The Burroughs

Updated 13 February 2020

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 Care Act 2014.

Inspection team

The inspection on day one was carried out by a member of the CQC medicines team who looked at how medicines were being managed. The inspection on day two was conducted by two inspectors, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Burroughs 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at all the information we held about the provider. This included notifications they had made about significant events, complaints and other information, they and members of the public had shared with us. We contacted the London Borough of Hillingdon quality assurance team to ask if they had any feedback about the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with 15 people who lived at the service and one visiting relative. We also spoke with one visiting professional. We met the registered manager and staff on duty who included care assistants, senior care assistants, team leaders, lifestyle coordinators, catering and domestic staff. We also met the regional director who visited the service.

We observed how people were being cared for and supported. Our observations included the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care records for seven people who used the service, staff training, recruitment and support records for five members of staff and other records used by the provider for managing the service, such as audits, records of complaints, records of accidents and incidents, meeting minutes and feedback they had received from stakeholders. The medicines team looked at how medicines were managed, including storage, administration and record keeping.

After the inspection

The registered manager sent us additional information in response to our initial feedback and told us action they had taken since the visit.

Updated 13 February 2020

About the service

The Burroughs is a care home for up to 75 older adults, some who are living with the experience of dementia. At the time of our inspection 67 people were living at the service. The service is managed by Care UK, a national organisation providing care services in the UK.

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

People explained they were well cared for at the service and their needs were met. They liked the staff, who were kind, considerate and polite. There was a wide range of leisure activities being offered and people were able to join these if they wanted. People were offered choices and these were respected.

There was enough to eat and drink and meals were freshly prepared at the service each day. There was a choice at mealtimes and different cultural and specialist diets were catered for. The staff monitored people's weight and made sure they stayed hydrated.

The staff worked closely with other healthcare professionals to monitor and meet people's healthcare needs. Visiting nurses offered daily support to people and the staff made referrals to other healthcare professionals when needed. People received their medicines in a safe way and as prescribed.

There were suitable procedures for recruiting, inducting, training and supervising staff. Staff felt supported and were able to discuss any concerns they had with their manager. There was good communication and team work. Senior staff were involved in training other staff, which included 'experience' training where the staff experienced receiving a number of care interventions so they could understand how it felt to receive care.

There were appropriate systems for safeguarding people from abuse, dealing with complaints, accidents and incidents. The staff had been proactive in working towards reducing accidents and falls.

People's preferences and needs had been assessed. Care plans were developed to describe how they should be supported. The provider operated a 'resident of the day' system where staff reviewed people's needs each month – involving the person, their family and all the departments in the service to identify if any changes were needed to their planned care. The risks to people's safety and well being had been assessed, planned for and monitored.

The building was suitably designed and had some additional features to engage people and help orientate them. Some of the communal rooms had been refurbished to provide a theme, such as a coffee bar and a cinema. The building was clean and free from hazards. Equipment was well maintained and safe to use.

The provider had introduced a number of initiatives to improve the service, such as a 'wish tree' where people could request specific activities and treats.

People using the service, staff and visitors found the registered manager approachable and were able to raise concerns or ask for support if needed. There were appropriate systems for monitoring and improving the quality of the service, including regular visits and checks by senior managers within the organisation.

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.

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 rating at the last inspection was requires improvement (Published 20 February 2019). We identified breaches relating to safe care and treatment and good governance. 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 regulations.

Why we inspected

This was a planned inspection based on the previous rating.