Burgess Care

Updated 14 April 2022

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

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 three inspectors and an Expert by Experience who contacted relatives by telephone. 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

Burgess Care is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

Our inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection and any recurrent themes of concerns. We sought feedback from the local authority, commissioners who work with the service, Healthwatch and an independent advocacy service.

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 carried out observations to assess people's experiences of the care provided. We spoke with the registered manager, the area manager, two house managers, six care staff and the office manager. We spoke with one person to gather their experiences of the care provided.

We reviewed five people's care records and risk assessments. We looked at three people's medicines records. We looked at a sample of records relating to the management of the service including health and safety checks, accident and incident records and safeguarding records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The Expert by Experience contacted eight relatives by telephone to gather their feedback about the support their family members received at Burgess Care.

Updated 14 April 2022

About the service

Burgess Care is a residential care home that provides care for 20 people who have a primary diagnosis of a learning disability or autism spectrum conditions, that require specialist care and support. There were 20 people living at the service at the time of our visit. This service was in a rural location and accommodation was provided across four houses. The service can also provide care for people in their own homes.

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

Managers and staff worked in partnership with people, their relatives and health professionals to ensure people received safe care. Staff were confident to identify any safeguarding concerns and knew how to report them.

There were enough staff to provide the level of support people needed, however there was a reliance on agency staff to cover shifts. The provider recognised a consistent staff team was an integral aspect of managing physical and emotional risks and was actively recruiting to the permanent staff team.

Holistic assessments of needs were developed into person-centred care plans with guidance for staff to follow. Relatives told us staff were responsive when events occurred that had potential to impact on people’s emotional well-being.

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’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured people’s medicines were reviewed by prescribers in line with these principles.

We were assured the service were following safe infection prevention and control procedures to keep people safe.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the key questions Safe, Responsive and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and independence.

Staff knowledge, observations and understanding of people as individuals encouraged a continuous review of what worked well for them. Staff understood people’s individual communication needs and used a variety of methods to communicate with people to enable them to express their views.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights.

Where people needed physical intervention by staff to support them at times of anxiety or distress, staff reflected afterwards to identify where changes could be made to develop more effective strategies and to understand the meaning of the behaviour. This promoted people’s dignity and respected their human rights.

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

Relatives consistently praised staff for being kind, caring, intuitive, proactive, and professional and praised the management team for the running of the service. Staff spoke positively about the training and support they were given to meet their responsibilities and the working culture within the service.

For more details, please see the full report which is on the CQC website at

www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 July 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to staffing and the culture within the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. We also checked they had followed their action plan following the last inspection and to confirm they now met legal requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from these concerns. The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Burgess Care 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.