Archived: Burrswood Health and Wellbeing

Updated 7 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was 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.

We used information the registered provider sent us in the Provider Information Return. This is information we require registered providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also examined other information we held about the service. This included notifications of incidents that the registered provider had sent us. These are events that happened in the service that the registered provider is required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 14 August 2018 and the inspection was unannounced. The inspection team consisted of an inspector, two specialist professional advisors and an expert by experience. One of the specialist professional advisors was a physiotherapist and the other was a nurse. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service.

During the inspection we spoke with all of the people who were using the service and with two relatives. We also spoke with two nurses, three care staff, a senior physiotherapist, a physiotherapist, an occupational therapist and two housekeepers. In addition to this, we met with a member of the spiritual wellbeing team, facilities manager, maintenance manager, director of corporate services, manager and chief executive officer. We observed care that was provided in communal areas including the hydrotherapy pool and looked at the care records for seven people who used the service. We also looked at records that related to how the service was managed including accidents and incidents, staff deployment, recruitment, training and quality assurance.

Updated 7 February 2019

We inspected the service on 14 August 2018. The inspection was unannounced. Burswood Health and Wellbeing is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided and both were looked at during this inspection.

Burswood Health and Wellbeing is registered to provide accommodation, nursing and personal care for 40 younger adults and older people who have physical and/or sensory adaptive needs. The service was principally designed to accommodate people on a short term basis. Some people were admitted from hospital to the service’s reablement unit. This was so that they could receive physiotherapy and occupational therapy in order to become more independent before returning home. Other people were admitted from their own homes to the service’s assisted living unit. This was for a variety of reasons including receiving care while their family members were away. On the day of our inspection visit there were seven people receiving care in the reablement unit and four people accommodated in the assisted living unit.

The service was run by a charitable body who described themselves as being ‘Christian but welcoming people of all faiths or none’. During the inspection visit the charity was represented by their chief executive officer. The former registered manager had left the charity’s employment shortly before our inspection visit. In their place the charity had appointed a new manager who was about to apply to the Care Quality Commission to become registered in their 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. In this report when we speak about the charitable body we refer to them as being, ‘the registered provider’. When we speak about nurses, care staff, physiotherapists and occupational therapists as a group we refer to them as being, ‘the professional staff’.

This was the first comprehensive inspection of the service using our new way of quality rating services. The service was registered on 21 January 2011 and we completed our last inspection on 11 and 26 July 2013 using our legacy inspection model.

At the present inspection we found four breaches of the regulations. The first breach was because the registered provider had failed to consistently reduce risks to people’s wellbeing by providing safe care and treatment. Lessons had not always been learned when things had gone wrong as a result of which robust arrangements were not in place to suitably safeguard people from the risk of experiencing harm. The second breach was because the registered provider had failed to establish the necessary systems and processes to ensure that we were promptly told when a person not been suitably safeguarded from the risk of experiencing harm. The third breach was because the registered provider had not established reliable procedures to ensure that only trustworthy people were employed to provide care. The fourth breach was because the registered provider had not made suitable arrangements to enable the service to learn, improve and assure its sustainability by ensuring that all regulatory requirements were met.

After our inspection visit the registered provider sent us information to show that they had addressed all the breaches of the regulations to provide people with safe care and treatment.

Our other findings were as follows: Medicines were managed safely in line with national guidance. There were enough professional staff on duty. Suitable arrangements were in place to prevent and control infection.

The registered provider had not given nurses and care staff all of the training and guidance they were said to need to consistently deliver care in the right way. People’s citizenship rights under the Equality Act 2010 were respected. People were supported to eat and drink enough to have a balanced diet to promote their good health. Suitable steps had been taken to ensure that people received coordinated support when they used or moved between different services. People had been supported to access any healthcare services they needed. The accommodation was designed, adapted and decorated to meet people’s needs and expectations.

People were supported to have maximum choice and control of their lives. In addition, the registered provider had established the necessary arrangements to ensure that people only received lawful care that was the least restrictive possible.

People were treated with kindness and they were given emotional support when needed. They had also been helped to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Confidential information was kept private.

People received person-centred care that promoted their independence. This included them having access to information that was presented to them in an accessible way. People were supported to meet their spiritual needs. They were also given interesting and innovative opportunities to pursue their hobbies and interests. The registered provider and staff recognised the importance of promoting equality and diversity. This included appropriately supporting people if they followed gay, lesbian, bisexual, transgender and intersex life-courses. Suitable arrangements were in place to resolve complaints in order to improve the quality of care. People were supported to make decisions about the care they wanted to receive at the end of their life in order to have a comfortable, dignified and pain-free death.

People who received support, their relatives and members of staff were actively engaged in developing the service. The registered provider was actively working in partnership with other agencies to support the development of joined-up care.