The inspection took place on 16 and 17 September 2017 and was unannounced.Brun Lea is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Brun Lea accommodates 20 older people and people living with dementia. The home is in a single storey building. There were 18 people living at the home on the day we inspected. Fourteen people had been diagnosed as living with dementia.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
The registered manager was also managing another of the provider’s homes. People told us that this meant they did not see much of the registered manager and would raise concerns with the head of care for the home.
This was the second consecutive time the home has been rated Requires Improvement. We saw that improvements had been made in the safe and responsive key domains but more work was needed in the effective, caring and well led domains.
We found that the care provided was safe and people’s needs were met. However, people’s experience of living in a care home could be enhanced if the provider and registered manager implemented areas of best practice within the home.
We have made a recommendation about keeping up to date with guidance.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the home support this practice.
The registered manager monitored staffing levels and ensured that there were enough staff to meet people’s needs. Staff received appropriate training and support to allow them to meet people’s needs safely. However, staff were focused on the tasks they were completing and failed to personalise the care to people’s individual needs.
Staff had received training in keeping people safe from harm and concerns were raised appropriately and investigated. Risks to people were identified and care was planned to keep them safe. The registered manager and staff worked with other care providers to ensure that information was shared when needed and that people received the care and support they required.
The environment was clean and staff knew how to keep people safe from the risk of infection. The home was also nicely decorated; however, it did not fully support the independence of people living with dementia.
People were happy with the quality of the food provided and were monitored to ensure they were eating enough to stay well. However, at times the care provided for people at mealtimes was not personalised to individual needs.
People had been involved in developing their care plans and were supported to make choices about their care. People’s care at the end of their lives was planned to respect their wishes and to keep them comfortable. People were happy with the activities provided.
The provider had effective systems in place to monitor the safety of the care provided. They also gathered the views of people living at the home and their relatives to make positive changes in the care they receive.