Briarvale is a residential care home that can accommodate a maximum of 10 people, some of whom may live with learning or physical difficulties. The service is set over two floors and has a small garden to the rear.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Since our last inspection the overall management of the service had changed. There was an acting manager in place who told us that an application for a registered manager was currently being dealt with. 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.

The staff were caring and kind and people and relatives told us the home had a relaxed atmosphere. Staff engaged with people and shared jokes with them, which people clearly enjoyed. Family members said they could visit at any time and always found people well-cared for and happy.

People were safe living at the home and staff knew how to support them to stay safe. Effective systems and checks ensured the premises were safe for people. There were sufficient staff to meet people’s needs. Medicines were safely managed and given to people when they needed them.

People’s needs were assessed prior to them moving into Briarvale, to ensure that staff were able to provide appropriate support. The staff were skilled, knowledgeable and experienced and had the necessary continuous training to support people in an appropriate way.

People had regular access to healthcare professionals and staff sought support from them when needed.

People were encouraged to make decisions about their support, care and day-to-day routines. Staff demonstrated that they worked within the principles of the Mental Capacity Act and there was documentation to support this.

People were encouraged to follow their interests. People and relatives told us about some of the activities they had enjoyed. These included shopping, meals out and holidays.

The culture of the home was caring and inclusive, with people at the heart of the service provided. People and relatives told us the acting manager and staff were always approachable and helpful.

There were effective systems in place to monitor the quality of the service. People and relatives had the opportunity to comment on the quality of the service that was provided.

We carried out our inspection on 9 March 2016. The inspection was unannounced.

The service provides accommodation for up to 10 people living with a learning disability and or physical disability. There were 9 people using the service at the time of our inspection.

The service had a newly appointed registered manager. 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.

People felt safe using the services of Briarvale. They felt safe for a variety of reasons which included their confidence in staff skills to protect them from avoidable harm and abuse.

Staffing levels were based on people’s assessed dependencies and needs. Enough staff were on duty to ensure that people needs were met safely. The provider completed relevant pre-employment checks which assured them that staff were safe to work with people.

People received their medicines as prescribed. The provider had effective protocols for their safe management. The registered manager supported staff to complete people’s medicines records accurately.

Staff received the training they required to provide support that met people’s individual needs.

Staff had a good understanding of the relevance of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards to their work. They supported people in accordance to relevant legislation and guidance.

Staff supported people to meet their nutritional needs. They also supported people to access health care services when they needed this.

Staff were kind and compassionate to people. Staff were knowledgeable about the needs of the people they supported. They also treated people with dignity and respect.

People’s care plans reflected their individual needs and preferences. People and their relatives were actively involved in the development of their own care plans. Staff also liaised with other professionals involved in people’s care in the development and reviews of care plans.

People and their relatives had opportunities to raise any concerns they had about the service they received.

People using the service, their relatives and staff complemented the registered manager. They were confident in the registered manager and their ability to run the service. The provider had effective procedures for monitoring and assessing the quality of service that promoted continuous improvement.

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection on 07 July 2014.  At the last inspection on 05 August 2013 we found that there was a breach with Regulation 15 Safety and suitability of premises. At this inspection we looked at the changes the provider had made to show how they were meeting this regulation.  

Briarvale provides accommodation for up to 10 people who have a learning and or physical disability.

 A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of our inspection there was not a registered manager in place. There was an acting manager employed at the service who had submitted an application to the Care Quality Commission to apply for the registered manager position.

The Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), is legislation that protects people who are not able to consent to their care and support, and ensures people are not unlawfully restricted of their freedom or liberty. We found people’s capacity to consent to care and support was not always recorded formally. On the day of our visit no person had an authorisation in place that restricted them of their freedom or liberty. An authorisation can only be granted by a supervisory body following assessments and only if strict criteria are met. The acting manager demonstrated they were knowledgeable of their responsibilities to protect people’s human rights.

The manager told us they were in the process of reassessing people’s dependency needs. This was important to ensure sufficient staff were available to meet people’s assessed needs.

We found people had care plans and risk assessments in place and these were reviewed on a regular basis. People were supported to attend health appointments and the provider worked well with health care professionals. Information about how to meet people’s needs was personalised.

Throughout our inspection we observed staff to be caring and attentive to people’s needs. Staff showed dignity and respect and demonstrated a good understanding of people’s needs.

We identified some concerns with the management and audit systems in place for medicines.

The provider had a complaints procedure in place that was in easy read language for people with communication needs. This meant people were informed of what their rights were and how to make a complaint. 

Whilst we saw some examples that people were supported with interests and hobbies and this included an annual holiday, we found some concerns. We observed that people who remained at home did not receive support to participate in interests and hobbies. Staff interaction was largely task centred, for example supporting people with drinks, and personal care.  

We saw the provider had a range of checks in place that monitored the quality and safety of the service. We found examples where these systems had not always identified and responded to actions required. The acting manager told us they were aware that the systems in place required reviewing and improving.

We were not able to speak to most people using the service because they had complex needs which meant they were not able to tell us their experiences. We gathered evidence of people’s experiences of the service using a variety of methods; we spoke with one person who was able to communicate their views to us verbally, we made contact by telephone with three relatives of people who used the service and we used the Short Observational Framework for Inspection (SOFI).

Care plans explained people’s individual communication styles and this helped staff to engage with people using the most effective means.

Assessments identified whether people required specialist advice in relation to their diet and nutrition, and if so this was provided by dieticians and/or speech and language therapists.

The lounge dining communal area was small in size for the number of people the service accommodated. When all the people using the service chose to spend time together in this area, along with staff, the room was cramped. There was also little opportunity for people to sit in smaller groups, or have private conversations with friends or relatives, other than in their bedrooms.

Staff had participated in regular training to help equip them with up to date, relevant skills and knowledge

Meetings had been held so that people and their relatives could discuss their views about the service and a satisfaction survey had been completed.

A new manager, Debbie Kramer, came into post in November 2012. At the time of our inspection the former manager, Harbans Dhir, was in the process of cancelling her CQC manager’s registration.

The people we met who were using the service had complex needs which meant they were not able to tell us about their experiences. Therefore we spoke to the relatives of five people using the service. They all told us that they were satisfied with the caring approach of staff and felt that their relatives were happy and content living at Briarvale. One told us, “The staff are very caring and take a genuine interest.” Another commented, “Overall I am happy with the care provided and the approach staff take.”

The relatives we spoke with expressed mixed views on the frequency and type of social and leisure activities provided. Although some people felt their relative’s needs were being fully met others expressed concern about this.

The home was clean, tidy and well maintained. Work was underway to make improvements to décor in communal areas of the home and a conservatory was to be added to the building to increase the communal space available to people.

Most of the people who used the service at Briarvale had specific communication needs which meant we were unable to speak to them at the time of our visit. We did speak to some people’s relatives to obtain their views on the service provided. Those we spoke to were very satisfied with the care and support provided at Briarvale. One told us how well their relative’s cultural needs were taken into account, including weekly visits to their place of worship. One told us; “The care is marvellous”, and another said, “They are cared for really well.”