CQC report explained · a nursing home
What the CQC found at Burton, Bridge and Trent Court Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, and staff understood identified risks. Inspectors found some risk assessments, medicines records and staff health checks needed further development.
- Effective?
- Good
- Staff had the skills and support to meet people's needs, and worked with healthcare professionals. Assessments could be improved, and the provider was working to improve access to some specialist support.
- Caring?
- Good
- Staff were kind, respectful and attentive. They promoted people's privacy, dignity, independence and everyday choices.
- Responsive?
- Good
- Staff knew people well and responded to their needs and preferences. Care plans needed more detail, and do-not-attempt-resuscitation records and end-of-life planning needed improvement.
- Well-led?
- Good
- The provider and manager were open about the work needed and had an improvement plan. Quality checks were developing, but records did not always show people's involvement in their care.
What inspectors found, June 2019
Rated Good; inspectors found kind, safe care, but some records, medicines information and end-of-life decisions needed improvement.
Inspectors visited on 2 and 3 May 2019. The first day was unannounced and the second was announced. They spoke with people, relatives, staff and health professionals, observed care, and checked care, medicines, recruitment and management records.
People said they felt safe and received help promptly. Inspectors saw staff treating people with kindness, respect and compassion. Staff knew people's needs and supported their choices, meals, activities and healthcare.
The main weaknesses were in record keeping. Some care plans did not clearly show people's needs or involvement. Medicines records had some gaps, and some do-not-attempt-resuscitation decisions did not show the required involvement or best-interests process. The buildings also needed refurbishment, with a slight odour in some areas.
The home was rated Good in all five areas and overall. This was an improvement from Requires Improvement at the previous inspection, published on 18 May 2018. The provider had an improvement plan and work was under way.
Kind and respectful care
Inspectors saw staff treating people with kindness, dignity and respect. Staff supported independence and took time to explain choices.
“We saw staff were friendly, polite, respectful and attentive towards the needs of the individuals throughout our inspection” from the report
People felt safe
People and relatives said they felt safe. Staff understood abuse risks and knew how to report safeguarding concerns.
“People were protected from potential abuse and avoidable harm as the provider and staff understood what different types of abuse could be” from the report
Prompt, personalised support
People received help when they needed it, and staff used their knowledge of people's likes, dislikes and needs when providing care.
“People and relatives told us they had a positive experience in respect of the care and support they received.” from the report
Improvement work
The provider recognised the home's weaknesses and had a formal plan to improve care records, staffing expertise and the buildings.
“The provider was very clear with us the service needed to improve but had identified what most of these improvements were” from the report
Care records lacked detail
needs fixingSome care plans did not clearly explain people's main and other needs, or show their involvement in planning care. The provider had started work on new care plan formats.
“Some people's records needed improvement to reflect people's involvement and how the person-centred care we saw was planned.” from the report
Do-not-attempt-resuscitation decisions
needs fixingSome records did not show that the person or appropriate people had been involved, or that a formal best-interests process had taken place. The home was told concerns about the process should be reported to the appropriate authority.
“Where these had identified a person did not have capacity there was no evidence of a formal MCA or Best Interests Meeting about this decision” from the report
Building condition
minorSome parts of the buildings had maintenance and cleaning difficulties, including a slight underlying odour. Refurbishment and deep cleaning were planned.
“We saw staff worked hard to maintain cleanliness, although there was a slight underlying odour in some parts of the buildings at times.” from the report
- 01Have all care plans been rewritten so they clearly show each person's main and other needs, preferences and involvement?
- 02How do you now make sure medicines given when needed, including creams, are recorded correctly?
- 03Have do-not-attempt-resuscitation decisions been reviewed to show the person's involvement, relatives' views where appropriate, and any best-interests decision?
- 04What refurbishment has been completed since the inspection, and are there still any odours or maintenance problems in the building where my relative would live?
- 05How are you making sure information from hospitals is received promptly when people return to the home?
This was a scheduled inspection covering all five CQC questions and the overall rating; Bridge Court was unoccupied, while 43 people lived in Burton and Trent Court. This explanation was written from the published report of 19 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Burton, Bridge and Trent Court Care Centre was rated Requires Improvement in every area, with staffing, dignity, activities and food needing attention.
This was the first inspection since the provider registered the home. Inspectors visited unannounced on 23 and 26 March 2018. They spoke with people, visitors and staff, observed care, checked care records and reviewed recruitment and quality checks.
The home was not consistently safe, effective, caring, responsive or well-led. Staff were not always available quickly enough, some people lacked clear guidance to prevent distressing behaviour, and meals were sometimes cold or did not suit people's preferences.
Inspectors also found that dignity was not always maintained and that activities and social opportunities were limited. Quality monitoring systems were still being developed, although the provider had identified the problems and was taking action.
The report says no regulations were breached. However, all five key questions and the overall service were rated Requires Improvement, meaning the home was not consistently meeting people's needs at the time of the inspection.
Medicines were managed safely
Inspectors found medicines were stored, administered and recorded safely. Staff had training and checks, including guidance for medicines given when needed.
“People were supported to receive their medicines safely and we saw the support people received at the lunch time meal.” from the report
Health needs were monitored
Staff worked with doctors, nurses and other health professionals. Records showed ongoing monitoring and referrals for needs such as diabetes and nutrition.
“Records showed the registered manager and staff team worked with healthcare professionals to enable people to access health care services, to maintain their health and well-being.” from the report
Kind interactions
Although dignity needed improvement, inspectors saw many respectful and caring conversations. Staff used people's preferred communication methods and encouraged independence.
“On the whole we observed staff spoke to people in a caring and respectful way.” from the report
Families were involved
People and their representatives helped develop and review care plans. The home also supported complaints and maintained people's family and community relationships.
“People and their representatives confirmed they were consulted and involved in their care planning and reviews.” from the report
Not enough staff at times
seriousStaffing levels did not always allow people to receive help promptly. Inspectors saw people waiting for help with meals and one person becoming distressed while waiting for two staff to support them.
“The numbers of staff available did not always ensure people's needs were met in a timely way.” from the report
Behaviour support plans were missing
needs fixingSome people who could become distressed or pose a risk did not have clear positive behaviour support plans. This meant staff did not always have guidance to prevent situations escalating.
“However no positive behaviour support plans were in place to guide staff on how to support a person to reduce these behaviours from occurring.” from the report
Food was not always suitable
needs fixingSome people disliked the meals and five people said their lunch was cold. The meal service was still being trialled and reviewed.
“On the first day of our inspection five people ate lunch in the dining room at Burton Court. All stated that the food was cold.” from the report
Dignity needed more attention
needs fixingSome people were not helped to change clothes after meals and some fingernails had not been cleaned. Inspectors also heard one instance of punitive language being used.
“We observed that several people had soiled their clothing with food following meals and people were not always supported to change their clothes, to ensure their dignity was maintained.” from the report
Quality checks were still developing
needs fixingThe provider had introduced audits and improvement plans, but the systems were not fully embedded and most actions remained in progress.
“The majority of actions at the time of the inspection remained 'in progress'.” from the report
- 01How many staff are now allocated to each unit at mealtimes and when people need two staff for personal care?
- 02Does every person who may become distressed or pose a risk now have an up-to-date positive behaviour support plan?
- 03What checks now ensure meals are served at a suitable temperature and match each person's preferences?
- 04How do staff check that people's dignity, clothing and personal cleanliness are maintained after meals?
- 05What activities are now available on each unit, and how often can people take part in activities they choose?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 18 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Burton, Bridge and Trent Court Care Centre
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Burton, Bridge and Trent Court Care Centre →
- May 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Burton, Bridge and Trent Court Care Centre →
- June 2017
Registered with the Care Quality Commission on 30 June 2017.
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