Branch House

Updated 15 July 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.

We undertook this inspection as part of a random selection of services rated Good and Outstanding

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

One inspector and an Expert by Experience carried out the inspection: 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

Branch House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We looked at all the information we had received about and from the home. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

One inspector visited Branch House on 23 and 24 May 2022. We spoke/communicated with the four people who used the service and one relative about their experience of the care provided. On 25 May 2022 an expert by experience spoke with a further five relatives about their experience of the care provided.

We spoke with five members of staff including the registered manager.

We checked two people’s medicines records and looked at arrangements for administering, storing and managing medicines.

We reviewed a range of records. This included three people’s care records and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included a referral to the local fire service in relation to fire safety.

Updated 15 July 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Branch House is a care home for up to four people. At the time of the inspection four people were using the service. An annexe had been built and adapted to meet the needs of one person.

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

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

The service gave people care and support in a clean, well equipped and well-furnished environment that met their sensory and physical needs. Some environmental risks were not being well managed. These were being addressed during the course of the inspection.

Staff supported people to have the maximum possible choice, control and independence and to be in control over their own lives; the policies and systems in the service supported this practice.

People were supported to be involved in decisions about their care and support. Staff were observed communicating with people in ways that met their needs and supporting people to make choices.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. We observed people being involved in aspects of daily living including cooking their meals.

Staff supported people to take part in home-based activities and pursue interests in their local area if they enjoyed this. One person had a voluntary job and others were starting to return to activities that had been paused during the pandemic.

People were supported in ways that reduced periods of distress. People were clearly relaxed with staff and reassured by their presence.

Staff enabled people to access specialist health and social care support in their local community.

Staff supported people safely with their medicines and worked with health professionals to achieve good health outcomes. Staff worked with other professionals to avoid people taking unnecessary medicines.

Infection control procedures and measures were in place to protect the people from risks associated with COVID-19.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Throughout the inspection we observed kind, relaxed, compassionate and caring interactions between people and staff.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People who had individual ways of communicating, such as using Makaton (a form of sign language) and pictures could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them. One relative told us “They are trying to introduce more Makaton signs and I believe [person's name] does use some signing as far as possible, I do think they understand”.

People’s care plans and risk assessments reflected their range of needs and this promoted their wellbeing and enjoyment of life.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Throughout the inspection we observed that staff were respectful of people and took time to offer support and reassurance when needed. One relative told us “I hope this is where [person's name] will stay. It would be a sad day if we had to move [person's name].”

People received good quality care and support because trained staff could meet their needs and wishes.

Staff knew and understood people well and were responsive; supporting their aspirations to live a quality life of their choosing.

Staff placed people’s wishes, needs and rights at the heart of everything they did.

Most relatives spoken too felt they were fully involved. They spoke positively about the service, with one relative stating they felt “completely” involved. However, another stated they didn’t feel involved.

The registered manager and nominated individual were open and transparent throughout our inspection. The registered manager and nominated individual acted efficiently on queries and feedback throughout the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating at the last inspection was Good. (Published March 2020)

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding

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.

This report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection, that rated those key questions, to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Branch House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.