Background to this inspection
Updated
15 March 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 22 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.
Updated
15 March 2022
This inspection took place on 6 June 2018 and was unannounced. The last inspection was in February 2017, where we found two breaches of regulation relating to medicines and governance of the service. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. At this inspection in June 2018, we found improvements had been made and the service was no longer in breach of regulations.
Burgh House residential 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.
The care home accommodates up to 43 people in one adapted building. At the time of this inspection there were 34 people living in the service.
Short stays were also provided to people who required a period of reablement. The purpose of reablement is to help people who have experienced deterioration in their health and have increased support needs to re-learn the skills required to keep them safe and independent when they return home. The short stay beds were located in a separate unit called ‘Oak Lodge’ on the grounds of the site. Physiotherapists and occupational therapists supported the care and treatment people received during the period of reablement. The average stay for people receiving reablement was two to six weeks. Three people were receiving re-ablement at the time of our inspection.
There was 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.
Improvements had been made to ensure people received their medicines safely, and there was evidence of learning from incidents. Additional audits were put in place to monitor medicines systems, which were now overseen regularly by the registered manager.
Care plans had been improved significantly, and contained detailed assessments of people’s health and social care needs, and their hopes and wishes for the future.
A schedule of activities that people enjoyed were provided, and people were supported to pursue their hobbies and interests. However, we did observe that at times during the day some people were sat for long periods with no meaningful interaction from staff. We have made a recommendation that the service ensures it is meeting people’s individual and specialist needs on a day to day basis.
People were supported to remain comfortable, dignified and pain-free at the end of their lives. We found some care plans in relation to people’s end of life care could be more detailed to ensure the full scope of people’s wishes were known. The registered manager told us they were planning to implement the Gold Standard Framework for end of life care to improve current arrangements further.
People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm.
There was sufficient numbers of staff to support people safely. However, some feedback indicated that at certain times of the day more staff may be needed. However, the registered manager was monitoring this, and would adjust staffing levels accordingly if a need was identified.
Staff took appropriate precautions to ensure people were protected from the risk of acquired infections.
Staff had regular supervision and they had been trained to meet people's individual needs effectively.
The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people's consent prior to care and support being provided. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.
People had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services when required.
People were supported by caring, friendly and respectful staff.
The provider had an effective system to handle complaints and concerns.
The service was well managed and the provider's quality monitoring processes had been used effectively to drive continuous improvements. The manager provided stable leadership and effective support to the staff. They worked well with staff to promote a caring and inclusive culture within the service.
Collaborative working with people, relatives and external professionals resulted in positive care outcomes for people using the service. Feedback was positive about the quality of the service.