Archived: Braemar House

Updated 12 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 23 and 24 August 2016 and was conducted by one adult social care inspector. As part of the inspection we reviewed the information we held about the home. We looked at previous inspection reports and other information we held about the service including notifications. Statutory notifications are changes or events that occur at the service which the provider has a legal duty to inform us about.

We contacted the local authority, Quality and Improvement Team, Healthwatch Devon and other healthcare professionals who provided information about the service. We used all of this information to plan how the inspection should be conducted.

During the inspection we looked around the home and met and spoke with everyone living there. After our inspection we spoke with four relatives by telephone. In addition, we spoke with two of the registered providers one of whom was the registered manager and four staff members.

We looked at the care plans, records and daily notes for three people with a range of needs, and looked at other policies and procedures in relation to the operation of the home, such as the safeguarding and complaints policies, audits and quality assurance reports. We also looked at three staff files to check that the home were operating a full recruitment procedure, comprehensive training and provided regular supervision and appraisal of staff.

Updated 12 October 2016

This unannounced inspection took place on 23 and 24 August 2016. The home was previously inspected in March 2014 and the home was meeting the regulations we looked at.

Braemar House is in Paignton, Devon providing accommodation and care for up to twelve people. People living at the home have a learning disability. On the day of our inspection, ten people were living at the home. Accommodation was provided over two floors, accessed by stairs. Each person has their own bedroom and some bedrooms have en-suite facilities. Communal space consisted of a large lounge area, kitchen and dining room.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The home was well decorated and adapted to meet people's needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff.

The focus of the home was on promoting people's rights and independence. People followed activities that they enjoyed and were given opportunities to gain new skills and to increase their independence. Support was planned and provided to take account of each person's needs, interests and preferences. People received personalised care that took account of their abilities as well as their needs.

People told us that they felt safe in the home and said the staff were nice and good at their jobs. People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way that was kind, caring, and respectful; it was clear they understood the particular needs of the people they were supporting.

People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. The registered manager and staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. People were protected from the risk of harm because staff knew about the importance of keeping the environment safe. Risk assessments were in place to support staff's understanding about maintaining people's safety.

There were sufficient staff employed to meet people's needs safely. New staff had been employed following robust recruitment and selection procedures and this ensured that only people considered suitable to work with vulnerable people were working at Braemar House. Staff told us they were well supported by the management team and felt they were given the opportunity to develop the necessary skills and knowledge to support people. We saw staff received regular supervision as part of their on-going development. This provided an opportunity to discuss their work, any concerns and any training opportunities they may have. We saw appropriate records were maintained to show these had taken place.

We looked at the way in which the home managed people’s medicines. Medicines were stored safely and accurate records were maintained. Staff received regular competency assessment checks to ensure the on-going safe management of medicines. Safe systems were in place to manage medicines so people received their medicines at the right times.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves.

People were supported to make their own decisions and choices whenever they were able to do so. The registered manager and staff understood the legal safeguards set out within the MCA and followed them when people were unable to make their own decisions and choices. Where people did not have the capacity to understand or consent to a decision the registered manager had followed the requirements of the MCA. An appropriate assessment of people's ability to make decisions for themselves had been completed. Where people's liberty may have been restricted to keep them safe, the registered manager had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person's rights were protected.

People and their relatives were involved in planning and agreeing how they were cared for and supported. People were receiving care that was responsive and tailored to their needs. Care plans were person centred and contained detailed information that clearly described how each person would like to be supported. The care plans provided staff with information to support the person effectively. Other health and social care professionals were involved in the care of the people living at Braemar House. Care plans were reviewed regularly.

People were supported to maintain a healthy diet. People were able to choose what they wanted to eat and were involved in the preparation of their meals where possible. Menus were discussed and planned with people during informal meetings and chats. People could access the kitchen at any time and were able to help themselves to meals, drinks and snacks. Risks to people’s nutrition were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. For example, where people had been assessed as being at risk with regards to their swallowing, we saw appropriate referrals were made to Speech and Language Therapy (SALT) and an action plan for staff to follow was provided.

Staff ensured people obtained advice and support from other health professionals when their health needs changed. We saw care plans included professionals involved in people's care and referrals were made to other professionals when required.

People and relatives were asked for their views about the care provided and informed how to make a complaint or raise any concerns. These were acted on and used to make improvements for people's care when required.

The registered manager’s quality monitoring system included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.