The Borrins Care Home

The Borrins is a 30 bedded residential care home for older people and people with physical disabilities. At the time of our inspection there were 23 people using the service on both permanent and a respite basis.

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

Medications were not always managed safely. Charts and documents were not in place for creams, and there were no ‘as and when’ required (PRN) protocols in place.

Audits had been completed by the registered manager and the provider; however these audit systems were not effective at identifying the issues found on inspection in relation to medication management and care plan accuracy.

The registered manager and provider were responsive to the inspection findings. They acted during and after the inspection and shared plans to improve their systems and processes.

Risks related to people's health and care needs as well as environmental risks were well managed. All areas of the premises were clean and infection control procedures were followed by staff with Personal Protective Equipment (PPE) being worn correctly and social distancing maintained.

People received person-centred care and care records were written in a person-centred way, inclusive of people’s likes, dislikes and preferences. Staff were kind, caring and compassionate and treated people well. People were treated with dignity and respect. There were activities taking place throughout the day.

Staff received an induction, training and support for their roles. However, areas of the staff training were low in completion. We therefore recommended that all staff's training is brought up to date and monitored consistently to ensure staff are not out of date with training.

Staffing levels were sufficient to meet people’s needs on the day of inspection however, there had been a rapid increase in admissions to the home, and the dependency tool calculator identified that the service was running under staff capacity. We have made a recommendation about the increase of staff in response to the recent capacity increase.

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. We made a recommendation to the provider that they complete the Mental Capacity Assessment for the people that did not have them in place.

People were supported to keep in touch with family and friends through calls and indoor visits. People had access to healthcare services. People were provided with a good choice of food, drinks and snacks throughout the day.

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

Why we inspected

The last rating for the service under the previous provider was requires improvement, published on 27 March 2019.

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.

We have found evidence that the provider needs to make improvements. Please see all the sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to using medications safely, and good governance at this inspection.

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

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

The premises were clean and well ventilated.

There was prominent signage and instructions explaining how to meet infection prevention and control standards.

Hand sanitisers and PPE stations were situated throughout the building.

The service had effective processes in place so laundry was managed safely.

Staff were observed wearing appropriate PPE.

The service had robust infection control auditing systems.