Archived: Burrows House

Burrows House is registered to provide accommodation and care for up to 54 elderly people including people living with dementia. At the time of our inspection there were 50 people living at the home.

There was a registered manager in place. 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.

We found that medicines were not always administered safely and effectively. Arrangements for the administration of covert medicines were not always followed in line with the provider’s policy. You can see what action we told the provider to take at the back of the full version of the report.

People using the service said they felt safe and that staff treated them well. Safeguarding adult's procedures were robust and staff understood how to safeguard the people they supported.

There were enough staff on duty to meet people's needs and the provider conducted appropriate recruitment checks before staff started work. The provider had carried out appropriate pre-employment checks to ensure staff were suitable and fit to support people using the service.

Staff received appropriate training and supervision. They asked people for their consent before they provided care, and demonstrated a clear understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Staff had a good understanding of people's needs and how these should be met. People and relatives said staff looked after people in a way which was kind, caring and respectful. Staff knew how to ensure that people received care and support in a dignified way and which maintained their privacy at all times. Staff supported people, where appropriate, to retain as much control and independence about their lives as possible, when carrying out activities and tasks.

People’s weight was not always monitored, food and fluid charts were not put in place and people were not referred to appropriate healthcare professionals such as the GP.

People were appropriately supported by staff to make decisions about their care and support needs. Care plans had been developed which reflected people's needs and their individual choices and preferences for how they received care. People's care and support needs were reviewed regularly.

People were supported to undertake activities of their choosing. The provider had developed good links with organisations in the community to increase the range of activities people could participate in.

Relatives and people knew how to complain if they wished and were given the opportunity to voice their views

People and relatives said the service was well managed. People and relatives were satisfied with the way the provider dealt with their concerns or issues and said senior staff were approachable and willing to listen.

The provider sought people's views about how the care and support people received could be improved.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

Following a fire at the home in October 2013 we found that the provider had taken steps to improve fire safety procedures in the home.

There were arrangements in place to deal with foreseeable emergencies. The deputy manager showed us an evacuation folder. The folder included an emergency evacuation plan for the home and personal emergency evacuation plan for each person using the service. The emergency evacuation plans would be used in the event of a fire, a gas leak, a flood or in any other circumstance where the building needed to be evacuated.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service effective?

People's health and care needs were assessed with them and their relatives if appropriate. A person using the service said 'I tell staff what's wrong and they help me.' A visiting relative said 'The staff do a very good job. I attend all of my mother's care plan reviews and have been involved in planning her care from the beginning.'

We saw that care plans and risk assessments recorded the specific needs of people using the service and what staff needed to do to support them. We also saw that care plans and risk assessments had been kept under regular review by staff.

Is the service caring?

We saw that satisfaction surveys that had been completed by people using the service, their relatives and visiting professionals. Comments from relatives included 'Very happy with the home, dad seems very calm and settled' and 'I think you all do a wonderful job.' Comments from professionals included 'I find that staff are caring and the clients well-being is always a priority' and 'Excellent examples of person centred care given during our work with Burrows House.'

Is the service responsive?

We saw that residents and relatives meetings took place on a regular basis where people using the service and their relatives could express their views and opinions about the home.

People we spoke with said they had not had cause to make a complaint but if they were unhappy about something they would talk with a member of staff or the manager and they were sure they would do something about it. We saw the homes record of complaints including details of how these had been investigated and resolved.

Is the service well-led?

We found there were effective systems in place to regularly assess and monitor the quality of service that people received.

The London Borough of Bromley commission services at the home. They told us they had conducted a contract compliance visit to the home on 11 April. They said the home had made significant improvements since the previous visit in October 2013. They were fully compliant with all areas on the Quality Assessment Framework, and there were no concerns noted during the visit.

At our inspection on 06 November 2013 we followed up on a fire incident that had occurred in the home on 14 October 2013, and on concerns shared with us by the local authority. Although people told us they felt safe living in the home, the provider did not always protect people against the risks associated with unsafe or unsuitable premises. For example, by ensuring that adequate fire safety measures were in place and that the premises were well maintained.

However, we found that while people's needs were assessed, care and treatment was not always planned and delivered in line with their individual care plans. Furthermore, the provider had not supported staff to ensure that they had received refresher safeguarding training in line with the provider policy.