Brunswick House

Updated 4 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

The inspection was carried out by 1 inspector and 1 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.

Service and service type

Brunswick House is a ‘care home’. 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. Brunswick House is a care home with nursing care. 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 17 January 2023 and ended on 26 January 2023. We visited the service on 17 January 2023 and 26 January 2023.

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, Healthwatch and professionals who work with the service. We used the 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. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection

During the inspection we spoke with 4 people who used the service and 15 relatives about their experience of the care provided. Not everyone who used the service communicated verbally or wished to speak on the telephone, therefore they gave us permission to speak with their relative. We spoke with 19 members of staff including the Nominated Individual, area manager, registered manager, two nurses, 10 care workers including 2 senior care workers, 2 domestics, 1 chef and 1 kitchen assistant. We received feedback from 2 health and social care professionals. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 4 people’s care records and multiple medicines records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training information and policies and procedures were reviewed.

Updated 4 March 2023

About the service

Brunswick House is a care home providing personal and nursing care to up to a maximum of 41 people. The service provides support to older people including people who may live with a dementia type illness. At the time of our inspection there were 38 people using the service.

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

The staff team supported some people with complex needs. There was evidence of collaborative working and good communication with other professionals to help meet people's needs. A relative commented, “The nursing care in this home is excellent. The staff are very in tune with [Name]’s needs. While doing their personal care, they chat and have fun, this brightens [Name]’s day. I don't have to worry about their care, it is the best.”

People and relatives were very positive about the caring nature of staff and had good relationships with them. They trusted the staff who supported them. A relative told us, “The staff at this home are friends and family to us. They care beautifully for [Name] and also have time to care for me. I think I would describe our relationship with the home as warm and very caring.”

There were sufficient staff to support people safely. People said they felt safe with staff support. A relative commented, I know [Name] is very safe at the home. Staff give me that confidence when I watch them looking after [Name] and other residents.” Staff recruitment was carried out safely. Staff followed effective processes to assess and provide the support people needed to take their medicines safely.

People's diversity as unique individuals with their own needs was well-respected by staff. The regular staff team knew people well and provided support discreetly and with compassion. A relative commented, “With most of the staff the care afforded for [Name] is excellent. I think agency staff do not have the same connection with the residents.” People’s privacy was respected, and people were supported to maintain contact with relatives and friends.

Records provided guidance to ensure people received safe and effective care. Risks were assessed and mitigated to keep people safe. Staff contacted health professionals when people’s health needs changed. People’s nutritional well-being was monitored to support their nutritional health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a strong and effective governance system in place. People, relatives and staff were confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and used to support service development. A relative told us, "When I came to visit the home I was given a very warm welcome by the registered manager. When [Name] came to the home all the staff knew their name and this made [Name] feel comfortable from day one. Good management skills." Strong processes were in place to manage and respond to complaints and concerns.

Staff followed good infection control practices and the home was clean and well maintained. A relative commented, “This home is very well-maintained and clean.”

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

Rating at last inspection

The last rating for this service was outstanding (published 4 February 2020).

Why we inspected

We received concerns in relation to the management of medicines, staffing and people’s care. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led.

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 remained outstanding based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this report.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.