Archived: Burlington Care and Support Services

Updated 5 October 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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of one adult social care inspector, a medicines inspector and an Expert by Experience who had consent to phone and gain feedback on the care provided by the service from people’s relatives. 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

Burlington House 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.

Registered Manager

The registered provider is also the manager. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection took place on the 28 April, 05 and 10 May 2022, the first day was unannounced

What we did before the inspection

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 information gathered as part of monitoring activity that took place on 22 March 2022 to help plan the inspection and inform our judgements. We reviewed the information we held about the service, including notifications we had received. Notifications are changes, events or incidents the provider is legally required to tell us about within required timescales. We sought feedback from the local authority. We used this information to plan the inspection.

During the inspection

We spent time with and spoke with seven people living at the service, six relatives, four members of staff, two assistant managers and the registered provider / owner of Burlington Care and Support Services. To help us assess and understand how people's care needs were being met we reviewed six people's care records. We also reviewed a number of records relating to the running of the service. These included staff recruitment and training records, medicine records and records associated with the provider's quality assurance systems.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, policies and procedures and we spoke with a representative from Torbay Council's Quality Assurance and Improvement Team (QAIT).

Updated 5 October 2022

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 guidance CQC follows to make assessments and judgements about services supporting people with a learning disability or autistic people.

About the service

Burlington Care and Support Services, referred to as Burlington House, is a residential care home that provides personal care and support for up to 13 people with a learning disability. At the time of the inspection there were 10 people living at the service. Accommodation is provided over two floors within two separate but adjoining buildings.

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

People told us they felt safe, they liked living at Burlington House and most relatives we spoke with did not raise any concerns about the care their loved ones received.

We found the service was not operating in accordance with the regulation and was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture and best practice guidance. This meant people were at risk of not receiving the care and support that promoted their wellbeing and protected them from harm.

Right support:

People were not always supported to have maximum choice and control of their lives and staff were not supporting people in the least restrictive way possible and in their best interests. People were not involved in a meaningful way in the development of their care and support and information was not always provided in a way which met people's individual communication needs

Right care:

Care was not always provided in a person-centred way which promoted people’s dignity, privacy or human rights. People’s care and support plans were not always reflective of their range of needs, supported their aspirations, or promoted their wellbeing and enjoyment of life.

Right culture: The ethos, values and attitudes of managers did not always ensure people using the services were enabled to lead confident, inclusive and empowered lives. Staff understood their role in making sure that people were always put first, but care and support was not always tailored to their individual needs and preferences.

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 14 December 2019). Following that inspection, the provider was asked to complete an action plan to show what they would do and by when the improvements would be made. At this inspection we found the provider remained in breach of regulations and has been rated requires improvement for the last four consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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.

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 Care and Support Services 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 will continue to monitor the service and will take further action if needed.

We have identified breaches in regulation in relation to safe care and treatment, recruitment, staffing, the need for consent, dignity and respect, person centred care, notifications of other incidents and governance.

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

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We will meet with the provider following this report being published and work with the 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.