Background to this inspection
Updated
11 August 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 one inspector.
Service and service type
Bush Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager. We reviewed a range of records. This included 5 people’s care records and multiple medication records. A variety of records relating to the management of the service, including audits were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, complaints, and quality assurance records. We spoke to 2 people who live at the home and 3 family members. We also spoke with 5 members of staff.
Updated
11 August 2023
About the service
Bush Rest Home is a residential care home providing personal and nursing care to 33 people aged 65 and over at the time of the inspection. The service can support up to 44 people.
People’s experience of using this service and what we found
Some care records required further detail about actions staff should take to keep people safe and to ensure compliance with the Mental Capacity Act. This was being acted upon by the registered manager. People felt the management team were approachable and that the service was well led. People had the opportunity to feedback on their experience of their care.
At the last 3 inspections we found shortfalls in the management of the delivery of care. This included a lack of understanding of risk and regulatory requirements, and care/risk plans without details of how staff should mitigate risks. At this inspection we found not all risks to safety had been assessed, however, staff knew how to reduce risks for people.
There were enough staff to meet people’s needs and people had received their medicines as required. There were infection prevention systems in place to reduce risks associated with infection..
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.
People were supported by staff who understood their dietary needs and ensured these were met. People had access to healthcare support where needed. Staff received training relevant to their role.
People felt staff were kind and caring to them. People were treated with dignity and were encouraged to maintain their independence where possible.
People were supported by staff who knew them well. Records held about people gave personalised information about their preferences with regards to their care.
People were supported to keep hobbies that were important to them. Where complaints were made, these had been investigated.
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 Good(published 06 October 2021).
Why we inspected
We received concerns in relation to the management of medicines and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We have found evidence that the provider needs to make improvements. Please see the well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full 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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.