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Inspection carried out on 23 January 2018

During a routine inspection

This comprehensive inspection took place on 23 and 29 January 2018. The first day was unannounced. At our last inspection in August 2015 we rated the service as Good and there were no breaches of the legal requirements.

Burwood Nursing Home 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.

Burwood Nursing Home accommodates up to 58 people in two adjacent buildings on the same site. One building, known as Burwood, has 16 individual ensuite bedrooms and the other, Yaffle, has 42. Burwood has a communal lounge and dining area, but most communal facilities are located in Yaffle and people in Burwood have ready access to these. When we inspected, there were 52 people living or staying at Burwood Nursing Home. They were older people with physical health needs, most of whom required nursing care. Some were living at the service; others were staying for a limited period of respite or recuperation.

The service had two registered managers. 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.

People and their visitors were very positive about their or their loved one’s care, and also praised the caring approach of the staff. The service had received compliments about exceptional care and how staff had gone the extra mile to ensure people were as comfortable as possible.

People were treated with kindness, compassion and respect. Their independence was promoted as far as possible, whilst respecting their choices. There was an emphasis on people having choices and their preferences being respected.

People and relatives took part in the interview process for new staff and had an influence over who was recruited.

Staff training had been developed around people’s particular needs; some people and relatives were involved in delivering this. This gave staff first hand insights into people’s conditions. Staff learning needs and styles were taken into account in how training was delivered.

Care and support was tailored to people’s individual needs. People, and where appropriate their relatives, were encouraged to be involved in the care planning and review process.

There was an emphasis on people experiencing a ‘good death’ when the time came, in other words, a dignified, comfortable and pain-free death in the place the person wanted to be. Staff had skills to understand and meet the needs of people and their families in relation to emotional support and practical assistance at the end of a person’s life.

Arrangements for social activities met people’s individual needs; there was an emphasis on people living as full a life as possible. There was an extensive range of optional group and individual activities. They took place both at the service and in the community. The management and staff teams went to great lengths to arrange activities that people really wanted to take part in, based on their interests or expressed wishes.

The service took a key role in the local community and was actively involved in building further links. There were strong links with a range of community organisations, including local churches, schools, the library, community groups and a nearby care home.

The premises had been designed with people’s needs and comfort in mind. People’s rooms had floor length windows, so people had a clear view over the grounds, even from their bed. There were different areas that people regularly used for activities, and also to spend time privately or with visitors. These included the ‘Railway Tavern’, furnished as a traditional pub, and an art deco thea

Inspection carried out on 4th and 5th August 2015

During a routine inspection

The inspection visit took place on 4 and 5 August 2015 and was unannounced.

Burwood Nursing Home is registered to provide personal care for up to 58 people. Accommodation is on three floors with two lifts for access between the floors. The home is divided into two separate buildings.

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.

At the last inspection on 10 June 2013 the service was meeting the requirements of the regulations that were inspected at that time.

There were 58 people living at Burwood Nursing Home at the time of our inspection. People who lived at the home, relatives and friends told us people felt safe and secure with staff to support them. We found people’s care and support needs had been assessed before they moved into the home. Care records we looked at contained details of people’s preferences, interests, likes and dislikes.

We observed staff interaction with people during our inspection visit, spoke with staff, people who lived at the home and relatives. We found staffing levels and the skills mix of staff were sufficient to meet the needs of people and keep them safe. The recruitment of staff had been undertaken through a thorough process. We found all pre-employment checks that were required had been completed prior to staff commencing work. This was confirmed by talking with staff members.

We observed medicines were being dispensed and administered in a safe manner. Staff members dispensing medicines wore tabbards to notify people of this to reduce the possibility of errors occurring. We observed the person responsible for administering medicines dealt with one person at a time to minimise risks associated with this process. We discussed training and found any person responsible for administering medicines had received formal medicine training to ensure they were confident and competent to give medicines to people.

People were asked for their consent before care was provided. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were supported by sufficient numbers of staff who had the knowledge, skills and experience to carry out their role. People told us that there were always staff available to help them when needed. Relatives of people who used the service told us that they visited the home at different times and on different days, and the staff always made them feel welcome. They said that staff were caring and treated people with respect, and that their relative was always comfortable and looked well cared for.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They were happy in their work, motivated and had confidence in the way the service was managed.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people.This took into account their dietary needs and preferences so that their health was promoted and choices respected.

People told us they could speak with staff if they had any worries or concerns and felt confident they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted their independence. People were actively encouraged to be part of the local community, and likewise, people from the local community were welcomed into the home.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

People using the service and their relatives had been asked their opinion via surveys, the results of these had been audited to identify any areas for improvement.

Inspection carried out on 10 June 2013

During a routine inspection

As part of this scheduled inspection we spoke with three people living at Burwood Nursing Home. We also talked to two relatives and five members of staff including the registered manager.

One person who lived at Burwood Nursing Home told us, “I am very happy living here, it’s a homely home”. A relative we spoke with told us the home was, “lovely”, adding that their family member “loves their room”. A member of staff we spoke with said, “I love it here, the girls are calm and nothing is too much trouble”.

We found that people’s needs were assessed prior to moving into Burwood Nursing Home, and that care plans were person centred and regularly reviewed.

It was evident from our discussions with staff that they knew people well and understood how to support them.

We found there were enough qualified, skilled and experienced staff to meet people’s needs.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

There was a complaints system available.