Background to this inspection
Updated
26 May 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
This inspection was completed by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Breadalbane 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. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 and we sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, the provider two support workers, and the cook. We observed interactions between the staff and people living at the service.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.
Updated
26 May 2022
About the service
Breadalbane Residential Home is a care home that provides accommodation and personal care for older adults, including adults who are living with dementia. The home can accommodate up to 15 people in one building over three floors. At the time of this inspection, there were 13 people residing at Breadalbane Residential Home.
People’s experience of using this service and what we found
Where there were systems and processes in place to monitor and improve the quality of the service provided these were ineffective as they had not picked up on the issues identified at this inspection. The service did not always check and maintain the premises and equipment to ensure people were safe.
Staff understood what it meant to protect people from abuse. Safe procedures were in place to make sure people received their medicines as prescribed. People gave us mixed feedback about the number of staff deployed.
We have made a recommendation the provider review their dependency tool and the deployment of staff.
Staff were provided with relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs.
Staff understood the requirements of the Mental Capacity Act 2005. 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.
People told us they enjoyed the food served at Breadalbane, which we saw considered their dietary needs and preferences.
People were supported to access relevant health and social care professionals to ensure they were getting the care and support they needed.
Positive, caring, and supportive relationships had been developed between people and staff. People were treated with dignity and respect.
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 the service under the previous provider was good (published on 08 January 2018).
Why we inspected
The inspection was prompted in part due to concerns about infection control. A decision was made for us to inspect and examine those risks.
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.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
We have found evidence that the provider needs to make improvement. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.