Appletrees Care Home

Updated 21 April 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.

Inspection team

The inspection was carried out by 2 inspectors, an inspection manager and an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. 2 inspectors visited the home on the second day.

Service and service type

Bluebrooke Nursing & Residential Care Home 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. Bluebrooke Nursing & Residential Care Home 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.

What we did before the inspection

We sought feedback from the local authority, Health watch and professionals who work with the service. Health watch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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.

During the inspection

We spoke with 6 people and 6 relatives. We spoke with 15 staff members including nursing staff, care staff, the chef, kitchen assistant, agency staff, the deputy and registered manager, the area manager and the provider. We reviewed a range of records in relation to people's care, including medication and nursing records. We also reviewed a range of records held by the service including, staff training and rotas, recruitment records, audits and premises checks.

Updated 21 April 2023

Bluebrooke Nursing and Residential Care Home is a nursing and residential care home providing personal and nursing care for up to 46 people. This includes people living with dementia. At the time of the inspection, 30 people were living at the home.

The home is an adapted building with care provided over 3 floors. People have access to lounges, dining areas, and accessible outdoor spaces. Bathrooms and toilets are situated near to communal areas.

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

People were not consistently protected from the risk of harm. People’s medicines were not always managed safely and in line with best practice. The provider was not following safe recruitment practices. We were somewhat assured by the providers infection control practices.

People could not be assured their needs would be fully assessed by the provider. People’s mealtime experience was not always positive. People’s care plans were not consistently reviewed. Information was not always provided in a way that all people would understand. People were not supported in activities and hobbies that met their needs. Not all people had been consulted about their end of life pathways. Governance and quality checks were not always effective. People were not always given the opportunity to engage in the planning of the service.

The home worked in partnership with other agencies. The home was adapted to meet people’s needs.

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.

The home had an effective complaints procedure. The provider understood their responsibilities under the duty of candour. People were supported by staff who were caring.

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

Rating at last inspection

This service was registered with us on 28 October 2021 and this is the first inspection.

The last rating for the service under the previous provider was good (published 17 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.