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.
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 team consisted of one inspector and an inspection manager.
Service and service type
Burlington 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. We sought feedback from the local authority and professionals who work with the service. 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. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service about their experience of the care provided. We spoke with three members of staff on site including the registered manager and a registered nurse. We spent time observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke to six more staff members and three relatives. We sought feedback from three professionals who regularly visit the service.
Updated
25 August 2021
About the service
Burlington Nursing Home is a nursing home providing personal and nursing care to people aged 65 and over. The service supports people who may be living with dementia or need support with their physical health. The service can support up to 40 people and 32 were living there at the time of inspection.
People’s experience of using this service and what we found
Staff were not always recruited in a safe way and assurances of their character was not always sought before they started employment. This was discussed with the registered manager who took immediate steps to address the concern.
Systems were in place to monitor quality of the service and drive improvement when needed. These were not robust enough in terms of recruitment, to monitor and ensure appropriate checks were complete.
The registered manager had oversight of matters within the service and took action to address concerns should they arise. We saw evidence of staff working in partnership with external agencies to ensure people’s needs were met.
People told us they felt safe at Burlington Nursing Home. We found effective systems in place to safeguard people from the risks associated with abuse. Risk had been assessed and was managed appropriately. People’s medicines were managed safely. Staff were suitably trained to meet people’s needs.
People and their relatives spoke positively about care staff within the home. They were supported to give feedback on the care at the service. One relative said, “I can always speak to the manager or deputy if I need to. It’s the right place for my [relative], he is well looked after.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 15 October 2019).
Why we inspected
This inspection was prompted by concerns received in relation to the standard of care people received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 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 those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. Whilst we did not find any evidence to confirm the concerns we received, we did find evidence that the provider needed to make improvement to their recruitment process. Please see the ‘safe’ section of this full report. You can see what action we have asked the provider to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Burlington Nursing Home on our website at www.cqc.org.uk.
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 have identified a breach in relation to the recruitment of staff, this is a breach of regulation 19(1) (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and in relation to good governance, regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.. Please see the action we have told the provider to take at the end of this report.
Follow up
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.