Archived: Brackenbridge House

Updated 26 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on the 6, 7 and 8 September 2016. The first day of the inspection was unannounced with the following days being announced. One inspector visited the home over the three days and an expert-by-experience visited on the first day. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience at this inspection had personal experience of caring for people who had dementia.

Before the inspection, the provider completed 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.

We also reviewed the notifications we had received from the service, records of safeguarding alerts and previous inspection reports.

During the inspection we spoke with seven people using the service, three relatives, three care workers and a housekeeper. We also spoke with the manager, head of care, the care quality officer and head of housekeeping. We reviewed the care plans and daily records for six people using the service, the medicine administration record (MAR) charts for 19 people, the employment folders for five care workers, the training and support records for 34 staff and records relating to the management of the service.

Updated 26 October 2016

We undertook an unannounced inspection of Brackenbridge House on 6, 7 and 8 September 2016.

Brackenbridge House is a residential home and is part of Gold Care Homes. It provides accommodation for up to 36 people in single rooms. The home is situated within a residential area of the London Borough of Hillingdon. At the time of the inspection there were 21 people using the service (of which two people were in hospital).

At the time of the inspection the service did not have a registered manager in post. Since the previous inspection the manager in post at that time had left. A new manager started at the home five weeks before the current inspection we carried out in September 2016 and was in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

At our last comprehensive inspection of this service on 31 January, 1, 3 and 4 February 2016, we found breaches relating to dignity and respect, meeting nutritional and hydration needs, fit and proper persons employed, safe care and treatment, safeguarding, good governance and staffing. As a result of these, our concerns were sufficiently serious for us to impose a condition on the provider's registration to restrict admissions to the service based on our concerns in relation to staffing issues. We rated the service as overall inadequate and consequently placed into special measures. At this inspection, we found some improvements had been made in these areas and we have informed the provider the condition would remain but they can now admit four people per calendar month to the home.

We also imposed a positive condition in relation to the provider providing us with regular updates on their progress in addressing the breaches we found with Regulations 12 (safe care and treatment) and Regulation 17 (good governance). At this inspection, we found there had been some improvement in relation to the breaches of Regulations 12 and 17 but sustained improvements had not been demonstrated so we therefore decided to continue with the positive condition. If the provider wishes to, they can apply to have this condition removed at a time they feel appropriate.

Some improvements had been made in relation to the number of care workers available, administration of medicines and information about the knowledge and skills of care workers provided by an agency.

The care workers now followed safe and suitable practices when they provided care and supported people.

A range of risk assessments were in place in relation to the care being provided. Processes were in place for the recording and investigation of incidents and accidents.

Some improvements had been made in relation to training and support for care workers to ensure they were providing appropriate and effective care for people using the service.

The provider had policies, procedures and training in relation to the Mental Capacity Act 2005 and care workers were aware of the importance of supporting people to make choices.

Some improvements had been made in the support provided to people to eat their meals and to make choices from the menu by providing photographs of each option available.

People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.

Improvements had been made to the type and variety of activities offered at the home and people were encouraged to be involved in the decisions about the activities and outings organised. People told us they felt there were limited activities arranged during the weekend. The manager confirmed they were in the process of recruiting an additional activities coordinator to provide support at weekends.

Appropriate equipment including specialist wheelchairs and height adjustable side tables were now available to meet the needs of people using the service. Equipment was clean and well maintained.

Detailed assessments of the person’s needs were carried out before they moved into the home and each person had a care plan in place which described their support needs. Care workers completed a daily record of the care provided.

People using the service and their relatives had a range of ways to provide feedback on the way care was provided and the quality of the service.

The provider had recently introduced a range of new systems to monitor the quality of the service provided.

Some improvements had been made in the recording of people’s care needs and the support provided.

Following our last inspection, we placed the service in special measures. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. As the provider has demonstrated improvements and the service is no longer rated as inadequate for any of the five questions, it is no longer in special measures.