Burton, Bridge and Trent Court Care Centre

People’s experience of using this service: People and relatives told us they had a positive experience in respect of the care and support they received. They told us they received support from staff in a timely way and were not kept waiting for assistance.

We saw people looked comfortable in the presence of staff and people told us they felt safe at the home. Staff were knowledgeable about potential risks to people and were able to tell us how these would be minimised.

People were supported by staff who were caring and expressed empathy and compassion towards people who lived at the home. We saw staff consistently respected people and promoted their privacy, dignity and independence.

People received effective person-centred care and support at the point this was provided and based on their individual needs and preferences. Staff were knowledgeable about people’s needs and preferences and the staff fostered good relationships with the people. Some people’s records needed improvement to reflect people’s involvement and how the person-centred care we saw was planned. The provider was aware of this with plans underway to revise all care plans.

People were supported by care staff who had a range of skills and knowledge to meet their needs. Staff understood their role, felt confident and well supported. Staff received supervision and felt well supported by the provider. People's health was supported as staff worked with other health care providers to ensure their health needs were met.

People were supported by staff to have choices, and the provider’s policies supported this practice. There was a lack of evidence of people’s involvement or that of appropriate persons in do not resuscitate agreements where these were completed by external professionals without the provider’s involvement. These needed reviews to ensure these decisions were in the person’s best interests.

We saw staff responded to people’s needs effectively and their preferences were known and respected by staff.

People and their representatives knew how to complain. Staff knew how to identify and respond if people were unhappy with the service. People were able to communicate how they felt to staff, and said staff were approachable and listened to what they had to say. Relatives told us when they had raised concerns these had been addressed appropriately.

People, relatives and staff gave a positive picture as to the quality of care people received and said management and staff were approachable.

Quality monitoring systems were in place, and the provider had used external professionals to carry out audits to assist them in identifying how to improve the service, and people’s experience. The provider was very clear with us the service needed to improve but had identified what most of these improvements were, and had a clear improvement agenda in place. The provider told us changes were being made, with evidence of this seen, but was ensuring the pace of change allowed people and staff to be involved so changes were successful and sustainable.

Rating at last inspection: The rating at our last inspection was ‘Requires Improvement’ (report published 18/05/18).

Why we inspected: This was a scheduled inspection based on the previous rating for the service.

Burton Bridge and Trent Court Care Centre 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. Burton Bridge and Trent Court Care Centre is registered to accommodate 99 people and provides nursing and personal care. At the time of our inspection 63 people were using the service. The service accommodates people across three buildings. All three buildings had their own bedrooms, communal lounges, dining area, kitchenette and outdoor areas. The main kitchen was situated next to Burton Court and food was transported to each unit via food trolleys. Bridge Court provides nursing, residential and dementia care to older people. Burton Court provides nursing care to women with mental health related conditions and Trent Court provides nursing care to men with mental health related conditions.

The service had 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.

This was the first inspection since the provider registered on 30 June 2017. Although we did not find any breaches of the regulations, improvements were needed in all five key questions to ensure good outcomes for people were met. The provider and registered manager had identified that improvements were needed and were taking action to address this.

The numbers of staff available did not always ensure people’s needs were met in a timely way. The provider confirmed that additional staff were being recruited. Where people demonstrated behaviours that put them at risk of harm, staff did not have guidance on how to minimise the risk of these behaviours escalating.

Some people did not always enjoy the meals available and the meals were not always served at a suitable temperature for people to enjoy.

People were not always supported to ensure their dignity was maintained. The opportunities for people to socialise and participate in activities of their choice were limited. The provider’s systems to monitor the quality of the service were still being embedded and improvements were ongoing.

People were supported by staff that had undergone recruitment to determine their suitability. People were supported to keep safe by staff that understood their responsibilities to report any concerns.

Medicines were managed in a safe way to enhance people’s well-being. Infection control procedures were in place to maintain hygiene standards. The provider was making improvements to the environment.

Trained staff supported people to have maximum choice and control of their lives and supported them in the least restrictive way possible. People’s health care needs were met and monitored on an ongoing basis to ensure the right support could be sought when needed.

People were able to move around the home and were treated with kindness by the staff team. Independent advocates supported people in decision making when needed. People were supported to maintain their independence and relationships with people that were important to them.

People and their representatives were involved in their care plan reviews and were supported to express any complaints or concerns. Opportunities for people to express their views on the home were provided. Staff felt supported by the management team and were provided with supervision.

The provider and registered manager understood their responsibilities and had resources available to them to develop the service.