Burrswood Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The needs of people were continually assessed. Assessments fed into person-centred care plans which ensured people’s choices and preferences were identified. The provider followed best practice guidance to support people such as malnutritional risk tools. People were supported effectively with nutrition and hydration. People received support from a host of health and social care professionals. People were reviewed regularly by a GP and received emergency health support when required. The management team had a good relationship with health and social care professionals in the best interests of people living at the home. People told us staff sought their consent before providing any interventions. We observed staff obtaining consent from people prior to offering care and support. Where people did not have the capacity to consent, care and support was agreed and recorded in people’s best interests.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had been involved in assessments and the sharing of information prior to moving into the home. Relatives also confirmed this and told us they had been involved in planning the care with their relation. Relatives were confident people were receiving the correct support from staff in a person centred approach.

Staff told us they were able to review assessments and any other records prior to a person’s admission. Staff told us they sat with people to learn more about them, and this fed into care plans. There had been no admissions to the home since the last inspection and the management team were keen to reopen to admissions following the improvements across the home. An admission criterion was to be agreed. Staff were able to describe people's assessed needs and staff were prompt to report any changes in people's wellbeing.

People who were nearing the end of their life were reassessed and the district nurses were asked to support people who were on a residential placement while the nurses worked with GPs for people on a nursing placement. Where there were changes in people's cognition, care records were updated incorporating new assessed needs. For example, one person's mental health had deteriorated, and they had been reassessed for additional support and a 1-1 care worker was now in place. Staff were continually assessing people using different clinical tools. The Braden scale was being used to predict pressure ulcer risks. NEWS (National Early Warnings) scores were being used to determine the wellness of people. Falls risk assessments were being used to monitor the risk of falls. A MUST (Malnutrition universal screening tool) assessment was being used to assess those people at risk of malnutrition. Moving and handling assessments were in place.

People were being assessed following best practice guidance in relation to nutrition, hydration, and weight management. People told us they found the meals served, healthy and nutritious and told us additional snacks were available day and night. Relatives confirmed people were supported effectively with nutritional hydration. Comments included, “I have seen the food and [Name] would complain if it wasn’t good. [Name] is on a special diet, and they cater for that. A moist diet with thickener in [Names] drink.” and “My sister and I have commented about how the food looks and smells. We would like to eat it. [Name] never complains about the food. They have fish and chips Friday and there is always drinks when [Name] wants one.”

Staff were aware of who had what type of diet and if people were on a specialised diet to aid swallowing or weight management. Staff told us they had been given information on dysphagia diets and received training. Kitchen staff presented modified meals in an appeasing manner which meant the meal looked appetising to those who required a modified diet.

The staff were following best practice guidance for nutrition and hydration. Assessments were in place for all people which highlighted the support people required to remain at a healthy weight. Care records captured where people required a fortified diet and where people required a modified diet. The provider was using several best practice guidance' to ensure they were striving for good levels of care and support for people living at Burrswood Care Home. This included ensuring good oral health for adults in care homes, safeguarding adults in care homes, managing medication in care homes as well as falls risk assessing and prevention.

People and relatives told us, the transition to the care home from their home or hospital had been smooth.

Staff told us they consistently shared information about people. In handovers, daily huddles, supervision, meetings and by reading daily records. Staff felt information sharing was much more improved in the best interests of people living at the home. Nursing staff told us they had received good feedback from GPs and had a more understanding relationship of partnership working. Senior staff and nurses worked well together and were able to share or delegate tasks to ensure people received prompt care and support. Staff told us the staff teams now worked together and in collaboration with each other. Staff felt the workload was shared equitably.

The local authority safeguarding team told us the management team were now open and transparent and this had been a huge improvement, and they felt the management had been key in improving this area.

The provider had developed a plan of which assessments and care records should accompany people to hospital on a planned or emergency admission to hospital. This included care plans, medication records as well as a brief overview of the person. There had been recent feedback from a hospital following an emergency admission from the home which recorded the home had supplied valuable and informative information which had helped the hospital support the person promptly.

People told us they were able to see their GP when required. Relatives told us they were informed when their relation was reviewed by a clinician. Relatives told us, staff encouraged people to live healthier lifestyles. One relative told us, “There have been many occasions when the doctors were saying it was time for palliative care. The home put several measures in place to improve her health outcomes and [Name] is still here. If you had told me, 4 years ago, [Name] would still be here, I wouldn’t have believed it.”

Staff told us they reported any concerns with people’s health and wellbeing to the nurse, the senior or the management team. Staff recorded any concerns in daily records, and we could see prompt action had been taken. Nurses and senior staff were responsible for completing the appropriate referrals, for example to speech and language therapy or for district nursing input. Staff told us they noticed changes in people’s wellbeing as they knew them well. For example, one person had begun to deteriorate following their medicines being changed and staff were prompt to notice the changes and request a review from the prescriber.

People received regular reviews from health and social care professionals. Everyone living at the home was registered with a GP and a weekly ward round took place in person or via the telephone. This had enabled people to receive a prompt diagnosis and treatment. It also had reduced admissions to hospital. People were encouraged to regularly move to protect their skin integrity and protect their skin from becoming sore. Where people could not physically move themselves, staff assisted in repositioning each person and recorded they had done so. All reviews with health and social care professionals were fully recorded by staff members.

People told us they were able to see a GP when they needed to, and staff were responsive when they were unwell. Relatives also confirmed this.

Staff told us and we saw they routinely monitored people’s well-being and sought medical interventions when required.

The provider had linked in with a local hospice, and they had offered a 6-month end of life course to two care workers. Records showed outcomes from health professional reviews were recorded. Governance audits were regularly completed to monitor and improve the home. Where improvements were highlighted, an action plan was completed, and responsibilities were allocated to particular staff members to action.

People told us staff were respectful and gained consent before they provided any care and support.

Staff understood the importance of gaining consent and we observed consent being sought for staff to move and handle people as well as being assisted at mealtimes. For people who did not have the capacity to consent, staff delivered care and support in people's best interests and in line with the persons care plan.

Most people had family involved in their care. Advocacy services could be contacted for anyone who did not have a representative. Policies were in place for The Mental Capacity Act and Deprivations of Liberty Safeguards processes, in relation to delivering personal care and support. These policies unpinned the practices staff should use and staff were aware of the processes. Where people did not understand the care and treatment they required, a capacity assessment was completed and a referral was made to deprive the person of their liberty. Care records reflected care and support should be given in people's best interests. Where relatives held power or attorney, this was captured in people's care records and relatives had been involved with the care planning.