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Inspection carried out on 26 May 2017

During a routine inspection

Burrell Mead is a care home that provides accommodation and personal care for up to 22 older people. It is located in West Wickham in the London borough of Bromley. At the time of this inspection 20 people were using the service.

At our inspection of this service on 5 and 7 May 2015 the service was rated Good. However a breach of a legal requirement was found. This was because although people's care and support needs were assessed there were no guidelines in place for staff on how they should support people to meet these needs. At our focused inspection on the 15 June 2016 we found that the provider had complied with this legal requirement.

At this inspection we found the service remained Good. The home demonstrated they continued to meet the regulations and fundamental standards.

People told us they felt safe living at the home. Training records confirmed that all staff had received training on safeguarding people from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. We observed a good staff presence at the home and staff were attentive to people’s needs. Action was taken to assess any risks to people using the service. Risk assessments included information for staff about action to be taken to minimise the chance of accidents occurring. Medicines were managed appropriately and people were receiving their medicines as prescribed by health care professionals.

Staff had the knowledge and skills required to meet people needs. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. People using the service told us they enjoyed the meals provided to them and could choose what they wanted to eat. People were supported to maintain good health.

People had been consulted about their care and support needs. The home had a well-established staff team. Most of the staff team had worked at the home for a long time and knew people very well. People’s privacy and dignity was respected.

People told us there were plenty of activities to partake in if they wished to do so. People’s care and support needs were assessed before they moved into the home. Care plans and risk assessments included detailed information for staff about how people’s needs should be met. The home had a complaints procedure in place and people said they were confident their complaints would be listened to and acted on.

The home had a registered manager in post. They had managed the service for nearly two years and they were knowledgeable about the requirements of their role. The provider recognised the importance of regularly monitoring the quality of the service. The provider sought the views of people using the service, their relatives and friends through residents and relatives meetings and satisfaction surveys.

Inspection carried out on 15 June 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 5 and 7 May 2015 at which a breach of a legal requirement was found. We found that people’s care and support needs were assessed, however there were no appropriate guidelines in place for staff on how they should support people to meet these needs. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Burrell Mead’ on our website at www.cqc.org.uk.

We undertook this focused inspection on the 15 June 2016 to check that the provider had complied with this legal requirement. This report only covers our findings in relation to the follow up on the breach in respect of person-centred care, Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014).

We found that the provider had addressed the breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014).

Inspection carried out on 5 and 7 May 2015

During a routine inspection

This inspection took place on 5 and 7 May 2015 and was unannounced. At our previous inspection 02 April 2013, we found the provider was meeting the regulations in relation to outcomes we inspected.

Burrell Mead is a care home that provides accommodation for up to 22 older people. At the time of this inspection the home was providing care and support to 21 people. The home had 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.

During our inspection we a found breach of a Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of person-centred care. We found that people’s care and support needs had been assessed however there were no appropriate guidelines in place for staff on how they should support people to meet these needs.

People using the service told us that they felt safe and that staff treated them well. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. The manager demonstrated a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). There were enough staff to meet people’s needs. Appropriate recruitment checks took place before staff started work.

People and their relatives, where appropriate, had been involved in planning for their care needs. Medicines were managed safely. People were supported to maintain good health and had access to health care support. They had hospital passports that contained information about them for transferring to hospital. They received appropriate end of life care and support. When necessary additional support was provided to the home by a local hospice end of life care team. People were being supported to have a balanced diet.

The home had a well-established staff team. People said the home was well managed and staff worked as a team. They said their privacy and dignity was respected. They knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary. There was a range of appropriate activities available to people using the service to enjoy.

People were provided with information about the home and they were aware of the services and facilities available to them. There were regular residents and relatives meetings where people could to talk to the manager about the home and things that were important to them. The provider took into account the views of people using the service and their relatives through meetings and surveys. The results were analysed and action was taken to make improvements for people at the home. Managers regularly attended provider forums run by the local authority. They had gained some useful learning from these events and put these into practice at the home.

Staff said they enjoyed working at the home. They received plenty of training and good support from the manager. There was an out of hours on call system in operation that ensured that management support and advice was always available when they needed it. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

Inspection carried out on 2 April 2013

During an inspection to make sure that the improvements required had been made

People we spoke with said that the staff at the care home were friendly and helpful. One relative we spoke with said that “there’s a culture of caring here”. Relatives said that staff were available when they needed them and spoke to them in a pleasant manner. They said in their observations that they had noted staff to be considerate and not rushing people.

We found that the staff received support and training in different aspects of care and demonstrated an understanding of safeguarding of vulnerable adults. Care records were stored securely and were mostly accurate.

Inspection carried out on 24 October 2012

During a routine inspection

People we spoke with said that the staff were caring and friendly. They were happy with the care provided at the home. One relative we spoke with said, "the staff are very caring and helpful. In all these years that my father has been here, I have never had any reason to complain." One person who lives at the home said, “I get all of the assistance I need.” They said that staff were available when they needed them.

However, on our visit we found gaps in staff training and their understanding of safeguarding of vulnerable adults, incomplete documentation of care plans and lack of regular supervision and support provided to staff.