Braintree Nursing Home

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

We reviewed 6 quality statements under this key question; safe systems, pathways and transitions, safeguarding, involving people to manage risk, safe and effective staffing, infection prevention and control and medicines optimisation. During the site assessment people and their relatives told us they felt safe living at Braintree Nursing Home. The registered manager promoted a positive culture based on openness and transparency. Concerns about safety were listened to, investigated, and reported to the relevant authorities where required. Staff had been recruited safely. There were enough, suitably trained staff to meet people’s needs. People received their medicines in a safe way and as prescribed. Risks to people had been assessed and planned for. Care plans contained information relating to individual people’s needs and guided staff as to how to reduce these risks. Effective infection prevention and control measures were in place.

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.

Feedback received from visiting professionals on the day of our assessment was positive, they told the service was proactive in reaching out to seek advice and support for people, standards and amenities had improved and staff knew people well and were always on hand.

There was an open and transparent culture at the service which enabled people, relatives and staff to voice their opinions and concerns. Staff felt supported by the management team. They told us they would not 'hesitate' to raise any issues and 'felt confident' they would follow up any issues they raised. The provider valued feedback from staff, people, relatives and other stakeholders. They were open to learn and reflect on their practices to improve the service people received.

The service had an open and honest approach to managing the safety of people and their staff. Systems and policies were in place to safeguard people against the risk of being abused or harmed and to learn from incidents. This learning was effectively used to drive improvement and reduce future risks. Incidents were assessed, and analysed, and appropriate actions put in place to reduce future risks, for example reviewing people's care needs. People and staff were encouraged to raise concerns and felt comfortable doing so. Staff meeting minutes showed the management team cascaded down to staff via team meetings and supervision.

People and their relatives were complimentary about Braintree Nursing Home. They spoke about how staff had supported there to transition into the service to ensure they settled in well. Comments included, “[Name] has been here about 10 weeks now and it is getting better and better,” And, “I feel settled here now, they [staff] help me get up, never rush me and treat me like family.”

The registered manager and deputy manager told us, “We receive recommendations by word of mouth, referrals via the local authority. We carry out face to face assessments wherever possible, and telephone assessments. We will meet with people and their representatives, and we both check the referral before we go out to visit to ensure we can meet the person’s needs.”

We spoke to 4 visiting health professionals on the day of our assessment visit. All were very complimentary about the service. One health professional told us, “They [staff] are really good at telling us when something is wrong. Sometimes they are overly cautious, but we are more than happy to address their concerns. I have got no concerns here.”

People’s care and support needs were assessed prior to admission to the service and the information used to create a person’s individual care plan. These were reviewed and evolved with the person as their needs changed. This ensured the care and support people received met their needs.

People had confidence in the staff and felt safe in their care. Comments included, “I feel safe, the staff always use the hoist for me, they are very good, and it is never a problem.”

Staff had received training in how to safeguard people. They knew how to raise any concerns internally with the management and externally with partner organisations such as the local authority. One staff member told us, “We have to protect residents from being hurt. I would tell the nurse who would go to the manager. I would whistle blow to CQC if I had to.”

Throughout the assessment visit we observed staff using safe practices to support people. This included ensuring people in the communal areas were not left unsupervised and the use of safe manual handling practices. Staff knew people well. Throughout the day the atmosphere felt calm, relaxed, and friendly.

Safeguarding policies were in place. The provider had systems in place to ensure, where appropriate, all safety concerns were investigated, and action taken to ensure people’s safety. Records showed the service had made appropriate safeguarding alerts to the local authority when necessary.

Care plans and risks assessments included information on how to support people safely. One person told us, “They pull the buzzer down from the wall at night and I just rub it and it goes off.”

Staff knew people well. They explained people’s current needs and how the person wished to be supported. A member of staff told us, “We find out about risks, like falls or choking. They are both life-threatening. We inform staff so they are aware. Every day we have a handover and update staff.”

During our assessment visit we identified some people’s wardrobes not attached securely to their wall, posing a potential risk of injury should someone pull it onto themselves. When we brought this to the attention of the registered manager, they responded immediately. By the following day we received confirmation all the rooms had been checked and were assured all the wardrobes were now safely secured. We also identified open stairways at the service. Although we did not see people use these on our day of assessment visit, we had some concerns regarding the potential risk of harm to a person should they attempt to use them without support. The deputy manager advised people residing on the upper floor were unable to mobilise independently, therefore mitigating the risk. They had also completed a risk assessment outlining additional control measures until the installation of the new gates scheduled for the beginning of July 2024. This included increased monitoring of the area during peak hours and staff break times. Following this assessment the provider confirmed this had been completed.

During the assessment visit, we reviewed people’s care plans. They contained information regarding risks to people and guidance for staff about how to manage potential risks. Systems and processes were in place to cascade information regarding changes to people’s care. These were reviewed regularly by the senior team.

The registered manager had prioritised safety and embedded it into the culture of the service. This meant people felt safe living at Braintree Nursing Home. One person told us, “I feel safe here, the staff know what they are doing.”

The registered manager told us systems were in place to ensure the home was safe for people to live in. They met regularly with the senior management team to discuss the business of the service and make improvements where needed.

We saw annual safety checks had been completed. The home was compliant with the safety requirements for gas, electrical and fire safety. People had up to date Personal Emergency Evacuation Plans (PEEP) in place which reflected their current needs.

Effective governance systems were in place to monitor risks to people, the safety of the environment and to drive improvement.

There were robust and safe recruitment practices to ensure all staff, including agency staff, were suitably experienced, competent, and able to carry out their role. There were appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that met their needs. We observed staff to be visible and attentive to people’s needs throughout the day. One person told us, “When I press the buzzer, they [staff] come quick enough, I have no complaints.”

The registered manager told us they use a dependency tool to determine the ratio of staff required to support people depending on their individual needs. From this they could increase or decrease staffing numbers as required. The staff we spoke with were positive about working at the service. They told us there were enough staff to support people safely. One member of staff said, “Yes, we have enough staff, it is always nice to have more but we manage.”

On the day of our assessment visit, we found there was enough staff to support people safely. The communal lounges had a member of staff present to attend to people’s care and support needs, and the home’s atmosphere felt calm and relaxed. Staff were attentive to people who preferred to remain in their rooms or were receiving bed care and people’s call bells were attended to in a timely manner.

Systems were in place to ensure there were suitably qualified, skilled, and experienced staff and safe recruitment practices were followed. We checked the recruitment records for 3 members of staff and all the required pre-employment checks had been completed. This included disclosure and barring service (DBS) checks and obtaining up to date references. The service used regular agency staff for continuity of care, although we found not all the agencies’ profiles had been updated. The care manager addressed this during our onsite assessment and all agency profiles were revised.

People told us they felt the home was comfortable, homely, and clean. Comments included, “There have been lots of improvement works being carried out, this lounge is 100% brighter than when I first came here.” And “Every day they [staff] clean, I bought my armchair from home and my larger bed, the new owners are doing a lot of work, all the floors are new now.” And “I would recommend it, [registered manager] came in on change over, they have completely redecorated it with healthy clean flooring and turned it into a far better place.”

Staff told us they had access to personal protective equipment (PPE) and had received training around infection prevention and control. Staff were complimentary about the improvements being carried out. Comments included, “I have seen loads of lovely changes for the better. All the rooms are singles now, there is a new lift in the White House and talk of new one here in the main building. The outside is being done up as it has an uneven surface. We have new furniture which is easy wipe and so much better to keep clean. It is fantastic and wonderful,” “My training involved how to keep rooms tidy, being aware of different cleaning products, use of different colour mops and buckets for different areas of the home and ensuring we place wet floor signs down when floors are wet to prevent accidents from occurring.”

The service was clean and tidy throughout. People’s bedrooms, communal areas and bathrooms were clean and free of malodours. Personal protective equipment was readily available for staff and was used appropriately. Equipment was observed to be clean and regularly checked by staff.

The provider had infection prevention and control policies and procedures in place. Monthly audits were undertaken, and any shortfalls were addressed. Staff had undertaken infection prevention and control training.

People told us they received their medicines when needed. One person told us, “I have my tablets 3 times a day, I have many, none are missed, I have them roughly around the same time every day. I have had no problems.” Some people, such as those with Parkinson’s disease, were prescribed time sensitive medicines. Their medicines were administered in line with the prescribers instructions to ensure maximum effectiveness.

The nursing staff and seniors were responsible for administering people’s medicines. We observed people receiving their medicines when they needed them, with trained staff following safe medicine management practice in line with the providers policies and procedure guidelines.

The provider had systems and processes in place for the safe management of medicines. Regular audits were completed, and actions taken in the event of any errors or discrepancies being identified. Staff received training and were assessed as competent before administering medicines.