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Burgh House Residential Care Home Limited Good

Inspection Summary


Overall summary & rating

Good

Updated 1 August 2018

This inspection took place on 6 June 2018 and was unannounced. The last inspection was in February 2017, where we found two breaches of regulation relating to medicines and governance of the service. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. At this inspection in June 2018, we found improvements had been made and the service was no longer in breach of regulations.

Burgh House residential home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 43 people in one adapted building. At the time of this inspection there were 34 people living in the service.

Short stays were also provided to people who required a period of reablement. The purpose of reablement is to help people who have experienced deterioration in their health and have increased support needs to re-learn the skills required to keep them safe and independent when they return home. The short stay beds were located in a separate unit called ‘Oak Lodge’ on the grounds of the site. Physiotherapists and occupational therapists supported the care and treatment people received during the period of reablement. The average stay for people receiving reablement was two to six weeks. Three people were receiving re-ablement at the time of our inspection.

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.

Improvements had been made to ensure people received their medicines safely, and there was evidence of learning from incidents. Additional audits were put in place to monitor medicines systems, which were now overseen regularly by the registered manager.

Care plans had been improved significantly, and contained detailed assessments of people’s health and social care needs, and their hopes and wishes for the future.

A schedule of activities that people enjoyed were provided, and people were supported to pursue their hobbies and interests. However, we did observe that at times during the day some people were sat for long periods with no meaningful interaction from staff. We have made a recommendation that the service ensures it is meeting people’s individual and specialist needs on a day to day basis.

People were supported to remain comfortable, dignified and pain-free at the end of their lives. We found some care plans in relation to people’s end of life care could be more detailed to ensure the full scope of people’s wishes were known. The registered manager told us they were planning to implement the Gold Standard Framework for end of life care to improve current arrangements further.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm.

There was sufficient numbers of staff to support people safely. However, some feedback indicated that at certain times of the day more staff may be needed. However, the registered manager was monitoring this, and would adjust staffing levels accordingly if a need was identified.

Staff took appropriate precautions to ensure people were protected from the risk of acquired infections.

Staff had regular supervision and they had been trained to meet people's individual needs effectively.

The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people's consent prior to care and support being provided. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.

People had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services when required.

People were supported by caring, friendly and respectful staff.

The provider had an effective system to handle complaints and concerns.

The service was well managed and the provider's quality monitoring processes had been used effectively to drive continuous improvements. The manager provided stable leadership and effective support to the staff. They worked well with staff to promote a caring and inclusive culture within the service.

Collaborative working with people, relatives and external professionals resulted in positive care outcomes for people using the service. Feedback was positive about the quality of the service.

Inspection areas

Safe

Good

Updated 1 August 2018

The service had improved to Good.

There was a robust system in place to recruit staff.

There were effective systems in place for managing medicines.

The provider had procedures in place designed to protect people from abuse.

We observed there to be sufficient staff to meet people’s needs. However, some feedback suggested that staffing levels were sometimes not sufficient. The registered manager was closely reviewing this.

Effective

Good

Updated 1 August 2018

The service was effective.

People were supported by staff who were trained and knowledgeable about people living at the service.

Capacity and consent were considered, and where people were deprived of their liberty the correct authorisation had been applied for.

There was effective liaison with health care professionals.

Caring

Good

Updated 1 August 2018

The service was caring.

Staff treated people in a caring and compassionate manner. Staff agreed that this was important and spoke kindly about the people they supported.

People's privacy and dignity was respected.

Visitors were welcomed into the service, and could visit at any time.

Responsive

Good

Updated 1 August 2018

The service was Good.

The service had systems in place for receiving, handling and responding appropriately to complaints.

There was a structured activity programme in place. However, we observed that some people had minimal meaningful interaction during the day and we have made a recommendation about this to ensure individual and specialist needs are met.

Care plans reflected people's needs and how they would like their care to be delivered.

Well-led

Good

Updated 1 August 2018

The service has improved to Good.

The management provided staff with strong leadership and led by example.

The registered manager had a good working knowledge of the day to day running of the service. There was a positive culture within the staff team.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

The service worked with other agencies to improve people's health and wellbeing.