Archived: The Borrins Care Home

Updated 27 March 2019

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.

The inspection was prompted in part by the number of notifications we had received in relation to people who used the service developing pressure ulcers and concerns there were not enough staff on duty.

Inspection team:

The inspection was carried out by one adult social care inspector, one assistant inspector and one 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:

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:

The inspection was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection in August 2017. This included details about incidents the provider must notify us about and information from the local authority. We used this information to plan our inspection.

People using the service at The Borrins were not all able to fully share with us their experiences of using the service. Therefore, we spent time observing staff with people in communal areas. We spoke with seven people who were using the service, three relatives, five care workers, one chef, a member of the tissue viability team, the registered manager and the area quality manager.

We reviewed a range of records. These included four people’s care records and medication records. We also looked at three staff files around staff recruitment and the training records of all staff. We reviewed records relating to the management of the home and a variety of audits implemented by the provider.

Updated 27 March 2019

About the service: The Borrins Care Home is a 25 bedded residential care home for older people and people with physical disabilities. At the time of our inspection there were 19 people using the service.

People’s experience of using this service:

At our last inspection in August 2017 the service was ‘good’ in all of the key questions and ‘good’ overall. Since then the service had been taken over by a new provider HC-One Oval Limited who were trying to sell the home.

At this inspection we found the service had deteriorated to ‘requires improvement’ in four of the key questions and ‘requires improvement’ overall.

There were not enough staff to keep to people safe and meet their care needs. Staff were not always available to provide the necessary supervision to people who were at risk, for example, of choking or falling. The lack of staff also impacted on the activities programme as the activities co-ordinator was frequently providing personal care.

Staff training was not up to date and staff did not feel supported and told us staff morale was poor. Staff supervisions and appraisals were not up to date.

Staff were recruited safely. People using the service and relatives spoke well of the care staff and told us there was a nice friendly atmosphere in the home.

Some improvements need to be made to ensure medicines were managed safely and available to people as prescribed.

People who used the service were very complimentary about the meals. The chef was very aware of people’s individual preferances and catered for these.

Care plans for people using the service were in the process of being up dated. Some information did not reflect people’s current needs and the support they required from staff. Risk assessments were in place but action had not always been taken to reduce or eliminate identified risks.

Appropriate referrals were being made to the safeguarding team when this had been necessary.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

Audits and checks were carried out, however, these were not always effective in identyfing areas which needed to be improved.

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

More information is in the full report.

Rating at last inspection:

Good (report published 25 August 2017).

Why we inspected:

This inspection was brought forward due to information of concern. We had received eleven notifications since the last inspection regarding people developing pressure ulcers. We had also received concerns there were not enough staff on duty to make sure people’s needs were met.

Enforcement:

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around staff training and support and governance. Details of action we have asked the provider to take can be found at the end of this report.

Follow up:

As the service has been rated ‘requires improvement, we will request an action plan from the registered provider about how they plan to improve the rating to Good. In addition, we will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.