5 July 2023
During an inspection looking at part of the service
Mulberry House is a residential care home providing personal and nursing care to 67 people who are living with a range of health needs, for example, diabetes and heart disease. The service also supports people living with an acquired brain injury, this can be due to an accident or health related such as a stroke. There were people with a learning disability, who were living with other health related conditions or an acquired brain injury, which was their prime reason for care. The home can support up to 72 people.
People's experience of using this service and what we found
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 manager was aware of the principles of RSRCRC. At the time of the inspection people living with learning disabilities and/or autism required nursing care.
Since the last inspection improvements had been made. There was a clear management structure that had established quality systems that supported effective leadership and oversight of the service. Audits and quality monitoring identified areas for improvement and development. For example, accidents and incidents were reviewed to identify any trends.
There had been a focus on improvement and service development for the benefit of people. For example, the environment had been subject to an intensive refurbishment and redecoration programme.
Infection control practice had improved, equipment had been replaced and staff were fully supported to follow government guidelines on infection control at all times.
Medicines were ordered, stored and administered safely. People received their medicines as prescribed and practice to support the effective and safe use of anticipatory medicines had been reviewed and were in place.
Care documentation had been reviewed and now confirmed why people stayed in bed and if they were able to use their call bells. Risk assessments clarified what was measures were in place if people were not able to use their call bells.
People received safe care and support by staff trained to recognise signs of abuse or risk and understood what to do to support people safely. Risk assessments were used to identify individual risk and to minimise risks as far as possible. There were enough suitably trained and experienced staff to meet people's needs including the individual 1 to 1 time required. Safe recruitment practices had been followed before staff started working at the service.
People received individual time with staff to engage in activity and entertainment that met their individual needs, this included individual trips out. Complaints were recorded and responded to effectively.
People's communication needs were assessed, and professional advice was used to enable the most productive communication models were used. End of life care was planned and involved additional health care professionals when needed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There was a stable management structure and staff felt well supported and valued. There was a positive culture and team spirit amongst all the staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 July 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 17.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.