Archived: Burton, Bridge and Trent Court Care Centre

Updated 3 November 2016

We carried out this inspection visit 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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection visit took place on 11 October and was unannounced. The inspection visit was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We checked the information we held about the service and the provider. This included notifications the provider had sent to us about significant events at the service. Notifications are changes, events or incidents that providers must tell us about. We reviewed the provider’s statement of purpose. A statement of purpose is a document which includes a standard required set of information about a service. We also spoke with the local authority who provided us with current monitoring information.

On this occasion we did not ask the provider to send us a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However we offered the provider the opportunity to share information they felt relevant with us.

We used a variety of methods to inspect the service to gain people's views about the care and to check that standards of care were being met. We spoke with 12 people that used the service, three care staff, two unit managers, the administrator, two visiting professionals and the registered manager.

Some people were unable to share their views with us, due to their mental health conditions. So we spent time with them and observed them being supported in the lounges and dining areas. We looked at the assessments and monitoring information in place for six people. We checked that the care they received matched the information in their records. We also looked at records relating to the management of the service, including quality checks and staff files.

Updated 3 November 2016

We undertook a focused inspection visit on 19 July 2016. This visit was unannounced and was required to check that the provider had addressed the areas identified as requiring improvement at our last comprehensive inspection visit on the 29 February 2016.

At our last visit we identified that improvements were needed to ensure safe medicine practices were always followed and that people's creams were available to them as prescribed. The quality monitoring systems in place required further development and improvements were needed to the recruitment checks and staffing levels.

The provider sent us a report on the 21 June 2018 to address the areas of concern we had identified. The provider and registered manager have continued to inform us on a regular basis of the improvements being made at Burton, Bridge and Trent Court Care Centre.

The areas that required improvement at our last visit were under the two key questions; is the service safe and is the service well led. This report covers the areas that required improvements and all key lines of enquiry (KLOEs) under these two questions. The KLOEs are a set of questions we use that directly relate to the five key questions we ask of all services.You can read the report from our last comprehensive inspection visit, by selecting the ‘all reports’ link for Burton, Bridge and Trent Court Care Centre on our website at www.cqc.org.uk

Burton, Bridge and Trent Care Centre is registered to provide accommodation for up to 99 people. They can offer support to people with dementia and mental health related conditions. Bridge Court, Burton Court and Trent Court are three separate buildings but are registered with us as one location. 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. All three units are allocated a unit manager.

At the time of our inspection visit 58 people were using the service. On Bridge Court there were 16 people, on Trent Court there were 27 people and on Burton Court there were 15 people.

There was a registered manager in post at the time of this inspection visit. This 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 saw that improvements had been made to medicines practice, discussions with nursing staff and records seen, demonstrated that improvements had been made to ensure medicines were available to people as prescribed. However nurses were not always given protected time to ensure they were not disturbed or distracted when administering medicines, therefore we could not be sure people would receive their medicines safety.

Staffing levels had improved since our last visit. However the deployment of staff on Burton Court over the lunch time period did not ensure people were supported in a timely way.

The recruitment checks undertaken at the service had been improved. Staff spoken with and records seen demonstrated that all of the required checks were undertaken before staff commenced employment.

We saw that the provider had made improvements to the environment. New furniture and equipment had been purchased, some redecoration had been undertaken and further environmental improvements were planned.

The recording of the support people received had improved. We saw that these records were completed and this enabled the management team to monitor the care people received and to address any identified concerns.

The provider had made improvements in the auditing process relating to the management of medicines. The records confirmed medicine audits were in place and undertaken each month. Any areas for improvement were identified and actions taken as required.

The staff understood how to protect people from abuse and had clear direction on how to support people who demonstrated behaviours that put themselves or others at risk; this ensured the support people received met their needs and kept them safe.

Assessments were in place that identified risks to people’s health and safety and care plans directed staff on how to minimise identified risks. Plans were in place to respond to emergencies to ensure people were supported in accordance with their needs. Care staff told us they had all the equipment they needed to assist people safely and understood about people’s individual risks. The provider checked that the equipment was regularly serviced to ensure it was safe to use.

There was clear leadership and direction for staff to ensure people's needs were met. Staff told us they were comfortable raising concerns which demonstrated that a transparent and open management approach was in place.

Quality monitoring checks were completed by the provider and registered manager and when needed action was taken to make improvements. The registered manager understood their responsibilities around registration with us.