Browns Short Break Respite Limited was rated Good overall across all five key questions at its December 2019 inspection, with people and families reporting positive experiences and staff demonstrating person-centred values. Two recommendations were made regarding best interest decision-making under the MCA and strengthening the quality monitoring system, both of which the registered manager began addressing immediately.
Concerns (4)
moderate
Consent / capacity
: “Information relating to people unable to make specific decisions had not always been discussed or recorded as identified within MCA guidance. For example, for the use of covert medication.”
minorGovernance: “the system in use was on occasions repetitive and did not demonstrate when areas of improvement for staff were identified, would be addressed.”
minorRecord keeping: “the coding used by staff to sign on medication administration (MAR) records did not always correspond with the guidance available to staff.”
minorStaff training: “Training records showed that a number of staff needed to complete refresher training in some areas.”
Strengths
· People felt safe and were protected from abuse; safeguarding procedures and referral pathways were in place
· Safe recruitment practices were followed with appropriate pre-employment checks
· People received medicines on time and medication procedures were in place
· Staff knew people well and positive relationships had been formed; people reported being treated with dignity and respect
· People and families were involved in care planning and review meetings
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough and to live healthier livesGood
effective: Adapting service, design, decoration to meet people's needsGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships and take part in activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Browns Short Break Respite Limited received a Good rating across all five key questions at its August 2015 announced inspection, demonstrating improvements since a previous inspection where regulations were not fully met. The service showed consistent strengths in safeguarding, person-centred care planning, staff training and support, and quality governance.
Strengths
· People felt safe and staff demonstrated clear knowledge of safeguarding responsibilities and reporting procedures
· Medication was managed safely with appropriate training, competency checks, and accurate MAR records
· Safe and thorough recruitment processes including DBS checks and minimum two references
· Sufficient staffing levels with travel time factored in and consistent staff allocation
· Staff received comprehensive training including mandatory topics and specialist care such as PEG care and stoma care
Browns Short Break Respite Limited was rated Good across all five key questions at its March 2017 inspection, with 60 home care clients and two residential respite users receiving safe, person-centred support from well-trained staff. No regulatory breaches were identified and the service demonstrated strong governance, robust recruitment, and effective care planning.
Strengths
· Robust recruitment procedures including DBS checks ensured only suitable staff were employed
· Sufficient staffing levels maintained at all times to meet people's needs
· People felt safe and trusted staff; safeguarding training was thorough and well understood
· Medication managed safely by trained and competency-assessed staff with regular audits
· Staff completed Care Certificate induction and received ongoing refresher training including specialist topics