Braintree Mews Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The local safeguarding team had advised the registered manager of some incidents that required a safeguard referral. Action had been taken to complete these. However, some improvements were needed to ensure all areas of care plans were updated with any new information/changes. Monitoring charts in place needed more oversight in order to trigger actions to support people's ongoing health, welfare and safety. Additional process checks were put into place following feedback from healthcare professionals. Recruitment processes were robust. Medicines processes were safe. During our assessment we found all areas of the service were clean and odour free.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives overall told us they felt confident speaking with staff at the service if they had any concerns. A person told us, “I have everything I need, if I had a complaint I would tell [registered manager].”

Most staff we spoke with felt confident raising any concerns about safety of people. A staff member told us, “I feel confident with reporting any concerns, and would go to the registered manager or deputy manager.”

The management team recognised there had been some communication issues with local services and had responded well to improve communication and exchanges of information to support the people they were caring for. Processes were in place to ensure there was a culture of safety and learning and communicated openly and honestly with people and their relatives following any accidents or incidents that had occurred at the service. All incidents were shared with staff to support their learning and avoid reoccurrences. There were communication systems in place for staff learning.

People told us they were happy with their transition and admission to the service. The registered manager assessed people either at home or in a hospital setting and people and relatives were given the opportunity to visit the service prior to their admission.

The registered manager told us there had been an incident where a person discharged from hospital had not been reviewed appropriately or had a body map completed following their discharge. They had learnt from this and now had more robust processes in place to prevent a reoccurrence.

Concerns had been raised in relation to delays in people receiving pressure care equipment. These concerns had now been investigated and resolved and during this assessment we found people had appropriate equipment in place. A healthcare professional reported issues had been resolved and communication had improved with the service.

The service was registered in November 2023 and was admitting people to the service slowly to ensure people’s needs could be met safely. The service recognised they had more work to do with local services to ensure people’s care and support and any risks associated with this support were communicated effectively with other professionals. A regular meeting was now in place to fully discuss risks associated with people’s care and support. A healthcare professional told us, “High risk equipment now is in place and the service has responded to our concerns.”

People and relatives overall were positive about their safety at Braintree Mews. A person told us, “I felt apprehensive moving from my own home but I feel safe here.”

Staff understood their responsibilities in recognising and reporting suspected harm or abuse. They told us they had completed training and knew what they should do if they thought someone was at risk of harm or they suspected abuse. A staff member told us, “Safeguarding is when you witness something not going well, I would report to my line manager, if concerned I would go to CQC.” Staff we spoke with were aware of whistle blowing procedures.

Throughout the onsite assessment we observed staff supporting people safely and responding to any requests. A person on the first floor was quite distressed and anxious about money. We observed the senior staff member was providing reassurance to the person and supported them to their room. As the person continued to be distressed another staff member supported them to go outside to provide a distraction.

The local Authority Safeguard team had recently visited and further clarified their reporting processes. The provider had been following the local policy; however, it was identified that not all issues had been reported appropriately. The registered manager responded and reviewed all accidents and incidents and raised these retrospectively. They acknowledged more work was required to ensure senior staff leading the teams recognised and reported all incidents pro-actively. Staff had access to a third-party whistle blowing service they were able to contact anonymously if required. The whistleblowing policy was clearly displayed so staff had the information they needed.

Most people and relatives told us they were fully involved with risks associated with people’s care and support. A person who had experienced changes to their care and support due to potential risk told us, “I do think staff know what they are doing. Having to use a hoist did change things, but in practical terms it is better with this set up. They have consulted us about everything.” A relative told us, “[Family member] falls frequently. The home has tried everything to prevent falls, we have tried a bed lowered to the floor but it was no better. There is an alert mattress on the bed now that goes off when they are up.” Whilst most of the comments were positive we did receive some feedback that stated some communication from staff was inconsistent. This had also been identified by the registered manager who appointed a deputy to work alongside senior staff to provide support and guidance to increase their confidence.

Staff told us they were updated regularly about the risks associated with people’s care and support. They told us senior staff updated them and various meetings were in place to keep them updated. Whilst some initial concerns about staff recognising and acting on potential risks at the earliest opportunity, the deputy told us they were working closely with senior staff to support them in this area. This support had recently started and needed more time for the deputy manager to get to know all staff and what support they might need. The registered manager told us they actively sought people’s views and supported people and positive risk taking was encouraged. An example was given where they told us many people independently accessed the coffee machine located in the main entrance.

During the onsite assessment we observed staff supporting people with their mobility safely. There were minimal restrictions on people’s freedom of movement and we observed people moving around freely and accessing outside areas. Doors to garden areas were open and accessible to people.

The provider assessed risks to ensure people were safe. Whilst updated information was recorded in the care plan and staff were aware of these changes, not all sections of the care plan or risk assessments had been updated to reflect the changes. This resulted in inconsistency of information and a risk to care being provided. The registered manager told us all care plans will be reviewed. Monitoring charts required improvement as whilst these were in place for repositioning, they did not always follow the guidance recorded within the care plan. Fluid charts were in place for people but not all charts identified a target staff could aim for which meant there was a risk staff would not identify concerns early enough. The registered manager followed this up and now all monitoring charts were being checked daily by senior staff. We will assess the effectiveness of this additional monitoring on our next assessment. Staff had received training in continence promotion & catheter care. However guidance in the care plan for catheter care was limited, this was addressed during the assessment and the updated information added for staff to follow. We also noted while accidents and incidents were recorded and investigated appropriately, the analysis or overviews we viewed did not always contain all the information needed to fully identify all potential trends or themes, whilst times were recorded, dates of accidents were not included or other information like staff on duty.

People were cared for in safe environments that were designed to meet their needs. People and relatives were positive about the environment. People and relatives were very happy with the facilities they had available. A documented comment stated, “The hairdressing and beauty salon are lovely, as are the cinema room, café area and private dining room, which all help to promote independence.”

The provider and registered manager had oversight in relation to all aspects of environmental safety.

Throughout the inspection we observed the environment to be safe including safe use of equipment. However, some concerns had been raised about doors to people’s living areas being left open and the main front door which could pose a security risk to people. The registered manager told us they had now addressed this with staff and ensured they were all aware of the locking process for the main door when the reception was unmanned.

The environment was purpose built to meet the needs of people living there. Maintenance staff were employed to ensure the premises were well-maintained and safe. There were systems in place to ensure any maintenance needed was responded to promptly. Records of checks were up to date which had been carried out on equipment and the premises. The service acknowledged more work may be needed to ensure the area, where people lived with dementia, was suitable for their needs. The provider said they preferred to get to know people living there and would take a person-centred approach to what individual people may want or need. People in this area had access to outside spaces with balconies and seating areas to be used when people wanted. The environment for people living with dementia already contained some items of interest in the way of artwork, baskets of items people could pick up, touch and feel but the provider stated they would add to the environment if they identified something an individual would benefit from.

People and relatives were mainly positive about the staff support they received and told us there were enough suitably qualified staff to support them. A person told us, “I find staff very good. I can call staff with the buzzer and it is not long before they come.” Another person told us, “Staff are very quick to respond to call buzzer, and very obliging, they cannot do enough for you.” A relative told us staff were suitably trained and said, “As far as I am aware they know what they are doing.” However, we did receive feedback from relatives where they had to keep asking for people to be transferred from their wheelchairs into armchairs and this was not always happening. They also commented that on some occasions there seemed to be less staff than usual so the consistency of staffing and deployment of staff required more attention.

We received mixed feedback from staff who told us there were occasions with last minute sickness where staffing felt very stretched and this resulted in people having to wait for assistance. Staff told us they had brought this to the attention of the management team but did not always feel listened to. A staff member told us, “It works well when we are fully staffed.” Another staff member said, “There is not always enough staff and this means people can be left waiting for us to get to them.” Another staff member added, “Some days we are short of staff as staff go sick. We have told them [management] there is not always enough staff.” Staff were positive about the training and support they received from the provider. A staff member told us, “I have had a lot of training including first aid, moving and handling, I did medication training online and had my competency checked, pressure sore and repositioning, moving and handling and catheter care training.”

We observed there were sufficient suitably qualified staff deployed in the service during the assessment. Call bells were responded to promptly.

The registered manager used a dependency tool to assess the level of staffing required within the home. They also told us they used their own observations and feedback from staff to support the tool and gave us an example of utilising other staff to support care staff during busy periods. The staff team were new and still required support to settle into their roles and responsibilities. Whilst we saw processes were in place staff told us they frequently worked above their hours to try to support people, and staff numbers changed frequently with staff sickness and absences. The registered manager told us staffing levels were above the recommended levels at present as the service was not full and they had recruited above. Recruitment was ongoing with some vacancies still being advertised. The service used a value-based recruitment process to ensure potential candidate's values, behaviours and attitudes align with the values, culture and expectations of the service. Staff received an induction and completed training suitable for their role. The registered manager had oversight of training completed or due, however we did note in some training files that some records were incomplete or undated. Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provides information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

People and relatives were very positive about the cleanliness in the service and told us there were no restrictions on visiting. A person told us, “The place is spotless.” We did receive a concern from a relative about the odour in their family members room and this was fed back to registered manager.

All areas of the service was seen to be clean and were odour free. Staff were aware of the current guidance for personal, protective equipment (PPE) and were observed using this appropriately.

Infection prevention and control processes were in place and seen to be followed. Staff had received training and were aware of the policies and procedures in place.

People and relatives did not have any concerns with how their medicines were administered. A person said, “They give me my medicines from the cupboard on the wall.”

Staff told us they had completed training and had their competency assessed prior to administering medicines. We spoke with a senior staff member as concerns had been raised in relation to the time taken to administer morning medicines. The senior staff member told us and we observed the time taken for morning medicines. The electronic system had a fail-safe system in place to avoid staff administering medicines too early.

People’s medicines were kept in individual cupboards in their own rooms and staff were aware of monitoring the temperature when the weather was hot. The service used an electronic medicine system and the MAR records we checked on the system were signed. The service completed a full stock check when medicines were received and the electronic system sent emails to notify stock levels. The deputy manager was working with seniors to improve the time taken administering medicines as they identified some staff took longer than others.