Mulberry House

Updated 23 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and 1 medicines inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced, with a follow visit being announced.

What we did before the inspection

We reviewed all the information we had received about the service since the last inspection. This included information contained within notifications, and any contact regarding complaints and safeguarding. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Throughout the inspection, we spoke with 8 people who used the service. We spent time talking with and observing people's interactions with staff. We spoke with 12 members of staff including the registered manager, the operations manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 4 staff files in relation to recruitment and induction. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

We spoke with 2 relatives in the service and contacted a further 6 by telephone or email, to gather their feedback about the service. We spoke to 3 visiting professionals during our visits and contacted a further 4 health and social care professionals by email for their view on the service. We continued to seek clarification from the provider to validate evidence found. We looked at training data, rotas and quality assurance records.

Updated 23 August 2023

About 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.