Care Home: Bryher

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What the care home does well Bryer provides people with a familiar homely and spacious environment that is safe and enables individuals with complex needs to have a sense of security. Some people who live at the home had been assisted to complete surveys. The overall picture was that people viewed living at the home very positively. People said they felt `listened to` and liked their environment, staff and being helped to make choices in their everyday lives. Staff who work at Bryer have a good understanding and knowledge of their complex needs and this is supported by good training and regular supervision. Staff who returned surveys said the following about what they believe the home does well `This is a home for service users and not a hostel. Its very friendly between service users and carers. We try to get people out most days when we have a driver for the bus.` `The clients live in a warm and secure home, have plenty of healthy food. There are helpful and kind staff to look after their needs.` `Striving to achieve the aims and needs of service users by using the knowledge gained by staff to know the individual likes and dislikes of the service user and make the most appropriate choices on their behalf.` All four returned surveys had ticked yes to the question did they have enough training and support to do their job. The staff group are working hard to continue to develop meaningful activities for people to engage in and these include both specialist activities and more generic things such as trips to the park shopping and to places of local interest. Care and support is delivered in a planned and consistent way and plans are being developed in a format that is more suitable to the individuals to understand. What the care home could do better: Plans of care should include a mental capacity assessment to ensure that all who work with the individuals are clear about what decisions they are able to make and those that they need guidance or full support for. The home does not currently have anyone on any controlled drugs but if they are prescribed storage would need to be provided that fully complied with regulation and guidance. The home have agreed to talk to their pharmacist about this. The front door of the home needs to be changed or fixed so that it sits correctly in the door frame and can be locked safely at night or when people are out and about. The recruitment process needs to be more robust to ensure that staff are only employed once all relevant checks and references are in place The manager is not yet registered with CQC, but is in the process of doing this. Random inspection report Care homes for adults (18-65 years) Name: Address: Bryher 36 Post Hill Blundells Road Tiverton Devon EX16 4ND one star adequate service 27/08/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joanne Walsh Date: 2 9 0 4 2 0 1 0 Information about the care home Name of care home: Address: Bryher 36 Post Hill Blundells Road Tiverton Devon EX16 4ND 01884242457 Telephone number: Fax number: Email address: Provider web address: Bryhers@Guinness.org.uk Name of registered provider(s): Name of registered manager (if applicable) Guinness Care and Support Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Bryher provides residential care for up to six people with learning and physical disabilities. The accommodation consists of a bungalow, with single room occupancy, shower room, bathroom, toilet facilities, laundry, kitchen, dining room and a sitting room. The home is accessible being on one level. The property stands in its own Care Homes for Adults (18-65 years) Page 2 of 9 2 7 0 8 2 0 0 9 Brief description of the care home grounds, in a residential area on the outskirts of Tiverton. The inspection report is made available within the home; a copy is kept in the office for anyone to see. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This random inspection was completed on a week day in April and looked at some key areas. These included plans of care and how relevant these are to the people they refer to. We looked at safe handling recording and storage of medications and also checked recruitment was robust to ensure that individuals are protected. We spent a small amount of time talking to and observing individuals and their carers within the home. Prior to this inspection taking place we sent out surveys to people who live at the home and to health care professionals and family members. Their comments are included within this report and have helped to inform our judgments. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. We found that plans of care looked at showed clearly what individuals needs were and described how these needs should be met. Plans were written in a way that evidenced a person centered approach. They gave good detailed information to carers about what individuals preferred routines were and what their likes and wishes were. Plans are being reviewed with an independent body to ensure that they are reflective of the individuals needs and wishes and that they are written in a format that the individual can understand. For some this may mean a series of photos and pictures. We saw some of the individual bedrooms and all of the communal areas. Staff have made great efforts to make bedroom personalised and reflect the personality of individuals. They have added art work done by individuals who live at the home to communal areas. The environment is fresh smelling and homely for people and we could see that thought had gone into making areas interesting for people. One person had a tactile board near where they sit with different belts and ropes of different textures. They have recently got a large rabbit so that individuals can stroke, brush and help care for a pet. It was noted that the front door does not sit in the door frame well and could easily be prised open. This is a potential risk to individuals who live and work at the home, especially as it is fairly isolated. This needs to be addressed as a matter of urgency. The manager said that the registered provider had been made aware that this needed addressing. We saw that staff interact in a kind and respectful way with people who live at Bryers. Staff who have worked at the home for a while have a really good understanding of how individuals express their needs and wishes and we saw that this information is now being passed to newer staff, as part of their induction and ongoing learning. The medication system is robust with good records kept, we would however recommend that any handwritten entires are checked and signed by two staff to help prevent any Care Homes for Adults (18-65 years) Page 4 of 9 errors occurring. We checked how the home ensures that there is a good audit trail for individuals personal monies with receipts kept and balances checked and recorded by more than one individual. The home keep good records of any accident and incidents happening within the home and there are policies and procedures available for staff on all safe working practices. Staff told us that training is available and that key health and safety training is either planned or booked to ensure that everyone has updates on an annual basis. The staff recruitment files are not kept on site but we were able to check this at a later date and saw that the provider does not have a robust system for recruitment. We saw that one person had been employed without two references in place. We checked the start dates given with when CRB checks had been obtained and when individuals had started training. Some of these dates did not match up, which would indicate that people may have started employment without thorough checks being done to ensure that they were suitable to work with vulnerable people. We were told that staff did not start working until they had been checked against a list of people who are not suitable to work with vulnerable people, but we were not provided with any documentation to evidence this. A robust recruitment system is needed that ensures that people are only employed to work once relevant checks and references have been obtained. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 5 of 9 Plans of care should include a mental capacity assessment to ensure that all who work with the individuals are clear about what decisions they are able to make and those that they need guidance or full support for. The home does not currently have anyone on any controlled drugs but if they are prescribed storage would need to be provided that fully complied with regulation and guidance. The home have agreed to talk to their pharmacist about this. The front door of the home needs to be changed or fixed so that it sits correctly in the door frame and can be locked safely at night or when people are out and about. The recruitment process needs to be more robust to ensure that staff are only employed once all relevant checks and references are in place The manager is not yet registered with CQC, but is in the process of doing this. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 34 The recruitment process must be robust, relevant checks and references must be in place before staff are employed to ensure that staff are suitable to work with vulnerable people 19/06/2010 2 26 13 The front door must be secure to keep individuals and staff safe 19/06/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 18 Plans of care should incude a mental capacity assessment The home should ensure that if anyone is prescribed controlled drugs that they have storage that meets requirements and guidance. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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