Berwick House Rest Home

Updated 22 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three inspectors carried out the inspection including one pharmacist specialist.

Service and service type

Berwick House Rest Home is a care home without nursing care. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The provider had recently appointed a new manager who had submitted an application to register with us. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 3 relatives about their experience of the care provided by Berwick House Rest Home. We spoke with 8 members of staff including the manager, the regional manager, carers, maintenance staff and the cook. We walked around the home to check it was safe and fit for purpose. We observed people’s interactions and the care they received. This helped us understand experiences of people who could not talk with us.

We reviewed a range of records, policies and procedures. This included 4 people’s care records, recruitment information for 1 carer, a senior and the manager and records relating to the management of the service. Our pharmacist specialist reviewed records and information relating to medication.

Updated 22 March 2023

About the service

Berwick House Rest Home is a residential care home located near South Shore Blackpool, providing Accommodation for persons who require nursing or personal care. The service provides support for up to 24 people; younger adults, older people and people living with dementia. At the time of our inspection there were 17 people using the service. The property is set over 2 floors with lift access to the upper floor. There were several communal areas and a large enclosed rear garden accessible for people to use. Aids and adaptations were in place to meet people’s individual needs.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Systems were in place for the safe handling, storage and disposal of medicines but management of ‘when required’ medicines was not always effective.

Relatives and staff told us they thought people were safe. However, the provider did not demonstrate that risks were consistently monitored around people’s care needs or fire safety.

Staff knew people well and had a person-centred approach, but this was not always documented. Some care plans did not include accurate and up to date information on people’s behaviours, mobility and support needs; at times information conflicted.

Though staff supported people in the least restrictive way possible and in their best interests; records and systems did not fully support this practice.

The provider did not always have established systems in place to continually assess, monitor or improve the quality and safety of the service.

A new manager had been in post since December 2022. There was a lot of favourable feedback from staff; “Things are really good, really positive.” “I like the new manager.” Staff referred to ongoing improvements to the home environment, activities, processes and staffing. The manager talked us through some of the changes they had implemented and those planned for the future. From our observations, people seemed happy and relaxed. When asked what they thought of the staff, relatives said, “Staff have been excellent” and “Staff are very kind.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted due to concerns received about medicines, staffing and management. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Following our feedback, the provider and manager have taken positive action to lessen the risk and drive improvement.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Berwick House Rest Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management of ‘when required’ medicines, risk management, record keeping relating to people’s care and support and assessing, monitoring and improving quality and safety.

We identified evidence that Deprivation of Liberty Safeguards (DoLS) were not complete and up to date for everyone.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.