Archived: Burrswood Care Home

Updated 19 October 2017

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection visit took place on 26 July and 2 and 3 August 2017 and was unannounced on the first day of the inspection. The inspection team consisted of two adult social care inspectors on the first day of the inspection. This took place between 3 and 10pm on Peel and Kay units. This was because concerns had been raised with us in relation to night time staffing arrangements as well as continence issues. One adult social care inspector undertook the rest of the inspection.

Before our inspection, we contacted the local authority commissioning and safeguarding teams and the clinical commissioning group (CCG). This helped us to gain a balanced overview of what people experienced accessing the service. We reviewed the information we held about the service including the previous inspection report and notifications the provider had sent to us.

Because this inspection was brought forward due to concerns raised with us, we did not request the service complete a provider information return (PIR); this is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.

During our inspection we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with the people in their care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with a range of people about the service. They included 6 people who lived at the home, twelve relatives, the registered manager, the clinical services manager, one unit manager, three senior care staff, four night care staff and six day care staff. We also spoke with the maintenance person, the chef, the housekeeper, the activities co-ordinator and two hostesses.

We looked at care records of seven people, the services staff team training record, supervision records, arrangements for meal provision, records relating to the management of the home and the medication records. We reviewed the services recruitment procedures and checked staffing levels. We also checked parts of the building to ensure it was clean and a safe place for people to live.

Updated 19 October 2017

Situated in a residential area of Bury Burrswood Care Home offers personal and nursing care for up to 125 people with a wide range of needs from residential care to nursing.

Accommodation is provided on four units. Dunster provides nursing care, Crompton provides residential care, Kay provides residential care for people living with dementia and Peel provides nursing care for people living with dementia. The home is set on two levels. There are lounges, dining areas and bedrooms on both floors. All bedrooms are single accommodation and most with ensuite facilities.

There has been a recent change of legal entity and the provider is now registered as Bupa Care Homes Limited. Therefore this is the first rated inspection for this service. We brought forward this inspection because concerns had been raised with us about night staffing levels and one concern about continence arrangements on Peel unit. This was an unannounced inspection which took place on over three days on 26 July and 2 and 3 August 2017. At the time of our inspection 116 people were living in the home with a wide range of support needs.

There was a registered manager in post. 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 registered manager was present throughout our inspection.

On the first day of our inspection the registered manager told us that prior to our inspection a decision had been reached to put the staffing levels back to three care staff on nights on Peel unit with the third night carer to be used potentially as a floating member of staff for the whole home. This action had been taken to ensure that there were sufficient numbers of staff on duty to support people in a safe consistent way.

We looked at the arrangements in place for managing people continence needs. We were informed that a three day continence assessment was carried out which was sent to the local continence promotion nurse who assessed people’s needs and arranged supply of the appropriate pads dependent on the type of incontinence. We saw that there were enough supplies of pads as well as stock available in an emergency for people to use.

There was a stable staff team in place to help ensure that people received consistent support. However staff commented that there could be better team work between the day and night shifts on the dementia units. The registered manager told us they would look into this.

We found staff had been recruited safely. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff wore protective clothing such as disposable gloves and aprons when needed. This reduced the risk of cross infection.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storage in place.

We looked around parts of the building and found it had been maintained, was clean and a safe place for people to live. We saw that routine servicing of the building, for example, gas and electrical safety had been undertaken.

The registered manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Staff had the skills, knowledge and experience required to support people with their care and social needs. Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived at the home.

People told us they were happy with the variety and choice of meals available to them and if they were not an alternative was always offered. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People had access to healthcare professionals to help ensure their health needs were met.

People who lived at the home told us they were happy with their care and liked the staff who looked after them.

We observed staff providing support to people throughout our inspection visit. We saw they were kind, patient and showed affection towards the people where appropriate that offered reassurance. We found staff were knowledgeable about support needs of people in their care.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them. We saw staff assisting people with mobility problems. They were kind and patient and assisted people safely.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

A range of activities were available for people to participate in if they wanted to. Staff and relatives thought there could be more opportunities made available for people who lived with dementia to engage in stimulating activity and occupation.

The service had a complaints procedure which was displayed at the home. The registered manager maintained a record of complaints made.

Staff spoke positively about the support they received from the registered manager and the management team. They said that the registered manager was supportive and visible around the home.

The registered provider and manager used a variety of methods to assess and monitor the quality of the service. These included ways to seek the views of people about the service.