Archived: Brunswick House

Updated 8 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 1 October and 7 October 2015. This was an announced inspection. We informed the registered provider at short notice (the day before) that we would be visiting to inspect. We did this because the location is a small care home for people who are often out during the day; we needed to be sure that someone would be in. The inspection team consisted of one adult social care inspector.

Before the inspection we reviewed all of the information we held about the service.

The registered provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

At the time of our inspection visit there were three people who used the service. We spent time with all three people. We spent time in the communal areas and observed how staff interacted with people. We looked at all communal areas of the home and some people showed us their bedrooms.

During the visit we spoke with the registered manager, a house manager and one support worker. We also sought feedback from two professionals who have visited the service and the local authority contracts and commissioning department. We also spoke with one relative during the inspection.

During the inspection we reviewed a range of records. This included two people’s care records, including care planning documentation and medication records. We also looked at two staff files, including staff recruitment and training records. We looked at records relating to the management of the home and a variety of policies and procedures developed and implemented by the registered provider.

Updated 8 December 2015

We inspected Brunswick House on 1 October and 7 October 2015. This was an announced inspection. We informed the registered provider at short notice (the day before) that we would be visiting to inspect. We did this because the location is a small care home for people who are often out during the day; we needed to be sure that someone would be in.

Brunswick House is a mid-terrace property located within walking distance of Guisborough high street. The service provides care and support for three adults who have a mental health condition The service is close to all local amenities.

The had a registered manager in place. 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 provider was not fully assessing risk and therefore the service was not doing all that was reasonably practicable to mitigate any risks it could. This meant staff were not enabled to have the guidance they needed to help people to remain safe.

There were not appropriate systems in place for the management of medicines which meant that people were at risk of not receive their medicines safely.

There were systems in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Staff we spoke with were able to describe how they ensured the welfare of vulnerable people was protected. We saw that although staff had knowledge, the organisation did not have robust safeguarding and whistleblowing procedures which would guide people who use the service and staff to understand fully how to report issues and who to report issues to.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

We saw that staff had received supervision on a regular basis and an annual appraisal.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. People told us that there were enough staff on duty to meet people’s needs. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant if required they would be working within the law to support people who may lack capacity to make their own decisions. We found that the policy did not ensure the process of what to do was clear for people to follow.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, respectful, patient and interacted well with people. Observation of the staff showed that they knew the people very well and could anticipate their needs. People told us that they were happy and felt very well cared for.

We saw that people were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met. At the time of the inspection people had been weighed on a regular basis and staff had appropriately referred people to relevant professionals where needed or provided advice to people.

We found that people were supported to maintain good health and had access to healthcare professionals and services.People were supported by staff to appointments if they chose this. Who people should visit and how frequently they should visit was not recorded clearly in peoples records. .

We saw people’s care plans were person centred and written in a way to describe their care and support needs. These were regularly evaluated, reviewed and updated. We saw evidence to demonstrate that people were involved in all aspects of their care plans.

The care and support documents were not in a format that helped staff to complete them with all their knowledge of people. The document did not contain a risk assessment tool for staff to use. This means information was missed and support was not risk assessed robustly...

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. We saw that there was a plentiful supply of activities and outings. Staff encouraged and supported people to access activities within the community.

The registered provider had a system in place for responding to people’s concerns and complaints. People were regularly asked for their views. We saw there was a keyworker system in place which helped to make sure people’s care and welfare needs were closely monitored. People said that they would talk to the registered manager or staff if they were unhappy or had any concerns.

We saw that where issues had been identified; action plans with agreed timescales were followed to address them promptly. We also saw the views of the people using the service were regularly sought and used to make changes.

There were systems in place to monitor and improve the quality of the service provided. Howeverthe auditing system was not always effective. The majority of the audits were a question with a tick box and as such they did not pick up on some of the areas that we identified during the inspection.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.