Background to this inspection
Updated
25 August 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.
Inspection team
The inspection team consisted of three inspectors and two Experts 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
British Home & Hospital for Incurables 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 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 inspection
We reviewed information we held about the service, including details about incidents the provider must notify us about, such as abuse or when a person injures themselves or others. We contacted relevant agencies such as the local authority and safeguarding teams. We used all this information to plan our 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 spoke with 20 people who used the service and two relatives. We spoke with 23 members of staff including the registered manager, registered nurses, therapists, housekeepers, administrators and care staff.
In addition, we reviewed a range of records. This included nine care plans and risk assessments and other records relating to how the service is run. We looked at nine staff files in relation to staff recruitment and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We asked the registered manager to send documents to further support how the service was run and to validate evidence found.
Updated
25 August 2021
About the service
The British Home and Hospital for Incurables (which is known as The British Home) is a residential care home providing accommodation and nursing care for up to 127 people with physical disabilities. At the time of inspection, 70 people were using the service.
People’s experience of using this service and what we found
At the previous inspection, we found the provider needed to make improvements in relation to dignity and respect and good governance. At this inspection, we found that sufficient improvements had been made.
People were happy with the quality of care they received. People were protected from the risk of avoidable harm. Risks to people’s health were assessed and managed. Staff knew how to identify and report abuse. The registered manager and provider ensured people received care delivered in a kind and compassionate manner. The registered ensured staff were supported to undertake their roles. Sufficient numbers of staff were deployed to deliver care and meet people’s needs. People and their relatives felt the service was managed well. Audits were carried out and action taken to make improvements to the quality of care provided.
We were assured the provider was following national guidance on good infection prevention and control protocols in relation to the COVID-19 pandemic. Measures were in place to mitigate risks in relation to COVID-19 pandemic and protect people from the risk of acquiring infections. Staff were trained and followed guidance to respond to Covid-19 and other infection outbreaks effectively. Sufficient Personal Protective Equipment was made available to staff who used it appropriately. Visitors underwent COVID-19 checks to minimise the risk of spreading of infection.
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 12 February 2020) and there were two breaches of regulation in relation to dignity and care and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection enough improvement had been made and the provider was not in breach of regulation in relation to dignity and care and governance. The service is now rated good.
This report only covers our findings in relation to the key questions; Is the service safe, caring and well-led.
Why we inspected
This was a planned inspection based on the previous rating and the breaches found at the last inspection. A decision was made for us to inspect and examine improvements against the breaches. As a result, we undertook a focused inspection to review the key questions of Safe, Caring and Well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for the key questions of effective and responsive were used in calculating the overall rating at this inspection.
We also 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 until we return to visit as per our inspection strategy. If we receive any concerning information we may inspect sooner.