Bybrook House Nursing Home

Updated 7 May 2021

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 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

This inspection was carried out at the service by one inspector. Another inspector reviewed documentation which had been requested, and gained feedback from staff and health and social care professionals. An Expert by Experience talked to relatives on the telephone to obtain their views about the service. 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

Bybrook House Nursing 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.

The service had a manager registered with the Care Quality Commission. This means that they 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We toured the home and spoke to three people who used the service, one staff member and the registered manager. We looked at the four people’s care plans and eight people’s medicine records. We reviewed the safe administration of medicines, and infection prevention and control practice.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We gained written feedback from one professional who regularly visits the service and spoke to one staff member on the phone.

Updated 7 May 2021

About the service

Bybrook House Nursing Home is a care home, which provides personal and nursing care to up to 30 people. However, there are some twin rooms that are used for single occupancy. This means the home usually accommodates up to 22 people. The home also supports people living with dementia. At the time of the inspection, 14 people were living at the home.

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

There were systems in place to assess risk and ensure measures were in place to enhance people’s safety. People felt safe within the home and were confident to raise any concerns if needed. Relatives confirmed this and were sure any issues would be quickly resolved.

People received their medicines safely, as prescribed. Staff had fully completed the records to evidence this. Medicines were stored securely although one medicine was incorrectly kept in the fridge. This was quickly addressed once brought to staff’s attention. There was detailed information about the administration of “as required” medicines. This ensured the medicines were safely administered.

Robust infection prevention and control measures were in place and government guidance was being followed in relation to COVID-19. This ensured regular testing, social distancing and strict procedures for visiting. The home was clean, and staff had access to personal protective equipment (PPE). This was worn and disposed of correctly.

There were enough staff to support people safely. Staff covered each other at times of sickness or annual leave and there was limited agency use. This enabled people to have consistency with their care. People were supported when required, and call bells were answered in a timely manner.

The registered manager was experienced and displayed strong leadership. They worked closely with people and staff, to develop relationships, and monitor service delivery. There was a clear ethos based on key values, and a desire to continually improve. Staff knew people well, which promoted person centred care.

There were various audits to check the safety and quality of the service. This included areas such as infection control, the environment and staff training. People, their relatives and staff were encouraged to give their views about the running of the home. Any feedback was considered and implemented if possible.

Rating at last inspection

The last rating for this service was good (14 November 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The service was due a comprehensive inspection but due to the pandemic, we are not routinely completing comprehensive inspections. We have covered safe and well-led to assess whether good practice, seen at the last inspection, has been maintained.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.