Bryher Court Nursing Home

Updated 4 April 2023

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.

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

Two inspectors undertook the inspection.

Service and service type

Bryher Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bryher Court Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and was planning to register with CQC. This person had worked at the home for 2 years and knew people and staff.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 21 September 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we reviewed the records of the home. These included recruitment records, accidents and incidents and quality assurance audits. We looked at medicine administration charts, 7 care plans and risk assessments along with other relevant documentation to support our findings. We spoke with 8 people who lived at the home, 2 visitors. We spoke with 14 staff members; this included the manager and the provider. We also received feedback from 3 health and social care professionals.

We observed people in areas throughout the home and could see the interaction between people and staff. We watched how people were being supported by staff in communal areas, this included the lunchtime meals.

Updated 4 April 2023

About the service

Bryher Court Nursing Home is a residential care home providing regulated activities personal and nursing care to up to 45 people. The service provides support to people who were living with a range of health care needs associated with their age and physical health conditions. At the time of our inspection there were 34 people using the service.

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

Improvements were needed to some aspects of risk management. Systems were not robust enough to demonstrate safety was always managed effectively. Improvements were needed to recruitment procedures to ensure there was a full employment history for each staff member.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Care plans and records did not always contain all the information staff needed to support people. An audit system was in place but this had not identified all the shortfalls we found. The manager and provider had oversight of the service and had implemented improvements which needed further time to be embedded into everyday practice. This included training, quality assurance feedback and accident and incident monitoring.

The home was clean and tidy throughout. Systems were in place to help ensure people were protected from the risk of infection. Staff understood safeguarding risks and procedures and knew what to do if concerns were raised. People were supported to receive their medicines when they needed them. There were enough staff working in the service to meet people’s needs.

People told us they were happy living at the home and we observed an open and friendly relationship between staff and people. Staff knew people well; they understood peoples care and support needs and were committed to providing good care. One staff member said, “We always try to do our best for people.” We identified areas that suggested care and support was not always person-centred. The provider and manager addressed this immediately. People, relatives and staff told us there was a positive culture at the home. They said the manager was approachable and they could speak with them at any time.

People were supported to maintain and improve their health with support from health care professionals. People were supported to have enough to eat and drink throughout the day to meet their nutritional and health needs, individual choices and preferences.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The service provided care and support to 2 people with learning disabilities and autism. The manager was aware of the principles of RSRCRC. At the time of the inspection these people’s needs required care from nurses due to their health needs .

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

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Rating at last inspection

The last rating for this service was Good (published 17 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bryher Court Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to Safe care and treatment, Need for consent and Good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.