety checks were completed on a regular basis to ensure the building and equipment used was safe.
People’s health needs were monitored closely. Action was taken quickly by staff and the registered manager when people were unwell or showed signs they could be unwell. The registered manager ensured referrals were made to other health professionals to meet people’s changing needs.
People said, and they looked like they enjoyed the food. Processes were in place to respond when some people started to become an unhealthy weight.
Staff said they were supported by their colleagues and the registered manager. Training was provided which reflected people’s needs. The registered manager completed checks to see if the training had been effective.
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 in the service supported this practice.
Staff were supportive and thoughtful towards people at the home. People’s privacy and dignity was promoted. Staff spent time with people and responded when they looked like they needed some help. There were activities and events taking place throughout the week. Staff were also mindful of those who spent a lot of time in their bedrooms. Staff spent time with these people too.
There was a positive culture at the home. Staff were open and friendly. The registered manager was very present in the day to day running of the home. The provider was also very involved with the home. Both the registered manager and the provider were open to change and suggestions.
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 19 August 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
St Brendans Residential Home is registered to provide care and support to 26 older people living with dementia. At the time of our inspection there were 24 people using the service.
There was a registered manager in post. 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.
People felt safe at the home and with the way staff provided them care and support. Risk assessments were in place to help staff understand how people could be protected from risk of harm. Staff were knowledgeable about safeguarding procedures and where and when to report their concerns internally or externally to local safeguarding authorities.
People told us there were enough staff to meet their needs in a timely way. There were robust recruitment procedures in place to ensure that staff were recruited safely to work in the service. People’s medicines were stored and administered safely.
Staff received a full programme of training and induction that enabled them to carry out their roles effectively. Training was regularly refreshed and updated as required. The manager regularly supervised staff and they received regular performance reviews.
Staff understood the Mental Capacity Act 2005 (MCA) and how this applied in practice. Deprivation of Liberty Safeguards (DoLS) authorisations that were in place were appropriate to keep people safe. People’s healthcare needs were identified and met, and they had access to health services as required.
People told us they received enough food and drinks and they had plenty of choices offered to them. Staff were knowledgeable about people`s likes and dislikes and delivered care and support accordingly.
The environment had been improved since our last inspection and people were consulted and involved in the decision making around the decorations around the home. There were plans to further improve the environment to help ensure it fully met the needs of the people living with dementia.
Staff demonstrated a caring attitude towards people and respected their privacy and dignity. People were given opportunities to discuss issues through residents meetings and surveys. The service had received many compliments about the care provided to people.
Care plans were detailed about people’s needs and also their likes and dislikes. These were still under development to ensure that the personalised care and support people received was accurately reflected in their care plans.
People told us that they enjoyed the activities at the home. The registered manager told us they were in the process of recruiting an activity coordinator to broaden the type of activities currently provided.
People, their relatives and staff were positive about the manager of the service. The visions and values of the service were clear and staff understood their job roles and responsibilities. The registered manager and the provider carried out regular audits in the home to assess the quality of the service provided and for identifying improvements that needed to be made in a variety of areas. Staff had the chance to contribute to the running and development of the service through team meetings.
St Brendans Residential Home provides care and support to older people living with dementia. At the time of our inspection there were 24 people using the service.
There was a registered manager in post. 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.
People felt they were safe living in the service. There were risk assessments in place which detailed the ways in which people could be protected from risk of harm. Staff knew how to report any signs of abuse and which agencies to contact if they had any concerns about people’s safety. Equipment was regularly checked to ensure that it was appropriate for use, and staff were trained to move people safely. There were robust recruitment procedures in place to ensure that staff were recruited safely to work in the service. Staffing levels were appropriate to meet people’s needs. People’s medicines were stored and administered safely.
Staff received a full programme of training and induction that enabled them to carry out their roles effectively. Training was regularly refreshed and updated as required. The manager regularly supervised staff and they received performance reviews and refreshers on their knowledge. Staff understood the Mental Capacity Act 2005 (MCA) and how this applied in practice. Deprivation of Liberty Safeguards (DoLS) authorisations that were in place were appropriate to keep people safe. People’s healthcare needs were identified and met, and they had access to health services as required. People had enough to eat and drink and there were varied menus in place with snacks throughout the day.
The design and decoration of the service was not always suitable for people living with dementia. There was little evidence of personalisation, and some elements of the environment could be confusing or disorientating. We have made a recommendation about creating a dementia-friendly environment for people.
Staff demonstrated a caring attitude towards people and respected their privacy and dignity. People were given opportunities to discuss issues through residents meetings and surveys. The service had received many compliments about the care provided to people.
Care plans detailed people’s needs and support they needed throughout the day, but they were not always person-centred. Some information was included about people’s background and social history, but it was not always clear how this was used to help people enjoy full and active lives. People’s activity programs were basic and limited, and people told us they did not have opportunities to go out or keep busy throughout the day. We have made a recommendation about following current guidance on activities for people living with dementia. There was a complaints system in place which handled and resolved people’s grievances efficiently.
People, their relatives and staff were positive about the manager of the service. The visions and values of the service were clear and staff understood their job roles and responsibilities. There was a robust system in place for identifying improvements that needed to be made in a variety of areas. Staff had the chance to contribute to the running and development of the service through team meetings.
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records.
We found that the home was meeting all areas.
If you wish to see the evidence supporting our summary please read the full report.
We considered our inspection findings to answer questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found
Is the service safe?
People had been cared for in an environment that was safe. The provider carried out routine safety checks on the premises. There were enough staff on duty to meet the needs of the people living at the home and a senior member of staff was available to provide support. Staff we spoke to told us that the home was 'alright' and people were 'settled'. Staff told us that the training available was 'brilliant' and there was a 'good level of care provided' to people using the service. We observed that people at the service were happy and had their personal care needs met. We observed that staff interacted well with people and provided them with encouragement and support.
Is the service effective?
On entering the home we observed that some people had chosen to sit in the communal lounge whilst others were finishing of their breakfast or had remained in their rooms. We noted whilst being shown around the home that people were happy and interacting well with staff. Staff told us that they were able to spend time with people and 'just chat', and people we spoke to also told us that they enjoyed the company of the staff and the manager. One person we spoke to told us that staff 'are very good'. From reviewing the care documents and observing staff with people we saw that they had a good understanding of the people's care and support needs.
Is the service caring?
People were supported by kind and caring staff. We saw that staff worked at a pace that suited the people using the service. Staff took interest in peoples conversations. We observed staff assisting a person into a wheelchair, we saw that staff communicated with the person and told them what they were doing so the person was aware at all times. Staff were softly spoken and referred to the person as 'darling' whilst listening to their conversation and taking interest in what they had to say. Staff told us that they provided people with person centred care.
Is the service responsive?
Care plans were regularly reviewed and updated according to the person's needs. Each care document provided staff with clear information about the person and the care they required. Staff were aware of people's needs and preferences and acted in accordance with their wishes.
Is the service well-led?
Staff told us that they would not change anything about the home. They said that the manager was 'supportive' and the home was 'well managed'. Staff told us that the management was 'approachable and they 'listen to problems and helped as much as they can'. When we spoke with people using the service we were told that the manager was 'the nicest person you could ever meet' and that all staff were 'very nice'.
The provider submitted an action plan, which stated that a full and extensive audit had been completed of all staff files. It confirmed that all staff files now contained all the information specified in schedule 3 of the Health and Social Care Act 2008. A completed matrix identifying visa details, passports and other supporting documents was submitted with the action plan. We reviewed this information and are satisfied the provider has strengthened their recruitment systems to protect people who use the service.
We observed positive engagement between staff and people who used the service, and noted that people's consent was sought before care and support was delivered. People were encouraged and supported to make their own decisions, and where people lacked the capacity to make decisions for themselves, appropriate processes had been followed to ensure best interest decisions were made on their behalf. For some people this process was in progress at the time of this inspection.
People had care plans and risk assessments in place so that care could be delivered safely and with continuity. Robust medication systems ensured that people received their prescribed medication on time and in a way they suited their needs.
Although people we spoke with told us they were happy with the staff that supported them, we found the recruitment systems were insufficient to ensure that the staff employed were suitable to work in this environment.
There was information displayed relating to the complaints procedure, so that people who used the service and visitors to the home knew how to raise any concerns with the provider.
We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. There was a relaxed atmosphere in the home, and the staff were friendly and polite in their approach to people and interacted confidently with them.
We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and treatment, and how they spent their time. One person said. "I'm very happy here, it's my home now. I go out each week with my friend and I love my music. As long as I have that I'm fine". They also talked about the range of activities and entertainment that was available to them. Within the care files we saw that care documentation had been signed by the individual or a representative to confirm their involvement and agreement with their particular care needs.
We spoke to people during our visit on 24 January 2012 but their comments did not relate to the two outcomes reported on in this report. During our visit we observed that people living at this home, and the staff, had good, professional, respectful relationships with the manager.
We visited this home in October 2010 and found there were a number of areas where the service was failing to meet the regulations. We visited again in December 2010 and found that improvements had been made. However, further improvements were still needed, in particular in the areas of medicine management and quality assurance. During 2011 the council made regular monitoring visits to the service. They reported that improvements continued to be made which were to the benefit of people living there.
We visited the service on 24 January 2012 and found that there had been improvements in all areas. A new manager had started about six weeks before our visit and was having a positive effect on the service being provided. People told us they liked the staff, who treated them well. People's views were taken into account to make improvements to the service.
One person told us that she liked living at St Brendans "very much", and another that "staff are very good". A family member commented on how well their relative had been looked after whilst unwell.
During both visits we saw staff treating people with respect and dignity but during our second visit we saw considerable improvement in the way staff were engaging with the people who live here. They were talking to people far more, explaining what was happening and doing activities with people.
People told us there was plenty of food, that it was of good quality and that it was hot when it was served. They said they were given a choice of meals and that special diets were provided.
We started this review because four safeguarding issues were raised which indicated that people were not being kept safe. The manager in post at that time, and the provider, had failed to follow procedures and had failed to keep people safe. The interim manager in post during our second visit has given us much greater confidence that people will be kept safe and that should any issues arise they will be reported following correct procedures.
St Brendans was not a very comfortable environment for people when we first visited. There was a strong odour of urine in the entrance hall, the lounge and some of the bedrooms, the furniture in the lounge was not arranged well and most of the home needed some refurbishment. By the time of our second visit a lot of work had been done, including decoration of most of the bedrooms, corridors and other shared areas, replacement of some of the flooring and much better arrangement of the seating and television in the lounge. People were happy with the changes.
Everyone we spoke with when we visited the home on 31 December 2010 told us that the interim manager was having a positive effect on the care provided to the people living here. The council's reviewing officer, who has visited the home a number of times between early October and the end of December, has reported that the interim manager has made 'some significant changes for the better' in spite of only being in post a few weeks.