Archived: Braemar House

Updated 12 December 2017

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 was 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 19 October 2017 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 including notifications. Statutory notifications are changes or events that occur at the home which the provider has a legal duty to inform us about. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

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

During the inspection we looked around the home and met with everyone living there. We spoke to seven people about their experiences living at Braemar House. After the inspection we spoke with three relatives and received written feedback from three relatives. We also spoke with a visiting health care professional, the registered manager, operations manager and three staff members. After the inspection we received feedback from two health care professionals.

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 was operating a full recruitment procedure, comprehensive training and provided regular supervision and appraisal of staff.

Updated 12 December 2017

This unannounced inspection took place on 19 October 2017. The home was last inspected under the provider's previous registration. This inspection was the first rated inspection under the provider's new registration.

Braemar House provides accommodation and care for up to eleven people. People living at the home have a learning disability. On the day of our inspection, nine people were living at the home. People had their own bedrooms and some had en-suite facilities. Communal space consisted of a large lounge dining area and kitchen.

There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.

There was a warm, friendly, family style atmosphere in the home and people were relaxed and comfortable in the company of staff. 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.

People were treated with dignity, respect and kindness and were involved in the planning and review of their care and support. We saw people and staff interacting and engaging with each other in a relaxed, friendly manner.

People appeared to be happy and well supported by the home. One person told us they were happy and felt safe living at Braemar House. Relatives were very positive about the care and support provided to people. Comments included, "I am pleased with the care [name] receives. It's clear he’s happy there and I would say my impression is staff genuinely like [name]."

Staff were focused on promoting people's rights and independence so that people lived fulfilling lives. People followed activities 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 they felt safe living at Braemar House. Systems were in place to protect people from the risk of harm. Staff were knowledgeable about safeguarding people from abuse and protecting their rights.

People were encouraged to be as independent as possible, while staff took into consideration their wishes, and any risks associated with supporting them. Risk assessments relating to people's individual care and to the safety of the home were completed and reviewed regularly. Where risks had been identified the least restrictive options were used to manage them and keep people safe.

Care plans were extremely detailed and personalised providing staff with knowledge on how people wished to be supported and how to meet their needs. People had been fully involved in creating and reviewing their support plans. They spent time on a regular basis with staff making sure their support plan was working for them. People's preferences and lifestyle choices were clearly recorded along with excellent guidance for staff in supporting people with these.

People had an individualised timetable of activities which encouraged the development of independent skills and also provided social interaction and entertainment. We saw care plan information was available in different formats appropriate to the needs and preferences of people who lived in the home.

People received effective care from staff who had been trained and had the necessary skills to meet people's needs. Staff were supported through one to one supervisory meetings, annual appraisals and staff meetings. They were able to seek advice when necessary and had opportunities to discuss and review their work.

There were sufficient numbers of staff available to meet people's needs and to spend time with people on an individual basis. The provider's recruitment procedures ensured staff were of a suitable character to work with people who lived at Braemar House.

People were supported to have maximum choice and control of their lives and staff supported them to make informed decisions. Where a person lacked capacity to make certain decisions they were protected under the Mental Capacity Act 2005. People were supported in the least restrictive way possible and staff were insightful about how to support people who presented behaviours which may challenge others.

People were involved in planning, choosing and preparing their meals. People and staff planned weekly menus together and pictures of food or meals were used to support some people's understanding and to help them make choices. They were encouraged and supported to have a healthy diet. People's nutrition was monitored to ensure they had sufficient to eat and to maintain their health and well-being.

Medicines were stored, administered and disposed of appropriately. Staff were trained in the safe administration of medicines including those medicines required in an emergency. Their skills were observed and assessed regularly. People were supported to access a range of healthcare services to promote their health and in response to any changes in their health. These included GP's, dentists, opticians and hospital specialists.

There were effective systems in place for monitoring the safety and quality of the home. Audits identified any areas which were in need of improvement and action was taken to address these. Fire procedures were easily available, so that people were aware of action they needed to take in the event of a fire. A range of internal checks were conducted and environmental risk assessments were in place, showing that actions taken to protect people from harm had been recorded. Records showed that equipment and systems within the home had been serviced in accordance with the manufacturer's recommendations. Evidence was available to demonstrate that good infection control protocols were being followed in day-to-day practice.

Complaints were managed well and people we spoke with were aware of how to raise concerns, should they need to do so. Systems were in place to ensure that any complaints received were responded to in a timely manner and a thorough investigation was conducted.

The home was well-led. There was a relaxed, friendly and open culture at the home. Staff were valued and supported by the registered manager and operational manager. The registered manager and operational manager were clear on the values and ethos they expected from staff. Staff worked to these values and told us they were led by example.