- Care home
The Briars Residential Care Home
Report from 8 February 2024 assessment
Contents
On this page
- Overview
- Learning culture
- Safe systems, pathways and transitions
- Safeguarding
- Involving people to manage risks
- Safe environments
- Safe and effective staffing
- Infection prevention and control
- Medicines optimisation
Safe
People were safe and protected from harm, procedures in place meant risks were managed. There were enough staff who were skilled to provide care and support. People received medicines as prescribed. Lessons were learnt from events within the service. Infection prevention and control measures were robust.
This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Learning culture
Staff sought feedback from people using the service and wanted to ensure people were accommodated and supported as positively as possible at The Briars. People told us that hey they felt safe living at the home and had no concerns. People experienced a satisfactory resolution to complaints they may make. Actions were taken forward to improve practice to benefit all people. We saw an effective and accessible system in place for receiving, handling and responding to complaints. Records contained 2 complaints. These were resolved to the complainants’ satisfaction along with actions taken forward to improve practice.
There was evidence to show that the provider understood reflective practice to learn from events and put in place actions. For example, they responded to and took action based upon the report produced by the local authority who contracted with them. Feedback from staff was that the management team were approachable and would listen and act upon feedback from staff to improve the service on offer to people.
The provider had been transparent with the people using the service about the necessary improvements made. There was an effective and accessible system in place for receiving, handling and responding to complaints. There were clear processes in place for analysing incidents, accidents and falls,
Safe systems, pathways and transitions
People told us that staff responded promptly when they pressed their call-bells and they felt safe. People who spoke with us felt that their health needs were monitored and they were able to see healthcare professionals when this was needed. One relative told us that their relative was better supported here than a previous larger care home. The relative felt listened to and was able to be part of the ongoing care and support system around their relative.
Staff told us there were systems in place to ensure effective communication amongst the staff team. This communication included all departments of the service including care staff, kitchen and domestic staff. Leaders at the service had taken time to develop a positive working relationship with both the GP surgery and the local supplying pharmacist.
Feedback from partner agencies was that the new provider was engaging well with good communication in place.
Care planning in place included peoples end of life wishes and included information about where they would like to be in their final days. Care plans where appropriate had a DNACPR completed and there was a clear process for obtaining end of life medicines.
Safeguarding
People who were able to talk with us told us they felt safe living at the home. They said the staff were responsive to their needs and kept them safe from harm.
Staff told us they were clear of their responsibilities when it came to safeguarding. They understood about whistleblowing and how to raise concerns.
We saw staff consulting people before providing care and support. Staff were attentive to people’s needs and ensured people were safe.
Safeguarding procedures were robust; a policy was in place and staff knew the correct reporting procedures. Staff had received safeguarding training.
Involving people to manage risks
People and their relatives told us the staff knew about risks to their health and wellbeing and protected them from harm. A relative said that they felt the managers had done all they could in relation to the stairs being a risk to their relative and would be happy to wait for a downstairs room to become available.
Where people were at risk of falls, there were suitable systems in place to prevent this from happening. For example, people had sensor mats in their bedrooms to alert staff if they were getting up. The mats were suitably placed and in working order. One person was at risk of choking and their assessment had been reviewed regularly to ensure any deterioration in swallowing was identified. They were under the GP and speech and language therapist (SALT). Nutritional risk assessments were in place and regularly reviewed. People had personal emergency evacuation plans in place.
We observed that the stairs had mesh stair gates installed top and bottom of stairs to reduce risk to people. This was not an effective barrier to stop people who may have dementia from unclipping, climbing over or pulling off the current installation. We observed that staff transported people in wheelchairs without securing the lap belt that is a safety feature of wheelchairs. This meant that people were at risk of falling. We observed a rug in a person’s room that had not been risk assessed to reduce the trip hazard it posed. Our observations were fed back to leaders who listened and agreed to action.
No risk assessments relating to the stairs were seen within health and safety assessments or for individual service users. This meant that risks were not effectively mitigated for individuals. Once the provider was made aware they quickly put into place risk assessments for all service users in relation to the stairs. People had risk assessments within their care plans that related to matters such as mobility, falls, nutrition and choking. These were regularly reviewed and kept up to date. Health professionals were consulted where needed. We identified some risks that did not have effective mitigation in place.
Safe environments
People lived in a clean care home that had recently had the majority of carpets removed and replaced with non slip laminate flooring. This had made the environment safer and cleaner. First floor windows had restrictions in place to ensure no one came to harm. Radiators in people bedrooms had been covered to ensure they were safe for people.
The Nominated Individual was present throughout our visit and told us all the environmental improvements made since taking over the service 6 months previously. This included a new nurse call system and all bathrooms now had a cord pull to summon help
We observed one radiator uncovered and this was brought to the attention of the owner who agreed to action to make it safer. Upon follow up this matter had been addressed. We observed the gardener arrive to maintain the small courtyard garden with container planting.
There were processes in place to ensure maintenance of the environment, this included servicing of equipment and facilities to maintain their safety. Each person had a personal emergency evacuation plan in place if needed.
Safe and effective staffing
The people we spoke with felt there were enough staff to meet their needs. They told us they never had to wait long when they called and had their needs met promptly. They also felt staff knew their jobs well and were well trained. We observed care and support. We saw staff were available and responded to people’s needs promptly and efficiently. There were good and respectful interactions with people and a calm and restful atmosphere.
Staff told us they received good training and new staff felt their induction was adequate to prepare them for their role. One member of staff told us, “The online training is far better now and more practical training is given . I’ve recently had Emergency first aid, fire safety and moving and handling.” Staffing levels had been a challenge for the new owners, but this had been resolved. A staff member told us that they rarely used agency staff.
We observed that staff were available, and people did not have to wait for care and support when they needed it. Staff engaged proactively and positively with people and were caring in their approach. Staff communicated effectively with one another to ensure people received the care they needed. For example, if a member of staff was busy supporting a person and another person said they needed support, the member of staff alerted a colleague. People who needed one to one support to eat and drink received this, including people who ate their meals in their rooms. Staff provided this support in a respectful and dignified way.
Staff meetings were consistently held. The provider had assessed the appropriate staffing level for the people living in the service and this was kept under review. Staff levels were meeting this assessment. Staff had been recruited safely with appropriate background checks, skills and experience. However, 1 staff member had started without obtaining a reference. It was agreed that this would be followed up immediately. Staff had received necessary training except for new starters and an action plan was in place to address this.
Infection prevention and control
People and their relatives said the home was well kept. A relative explained how the laundry worked saying that clothes came back clean. Occasionally items went astray, however they told us that the overall care and attention given to their relative was positive.
Staff confirmed they has training in infection prevention and control in their induction and that this formed part of the mandatory training staff received.
Our observations were that there were no odours. Everywhere was clean and fresh. Staff wore appropriate clothing and equipment to keep themselves and people safe.
The manager had completed an audit of infection control which demonstrated practices were being completed which ensured a clean and safe environment. Areas for improvement were immediately responded to.
Medicines optimisation
People received their medicines as prescribed. There were safe procedures in place for ordering, storage, and administration of medicines. People were confident they received their medicines on time and records reflected this. We observed staff administering medicines. Staff were mindful and explained people’s medicines to them, saying what they were for and ensuring water was at hand.
Staff worked safely to ensure people had their medicines on time. Staff received training, both theory and practical together with ongoing checks to ensure safe practices. Records confirmed this had taken place.
We observed staff practice and this followed safe practices laid out in national guidance. Medicines were regularly audited to ensure practices were as safe as possible. Changes were made when needed. Records examined showed that high risk medicines were given at appropriate times and courses of antibiotics were given as the prescriber intended.