Burger Court

Burger Court is a residential care home. The service provides support with personal care and accommodation for up to 17 people. At the time of our inspection, there were eight people living at the home. The service was providing support to people with a range of needs, including younger and older adults with mental health needs.

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

Improvements had been made to the service. Systems and processes had been introduced for the reporting and recording of issues related to safeguarding, accidents and incidents. The management team and wider staff group fully understood their individual and collective responsibilities in this area.

The management of medicines had improved. People received their prescribed medicines when they needed them. The service worked in partnership with other professionals, and the community when able to do so.

There were enough staff available to make sure people received the personal care and support that they needed. People's needs had been assessed and assessments had been used to plan staffing levels. Staff had been recruited safely to make sure they were suitable to work with people at Burger Court.

Since our last inspection we found the provider has completed a full-service review of their training resources provided to staff. Further work was still to be completed to ensure inexperienced or new staff were provided with the care certificate, we have received assurances this will take place. The care certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.

Risks relating to infection prevention and control (IPC), including in relation to COVID-19 were assessed and managed. Staff followed good infection, prevention and control (IPC) practices. They had access to the required personal protective equipment (PPE), and they used and disposed of it safely.

The provider's quality assurance processes had improved and were effective in driving in improvements across the service. This was evident in the premises, fire safety and review of incidents and accidents to ensure people received a safe service. However, we found safety checks connected to the home's passenger lift had not been completed in the correct timeframe. Shortly after the inspection the passenger lift received the appropriate examination and measures were introduced to ensure this would not be missed in the future.

The home had a new manager in post who had worked at Burger Court for approximately three months at the time of our inspection. The feedback we received was positive regarding the changes they made since taking up the role. The current staff team spoke of a positive culture at the home, with good team work throughout.

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 inadequate (published 26 August 2020) and the home has been in special measures since this date. During this inspection the service demonstrated that improvements have been

made. The service is no longer rated as inadequate overall, or in any of the key questions. Therefore, this service is no longer in Special Measures.

At the last inspection we issued the provider Warning Notices for Regulations 9, 12, 17 and 18. 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 had met the requirements of the Warning Notices.

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

Why we inspected

A decision was made for us to inspect, examine and follow up what improvements had been made since the last inspection in March 2020. Due to the COVID-19 pandemic, we undertook a focused inspection to review the key questions of Safe, Effective, Responsive and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The rating from the previous comprehensive inspection for the Caring key question was not looked at on this occasion. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Burger Court is a residential care home providing personal care to people aged 18 and over. The service can accommodate 17 people and at the time of our inspection 12 people were using the service.

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

There were not enough staff to keep people safe and meet their needs. Risks to people’s safety and welfare were not properly identified and managed. The call system had been taken out and there was nothing in place to enable people to summon help in an emergency. The service did not have effective systems in place to protect people from the risk of abuse.

Checks were carried out on new staff, but the provider’s recruitment procedures were not followed.

People’s medicines were not managed safely, people missed medicines because they were out of stock.

People had access to support from health and social care professionals. However, no one was registered with a dentist.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People did not experience person-centred care; their needs were not properly assessed before they started using the service and care plans were not up to date.

People were not supported to take part in meaningful and appropriate activities in the home or in the local community.

Improvements had been made to the environment, but people did not have access to Wi-Fi unless they paid for it themselves.

People’s dietary needs and preferences were catered for.

There was a lack of effective leadership and staff were not properly trained and supported to carry out their roles.

The provider did not have effective systems in place to assess, monitor and improve the quality and safety of the services provided.

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 15 March 2019) and there were two breaches of regulations. The provider completed an action plan after the last inspection. At this inspection we found improvements had not been made and the provider was in breach of multiple regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified multiple breaches in relation to safe care and treatment, risks to people’s safety and welfare, medicines, staffing, training and support, safeguarding, consent to care and treatment, person-centred care, supporting people to be involved in the local community and monitoring, assessing and improving the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service 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 rating, 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.

Burger Court is a residential care home that provides nursing and personal care including respite and rehabilitation services for up to 17 people aged 18 and over. At the time of our inspection 17 people were using the service which meant the service was full.

People’s experience of using this service:

There were not always sufficient staff on duty to support people safely and for a varied range of meaningful activities to take place. Staff were not always recruited safely.

The environment was generally tired and in need of refurbishment. A refurbishment plan was in place to commence shortly. Although a cleaning schedule was in place, some communal areas had not been cleaned effectively or essential supplies maintained in toilets and bathrooms.

Medicines were generally managed safely and people’s health care needs were supported.

Staff were caring, compassionate and warm and supportive of the people who lived at the service. Staff knew people well, including likes, dislikes and care needs. People’s choices and privacy were respected. Information about people’s care and support was up to date and very person centred. However, some people’s archived information was not stored in a confidential manner.

Staff training was up to date or booked and staff told us they received good support from the registered manager. A system for regular staff supervision and annual appraisal was in place.

Staff had been trained to understand how to keep people safe and report any safeguarding concerns. Accidents and incidents were investigated and analysed for themes, trends and lessons learned. Risks to people’s safety had been assessed and reviewed and actions put in place to minimise these risks.

People were supported to live as independently as possible. Staff supported people to choose and prepare some of their own meals and encouraged people to eat healthily. Where concerns about people’s diet or weight were raised, advice was sought from healthcare professionals.

People’s views were sought about the running of the service. A complaints procedure was clearly displayed and people told us they had not needed to make any formal complaints.

A range of quality checks were in place and required actions documented. However, several actions had been ongoing for several months and we found some of the same concerns remained at our inspection.

More information is in the detailed findings below.

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around staffing, governance and the environment. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: This was the first inspection carried out since the service had registered under a new provider.

Why we inspected: This was a planned inspection following the service registration in May 2018.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.