We carried out an unannounced comprehensive inspection of this service on 15 April 2014. After that inspection we received information about concerns in relation to the service. As a result we undertook a focused inspection on 12 November 2014 to look into those concerns. You can read a summary of our findings from both inspections below.
Comprehensive inspection 15 April 2014
Bromford Lane Care Centre provides residential and nursing care for up to 116 people. At the time of our inspection 109 people used the service and the home consisted of six units which included; a residential unit, a complex needs unit, a nursing unit, a dementia unit, an enhanced assessment unit and a unit for younger people with physical or cognitive disabilities. There was a registered manager in post at the home. This meant that there was an allocated person who was responsible for the day to day running and management of the service.
People told us they felt safe. We saw that staff understood the risks posed to people’s health and wellbeing and they knew how to keep people safe. We found that this process could be improved if there was a system in place to ensure documentation relating to risk was kept up to date.
The staff understood the needs of the people who used the service. Care records contained the information staff needed to provide care that was based upon each person’s personal preferences. However, systems could be improved to ensure that the information contained in people’s care records was up to date.
Care was provided with kindness and compassion by staff who were appropriately trained, but we found that staff would benefit from further training to develop their skills in dementia care.
Some people who used the service did not have the ability to make important decisions about some parts of their care and support. Senior staff had an understanding of the systems in place to protect people who could not make decisions about their care, support and safety. These systems followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). This legislation sets requirements to ensure that where appropriate decisions are made in people’s best interests. However, we saw that other staff at the home were not always aware of their role in offering and supporting people to make choices about their day to day care and support.
The home promoted an inclusive culture. People told us their independence was promoted and we saw that staff provided care to meet people’s diverse cultural and religious needs.
People could not always be assured that they had received their medicines as instructed by the prescriber and effective systems were not in place to ensure medicines were stored in accordance with manufacturer’s guidance. We identified that improvements were required to ensure these systems protected people from the risks associated with their medicines. You can see what action we told the provider to take at the back of this report.
The registered manager had a noticeable presence within the home and the staff all reported that improvements to the quality of care provided had been made since the new manager had been appointed. The registered manager assessed and monitored the quality of the care so that improvements could be made.
The registered manager demonstrated they were committed to improving the quality of care and during our inspection we saw examples of good care that was based upon best practice evidence.
Focussed inspection 12 November 2014
Following our inspection of 15 April 2014 we undertook a focused inspection to look into concerns about the service. The inspection took place on 12 November 2014, and looked into concerns about staffing levels at night. During the visit, we spoke with a nurse and two care staff. People living in the home were asleep at the time of our visit.
We saw that there were sufficient numbers of staff on duty and appropriately deployed at night to meet the needs of the people on the two units we inspected. Staff spoken with told us there were sufficient numbers of staff to meet the needs of people. This showed that there were sufficient staff available to meet the needs of the people living there.
Staff spoken with were knowledgeable about the needs of people and how to manage identified risks. Staff were able to explain the actions they would take in the event of a fall and records showed that falls and actions taken in response were recorded so that they could be monitored and care records updated as necessary. We saw that people at risk of not eating and drinking sufficient amounts to remain healthy were identified and plans put in place to manage this. Where risks were identified referrals were made to the appropriate healthcare professionals to ensure that they were supported to eat and drink safely . This showed that people were supported to receive adequate amounts of food and drink to promote good health.