Eston Lodge care home

Updated 4 May 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

The inspection team consisted of 1 inspector, a Pharmacist Specialist, 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

Briarwood Care Home 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. Briarwood 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.

Notice of inspection

This inspection was unannounced on the first day.

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, Healthwatch, and professionals who work with the service. Healthwatch 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 (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

We spoke with 4 people who use the service and 4 relatives. We spoke with 12 members of staff including the regional manager, care home manager, agency nurse, care staff, activity co-ordinator, housekeeping staff and catering staff.

We reviewed a range of records. This included 5 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. 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 regional manager to validate evidence found.

Updated 4 May 2023

About the service

Briarwood Care Home is a residential nursing home providing care and support to up to 49 people. The service provides support to older people and people living with a dementia. Bedrooms are situated over 2 floors. At the time of our inspection there were 21 people using the service, only accessing bedrooms the ground floor.

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

Following the previous inspection in July 2022 the provider sent us an action plan to make the necessary improvements to the service. Whilst some improvements to the service had been made, some areas were identified as needing further action.

People’s medicines were still not always managed safely. Records demonstrated medicines were not always given as prescribed.

Care plans were not person centred. They did not always contain information on how people wished to receive their care and support. Risk assessments were in place for people around risks to their health and wellbeing and there was guidance for staff around supporting people. However, there was still some inconsistency in how information was documented.

Actions had been taken to continue to improve the provider oversight, however audits had not always identified the areas for improvement evidenced during inspection.

People told us they felt safe and well cared for. We observed staff supporting people with kindness and compassion. We saw people smiling and joking with staff, appearing comfortable in their presence.

People were supported to eat enough food and drink. Staff were knowledgeable about people’s nutritional needs. People were supported to access the appropriate healthcare professionals to support their physical and emotional wellbeing.

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.

There were enough staff to meet people’s care and support needs, improvements had been made regarding the use of agency staff. Appropriate background checks and inductions were now in place and recorded.

Staff spoke positively about the management of the service and the support they received. They felt there had been some improvements since the last inspection, especially around the recruitment of permanent staff. There was a new home manager in post who, along with the regional manager, offered reassurances regarding their commitment to make the necessary improvements.

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 10 August 2022) with breaches of regulation. 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 some improvements had been made in some areas. However, the provider remained in breach of some regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last inspection, by selecting the 'all reports' link for Briarwood Care Home on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified continued breaches in relation to good governance. We continued with the recommendation around ensuring consistency and clarity within people's support plans.

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 and meet with the manager and provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.