02/04/2014
During a routine inspection
Brandon Park Residential and Nursing Home is a care home providing short and long-term care, offering nursing, palliative, convalescence and respite care, as well as care for those diagnosed with Parkinson’s and dementia.
The service can accommodate up to 55 people. There were 25 people in residence when we visited. This was because at our previous inspections of the service on 13 June, 22 August and 25 November 2013 we identified concerns in relation to the standards of care and welfare of people who used the service. We also found that the provider did not have systems in place that assessed and monitored the quality of the service and which protected people from the risk of unsafe care and treatment. We took action against the provider and asked them to tell us what action they would take to put things right. As part of their action plan the provider agreed to voluntary suspend new admissions to the service.
At this inspection we identified further shortfalls which breached two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.
The first breach related to the provider not having clear systems in place that assessed and monitored staffing levels and managed short notice absences. This resulted in the provider not ensuring there were sufficient staff on duty at all times.
The second breach related to people not experiencing care and support that met their needs and protected their rights. This was evidenced at the midday meal which was observed to not be a sociable experience. This was due to staff moving between dining rooms resulting in some people not receiving the support they needed to eat their meal. Additionally the records we looked at showed that not all staff had received training that ensured they were fully able to communicate with people living with dementia and understood their individualised needs.
The service has not had a registered manager in post since November 2013. The interim manager told us that they were applying to CQC to be the registered manager until a new permanent manager was recruited. Generally we found the service had improved under the leadership of the interim manager since our last inspections.
People told us that they felt safe living in the service and that staff respected their privacy and dignity at all times. They were happy with their care and said that staff were kind, caring and considerate.
The service had arrangements in place to keep people safe. Staff were knowledgeable about the procedures to take when safeguarding concerns were raised with them. People’s care records showed that staff were following effective risk management plans to protect people from the risks of harm. Appropriate arrangements were in place that ensured people who used the service received their medicines, as prescribed. Records showed that incidents and accidents that occurred in the service were fully investigated and action was taken to ensure they were less likely to happen again. Routine health and safety checks were being carried out to ensure that the environment and equipment were safe and well maintained.
People’s needs were assessed and their care and treatment was planned and delivered in line with their individual needs.
We saw that where a person lacked capacity to make decisions about their end of life care, a best interests meeting had been held in accordance with the requirements of the Mental Capacity Act (MCA) 2005. We saw that people, and those that mattered to them, had been involved in the planning for their end of life care, so that their final wishes would be respected at the time of their death.
The service was applying the Deprivation of Liberty safeguards (DoLS) appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed. Whilst no applications have needed to be submitted by the home, proper policies and procedures were in place, the manager understood when an application should be made.