The Borrins Care Home

Updated 1 February 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. 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

The inspection was carried out by two inspectors, a medicines inspector and an 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 Borrins 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

We announced the inspection from the car park shortly before going on site. This was because we needed to check the arrangements in place for preventing and containing transmission of COVID-19 prior to entering the building. Inspection activity started on 23 November 2021 and ended on 9 December 2021. We visited the service on 23 November 2021. The other dates were spent reviewing information off site and making phone calls to people, relatives and staff.

What we did before the inspection

We reviewed information we had received about the service and we sought feedback from the local authority commissioners, safeguarding team and Health-watch. Health-watch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided and 11 relatives remotely via phone calls. We spoke with seven members of staff including the registered manager, deputy manager, wellness champion and care staff. We also spoke with one professional who was onsite during the inspection. While on site we spent time with people in the communal areas observing the care and support provided by staff.

We reviewed a range of records. This included four people's care records, inclusive of risk assessments, daily notes, and two people’s medicine care plans. We also reviewed multiple medication records. We looked at two staff recruitment files. A variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 1 February 2022

About the service

The Borrins is a 30 bedded residential care home for older people and people with physical disabilities. At the time of our inspection there were 23 people using the service on both permanent and a respite basis.

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

Medications were not always managed safely. Charts and documents were not in place for creams, and there were no ‘as and when’ required (PRN) protocols in place.

Audits had been completed by the registered manager and the provider; however these audit systems were not effective at identifying the issues found on inspection in relation to medication management and care plan accuracy.

The registered manager and provider were responsive to the inspection findings. They acted during and after the inspection and shared plans to improve their systems and processes.

Risks related to people's health and care needs as well as environmental risks were well managed. All areas of the premises were clean and infection control procedures were followed by staff with Personal Protective Equipment (PPE) being worn correctly and social distancing maintained.

People received person-centred care and care records were written in a person-centred way, inclusive of people’s likes, dislikes and preferences. Staff were kind, caring and compassionate and treated people well. People were treated with dignity and respect. There were activities taking place throughout the day.

Staff received an induction, training and support for their roles. However, areas of the staff training were low in completion. We therefore recommended that all staff's training is brought up to date and monitored consistently to ensure staff are not out of date with training.

Staffing levels were sufficient to meet people’s needs on the day of inspection however, there had been a rapid increase in admissions to the home, and the dependency tool calculator identified that the service was running under staff capacity. We have made a recommendation about the increase of staff in response to the recent capacity increase.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support this practice. We made a recommendation to the provider that they complete the Mental Capacity Assessment for the people that did not have them in place.

People were supported to keep in touch with family and friends through calls and indoor visits. People had access to healthcare services. People were provided with a good choice of food, drinks and snacks throughout the day.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The last rating for the service under the previous provider was requires improvement, published on 27 March 2019.

We 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.

We have found evidence that the provider needs to make improvements. Please see all the sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to using medications safely, and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.