Burwood Grange Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people’s needs were met.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment. Although the provider had created a community on the first floor specifically for people living with dementia, they had not developed the environment to meet the needs of people living there.

For example, there was a number of people walking with a purpose and in line with good practices in dementia care environments, there was a lack of any objects of interest to engage them or for them to interact with, such as sensory items they could feel at the end of the corridors where they stopped and turned to go back in the opposite direction.

All items contained in or on the cabinets in the corridor, appeared more for decoration and display to tie in with the corridor’s decoration theme. There didn’t appear to be any differentiation in texture or manipulative/touchy feely objects for anyone to access. There were no reminiscence boxes outside rooms and as the name plates on bedroom doors contained small or difficult to decipher pictures. This would make it difficult for people living with dementia to recognise their bedroom door.

There was no signage displayed to support and orientate people living with dementia, such as toilets and lounge areas. We fed this back to the provider, who said they would be taking appropriate action to make improvements. Following the inspection, they sent us evidence they had started to purchase equipment to support the needs of people living with dementia.

Notwithstanding the above, people told us they received person-centred care in line with their needs and preferences. One person said, “The staff are very nice, it’s hard work for them, they have difficult hours. They are alright to me, no animosity.” A relative agreed and said, “Yes, all the staff that I’ve encountered have been really nice, really friendly. I think they’re well trained.”

People’s aspirations were identified and respected. People’s care and support plans were clear and included their biography, preferred activities and what made them happy and fulfilled. Care notes were completed appropriately and respectfully, and included details of any event, activities and interactions, and any healthcare concerns.

We witnessed staff delivering person-centred support that met people’s needs. People appeared happy to engage with the staff in their own way, and staff understood them. A healthcare professional told us, “I have the pleasure of regularly spending time at Burwood Grange Care Home, and I am always impressed by the kindness, patience, and professionalism shown by everyone on the team. The level of care and attention given to each resident is truly heartwarming.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People and relatives told us the service delivered good care that met people’s healthcare needs. Support plans detailed these needs and were personalised. There were clear instructions for staff to follow, so they understood each person’s condition and how it impacted on their daily lives.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The registered manager told us they recognised the importance of effective communication.

People’s communication needs were assessed during the pre-admission assessment so information could be made available to them in a format that suited them. People's care plans detailed their preferences and any aids they needed to support effective communication.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and relatives were involved in the planning of their care and support. Care plans were reviewed regularly, and people and relatives were asked for their feedback about the care they received and anything they would like to change.

The provider ensured people and relatives had the necessary information in relation to processes for sharing feedback or raising concerns. Records showed complaints received were addressed in accordance with the provider’s policies and procedures. Any learning from complaints and concerns was shared with staff to inform their future practice. People told us, “They come in and see if you are alright every day. They ask me if there are any problems” and “I would feel comfortable making a complaint.” Relatives added, “We would feel comfortable about complaining – especially if it was about our relative’s care. We think they would listen” and “When I have complained, it’s been dealt with.”

Several people had formed a ‘residents’ council’ and represented people’s views or concerns during meetings. One person told us, “People complain to me and then I take their complaints to the meetings. There was a problem with people wiping their noses on napkins during the mealtime and people said it was vile so they have now provided tissues on the tables.”

Staff were encouraged to monitor people’s care to help identify issues before they could develop into complaints or concerns. There were regular meetings with people so they could raise concerns and make suggestions.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People told us they had access to the care and support they required and were happy with this. They felt their needs were met and the staff cared and supported them effectively. Records showed they were supported to attend appointments, and a range of healthcare professionals visited the home regularly. Records of visits were included in people’s care plans and the staff ensured they followed instructions.

Care plans were regularly reviewed to identify any changes in a person’s care needs so the appropriate support could be found if needed. This included making appropriate referrals to external professionals as needed.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People were supported to undertake activities and there was an activity coordinator in place. However, people’s views of the activity provision varied. Their comments included, “There’s a few things they do but there’s no entertainment here”, “Most of the activities are not for me. I spend most of my time reading and staying in contact with friends by email. I would be tempted to join in if there was something that I was really interested in” and “I join in with some of the things. I’m not keen on the quizzes. When [previous activity coordinator] was here [they] started a bingo session for people with memory problems which was very well designed. I quite enjoyed it even though my memory is OK.”

On the first floor, there was an activity room but we did not see any activities taking place in there throughout the day. There was an activity schedule stating that at 11.30am, there was a plan for outdoor garden activities (weather permitting). However, despite the weather being sunny and warm, this activity did not happen. We discuss this with the registered manager during out feedback. No reasons were identified to justify this.

Downstairs in the lounge at 2.50pm, the activity co-ordinator had 13 people sitting in a circle taking it in turns to kick a beach ball. People didn’t seem particularly engaged and there was no laughter or conversation. One person got up to leave assisted by a care worker. We saw 2 care workers engaged in one-to-one activities with people, which they seemed to enjoy.

We fed this back to the provider. They explained the previous activity coordinator had recently left and the new one was getting to know people. They emphasised that they believe in a whole home approach and encouraged all staff to engage people in a range of activities.

The provider had an equality and diversity policy in place and was committed to creating a welcoming and inclusive atmosphere for all people and staff, regardless of sexual orientation, gender identity, or gender expression.

People’s care plans indicated they or those who knew them well, had been consulted in decision making, including whether they preferred to receive care from a male or female care worker. Their care plans reflected people’s physical, mental, emotional and social needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. However, this was not always a subject people or their relatives were willing to discuss and this was approached sensitively by the management team and the care team.

Where people had end of life support plans in place, these detailed information about the person, important people in their life and how they wanted to be cared for at the end of their life.

Some people had ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) forms in place. DNACPR is a documented medical decision that instructs healthcare teams not to attempt CPR if a patient’s heart or breathing stops. These were appropriately approved by relevant professionals.

Some people’s records containedRecommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. A ReSPECT form isa personalized document that records preferences for treatment, including CPR, for those with complex needs or nearing end-of-life.

At the time of our inspection, nobody was receiving end of life care.