Brindley Court

Brindley Court is a residential care home providing personal and nursing care for people aged 65 and over, and younger adults with physical disabilities. The service can support up to 52 people. The accommodation is provided in a single building, arranged over two floors, with communal facilities including lounges and dining rooms on each floor, a hairdressing salon, and a secure garden. At the time of our inspection, 48 people were using the service, some of whom were living with dementia.

People’s experience of using this service and what we found

People were cared for by kind, caring staff who created a warm and welcoming environment. People told us the staff always respected their privacy and dignity and provided care in their preferred way. People were supported to have maximum choice and control of their lives, in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People felt safe and were protected from the risk of harm by staff who understood their responsibilities to identify and report any signs of potential abuse. There was a consistent approach to safeguarding and any concerns were taken seriously and investigated thoroughly in an objective way.

Risks associated with people’s care and support were managed safely. People received their prescribed medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. Staff were trained and supported to meet people’s changing needs. The provider ensured there were enough, suitably recruited staff to meet people's needs and promote their wellbeing.

People’s care and support plans reflected their needs and preferences and were regularly reviewed. People’s diversity was recognised and promoted by the staff and systems were in place to meet people’s communication needs.

People were supported to access activities that were inclusive and based on their interests. They benefited from close links with the local community, which increased people’s opportunities for friendship. People had choice over their meals and were supported to access other professionals to maintain good health.

People were actively involved in the running of the home and their views on how the service could be improved were acted on as far as possible. People and their relatives had access to a formal complaints procedure and felt confident any issues raised would be resolved.

There was an open and inclusive culture, led by a registered manager who was committed to improving people’s care and support. Governance arrangements were well embedded and effective in highlighting and rectifying any shortfalls. Staff felt valued and supported in their role.

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 8 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.

A comprehensive inspection of the service took place on 23 November 2016 and was unannounced. We found there were breaches of legal requirements and the overall rating for the service was 'Inadequate'. This meant the service was placed in 'special measures’; services in special measures are kept under review. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Brindley Court on our website at www.cqc.org.uk

At this inspection we found the provider had taken action to make the improvements required.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 received support from staff that understood how to safeguard them from abuse and provide care that minimised risks to their safety. People received support from sufficient amounts of staff. The provider followed safe recruitment practices when employing staff.

People were supported by suitably skilled staff that had regular updates to their training. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were given a choice of food and drink and were supported to meet their needs and preferences for food and fluid intake. People were supported to monitor their health and wellbeing and had access to health professionals as required.

People were supported by staff that cared for them and they had good relationships with staff. People were supported to maintain their independence and were involved in all aspects of their care and support. People were treated with dignity and respect and staff observed their privacy.

People were involved in their assessments and care planning was reviewed regularly. People had access to activities and could follow their individual interests. People understood how to make a complaint and felt confident these would be addressed.

The registered manager was accessible to people, relatives and staff and everyone we spoke with felt the service was well led. People, relatives and staff felt involved in the service and could share examples of how they had been involved in giving feedback and influencing changes. The registered manager had systems in place to support staff and check the quality of the service people received.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service had a registered manager. 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.

Risks to people’s health and wellbeing were not managed to keep them safe from harm. Some situations which could be harmful to people were not risk assessed and when risk was assessed staff did not always follow the plans put in place to reduce it. Accidents and incidents were not thoroughly reviewed to try to avoid repetition. There were not enough staff available to support people safely as agreed or to respond to their needs in a timely fashion. People did not always receive their medicines as prescribed and the systems in place to manage the risks associated with them were not always followed.

When harm had occurred to people the circumstances around the incidents were not always thoroughly investigated or reported to the local authority to safeguard people from potential abuse. Some people had legally approved restrictions on them to protect them when they didn’t have the capacity to make their own decisions. However, some staff were not aware of these safeguards or what the restrictions were and therefore may not support them as defined.

Staff did not always uphold people’s dignity or treat them with respect. They were often rushed and task focussed and this resulted in not responding to people’s requests or questions. They sometimes spoke about people in front of them and did not always allow them to make choices about their care.

Care was not always provided to meet people’s preferences. Staff were not always aware of people’s changing needs and records were not always amended to reflect the changes and ensure that the care was correct. Audits and quality monitoring systems were not always regularly completed and did not always record all relevant information so they were not effective in driving improvements.

Mealtimes took a long time because there weren’t enough staff to meet everyone’s needs promptly. People were not always given a choice of food. People told us that the food was of good quality.

Staff did not always receive the training and support that they needed to complete their roles effectively. Some staff felt that when they raised concerns they were not listened to and no action was taken to resolve them. Surveys were completed by relatives on an annual basis and although some concerns were responded to others were not thoroughly investigated. The registered manager had not notified of all of the events that they need to meet their registration.

People saw healthcare professionals when needed. The provider had a complaints procedure in place and complaints were responded to within the defined timescale.

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.

During this inspection we found that suitable and sufficient improvements had been made where we had identified concerns. We saw the provider had put right what was required. This meant the provider could demonstrate people's medication was handled safely.

In August 2013 we received information of concern regarding the staffing levels at the home. We asked the provider to send us their staffing rotas and followed this up during this inspection. We found there were suitable and sufficient staff to meet the needs of the people using the service.

This inspection was to look at the evidence available following the action plan we received from the provider. We needed to see if improvements had been made in relation to medication management.

We found that some improvements had been made in the areas where we had identified concern, but suitable and sufficient improvements had not been made with auditing medication and ensuring fridge temperatures were taken on a daily basis. This meant the provider was non complaint and had not ensured people using the service received medication that was managed in a suitable and safe way.

We saw that people experienced care, treatment and support that met their needs. People were cared for by staff who were supported to deliver care to an appropriate standard. We saw that accurate and appropriate records were maintained. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable and nutritious food and drink.

We saw that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

We were told by the people using the service that they were happy with the care and support that they received. All of the people said that the staff were kind and looked after them well. One person said 'I only have to ask for something and they do it for me'.

We observed staff carrying out their duties in a kind and respectful way.

People spoken to who were participating in the 'reading the news activity' said they enjoyed it. One person said, 'it gives us something to think about'.

Everyone we spoke to said that they felt safe living in the home and said they would have no problem telling someone if they had a problem or a complaint.

One member of staff told us that since the home had transferred to new ownership they could see that investments were being made to improve the quality of life for people at the home. They told us that a new mini bus had recently been purchased to be able to take people for trips out.