We undertook this inspection on 5 July 2016. Our inspection visit was unannounced. Our previous inspection took place in March 2015, when the service was found to be meeting legal requirements, but was given an overall rating of: Requires improvement. Improvements were recommended to ensure people had maximum choice and control over their lives and were always treated with dignity and respect by staff.
Brackenley is a residential care home. It is registered to provide care for up to 13 people who are younger adults, older people and may have sensory impairment and eating disorders. At the time of this inspection 12 people were living at the home.
The home is located on a main road into Harrogate. The property is a detached house that has been adapted for use as a care home and has its own driveway and gardens.
The service had a registered manager who had been registered with us since August 2015. 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.
The registered manager was appropriately supervised and supported by the registered provider. Staff and people who used the service were positive about the registered provider and manager and the changes and developments that had taken place since the last inspection.
People using the service told us they felt safe. Staff knew how to report any concerns about people’s welfare and felt that they would be listened to.
Staff had received training on how to assist people with their medicines and could explain how medicines were managed safely. Some improvements were needed to records, to ensure that clear and up to date guidance and information was available to staff about medicines prescribed on an ‘as required’ basis.
Staff were recruited safely and there were enough staff on duty to provide the care people needed. Staff felt supported and had received training that was relevant to their roles.
The service was following the principles of the Mental Capacity Act 2005, but needed to improve how information about decision making and consent was recorded in people’s records. At the time of the inspection four people had deprivation of liberty authorisations in place and one authorisation request was awaiting assessment by the local authority.
People told us that they were supported well and treated with dignity and respect by staff. Staff could describe how they involved people in decisions and supported people to live fulfilling lives.
People were involved in planning and reviewing their support. The staff we spoke with knew people well and were able to describe people’s individual needs. We found that some care plans and records had not been updated to reflect changes in people’s needs and did not accurately reflect the care that was actually being provided.
People told us how staff supported them to access the local community and attended activities that interested them. People also told us about recent holidays and events they had taken part in.
A complaints procedure was in place and a record of concerns and complaints showed what had been done in response. Where it was felt to be appropriate apologies had been given.
People had been encouraged to be involved and provide feedback through their keyworkers, reviews, meetings and surveys.
The registered provider had recognised that quality assurance and governance systems could be developed and were in the early stages of implementing a quality monitoring package and undertaking an accreditation scheme.
We found a number of examples where records were not up to date and have recommended that the provider takes action to improve record keeping practices.