Archived: Brierfield Residential Home

Updated 25 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

Brierfield Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brierfield Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and observed interactions between staff and people. We spoke with the nominated individual who is responsible for supervising the management of the service on behalf of the provider. We also spoke with seven staff members, including the registered manager, deputy manager, nominated individual’s personal assistant, senior care staff, care staff and an individual employed to undertake maintenance.

We reviewed a range of records associated with the governance and health and safety of the service and medicines. We reviewed three staff personnel files, one of which had recently been employed.

Following our visit, we reviewed the care records of four people using the service and the staff training records.

We fed back our findings to the inspection to the nominated individual and registered manager using electronic video call on 26 August 2022.

Updated 25 October 2022

About the service

Brierfield Residential Home is a residential care home providing personal care to up to 26 people. The service provides support to older people in one adapted building. At the time of our inspection there were 19 people using the service, some people were living with dementia.

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

Risks were not always being identified and measures put in place to reduce these risks. This included the safety of the stairs in the building and routine checks on the water system to reduce the risks of legionella bacteria. This had not been identified in the provider’s own governance systems.

Risks in people’s daily lives were being assessed, however the risk assessments in their care plans did not always provide detailed guidance for staff in how the risks were mitigated. There were some inconsistencies in people’s care plans, we were assured this was being addressed by the registered manager.

Prior to our inspection, we had received concerns regarding the quality and safety of care provided in the service. The service was working on an action plan with support from the local authority to implement improvements. Although some improvements had been made, for example in the staffing levels, progress had not always been made in a timely way. We were also concerned that all of the shortfalls had not been independently identified by the provider and actions taken prior to them being pointed out.

Improvements were needed in the provision of training for staff, not all staff had received training in safeguarding and there was only one staff member who had received training in supporting people with behaviours others may find challenging.

Medicines were being monitored and checked. The management team had identified shortfalls in the recording of the administration of medicines, such as creams, and medicines to be administered where required. We were assured actions were being taken to improve this.

Improvements were needed in the general cleaning of the service, such as cobwebs in the communal lounge and a build-up of dust on the stairs. Staff wore appropriate personal protective equipment (PPE) such as masks. However, where staff were wearing gloves and aprons to support people with their personal care needs, they were seen to be walking around the service in these prior to and following supporting people, which is not recommended infection control practice.

During our inspection we found that improvements were being made in areas such as how much people had to drink, how staff were deployed to reduce risks in the communal areas, governance systems and the overall monitoring of the service provision to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Deprivation of Liberty Safeguard referrals were made where required and people’s capacity was identified in their care records.

People using the service told us they were happy, and the staff treated them with kindness. During our visit several people went out for a meal in a local restaurant.

The management team were working to improve the service and had developed a shared a commitment to ensure people were receiving good and safe quality care moving forward.

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 4 February 2020).

Why we inspected

We received concerns in relation to governance, the safety of the service provision and care provided and staffing levels. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brierfield Residential Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.