Brunswick House Nursing Home

Updated 10 March 2023

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 Health and Social Care Act 2008.

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

One inspector and 2 Expert by Experience carried out this inspection. 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

Brunswick House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brunswick House] is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The newly appointed home manager was completing their application to us to become the service’s registered manager.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

On-site we spoke with 10 people who used the service and 2 relatives to gain their view of the services provided. We spoke with 9 staff which included; the manager, deputy manager, a nurse, a team leader, the housekeeping and services manager, head cook, maintenance person and a housekeeper. We spoke with the provider’s representative, the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 2 visiting health professionals, one of whom visits the care home regularly. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. Off-site we spoke with a further 9 relatives (by telephone) to gain their view of the services provided.

We reviewed 6 people’s care records including a selection of medicine records and records related to the Mental Capacity Act. We reviewed 3 staffs’ recruitment records, the staff supervision program and service’s training record. We reviewed cleaning records. We also reviewed records related to the management of the service, which included, audits.

Updated 10 March 2023

About the service

Brunswick House is a residential care home providing personal and nursing care to a maximum of 46 people. The service provides support to older people, some of whom live with dementia. At the time of our inspection there were 41 people using the service. People are accommodated in one adapted building which has been extended.

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

We found the improvements required following our last inspection had been made. The provider had effective quality monitoring processes in place and the management of people’s care records had improved.

Prior to our inspection the registered manager had left and the deputy manager was now the new manager. They had been in this role for 6 weeks. They had been involved in the improvement program so were well informed about what now needed to be sustained.

People were aware of the change in management but were not concerned by it. They told us they already knew the new home manager, who they described as “friendly” and “approachable”. Staff felt supported and valued by the senior staff and were working with them, as one team, to provide people with the services they required. The new home manager had a clear vision for the service and had the support of the provider’s representative to achieve this.

People told us they felt safe because the staff were caring, friendly and always available to help them when needed. We found, there were enough staff to meet people’s care needs and to respond to them when needed to ensure their safety. People’s medicines were managed safely. People told us the home was kept clean and we found effective cleaning and infection, prevention and control arrangements in place. Safety checks and servicing arrangements ensured the ongoing safety and effectiveness of the building, equipment, all utilities and emergency systems.

People told us their health needs were met and they had access to the health professionals when needed. We spoke with two health care professionals who confirmed staff worked well with them to support and maintain people’s health. People’s care records provided clear information about their needs and how these should be supported. Staff were provided with training and support to meet these needs effectively. People told us their consent was sought and they were able to make independent decisions about their care and treatment. People’s nutritional needs were assessed and met. People told us staff were aware of and met their personal choices and cultural preferences regarding food and drink. Changes were made to people’s environment, their equipment and the care delivered to them as their needs altered.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 3 November 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was planned to see if the provider had met their action plan regarding the actions, they told us they would take to improve. We had also received concerns in relation to staff availability, staff culture and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found no evidence during this inspection that people were at risk of harm from these concerns.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection these were inspected, to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brunswick House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.