British Home & Hospital for Incurables Also known as The British Home

Ratings

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

British Home & Hospital for Incurables is a nursing home for up to 127 people with physical disability. At the time of our assessment, 78 people were living in the home. The assessment started on 12 September 2024 and ended on 21 October 2024. We conducted this assessment due to concerns we received about the management of risks and medicines within the home. We looked at 24 quality statements including learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risk, safe and effective staffing, safe environments, infection prevention and control, medicines optimisation, assessing needs, delivering evidence based treatment, how staff and services work together, supporting people to live healthier lives, consent to care and treatment, kindness, compassion and dignity, independence choice and control, person-centred care, equity in experience and outcomes, shared direction and future, capable and compassionate leaders, freedom to speak up, workforce equality, diversity and inclusion, governance, management and sustainability, partnership and communities, learning, improvement and innovation. For those areas we did not assess we used the ratings awarded at the last inspection in July 2021 to calculate the overall rating. We looked at a range of records related to the management of the service. We spoke with the director of care, the interim manager, 3 nurses, the chef, 3 nurses, 8 care assistants, and an activities coordinator. We identified breaches of 4 regulations relating to consent to care and treatment, premises and equipment, good governance and staffing. Risks were not always managed safely. Medicines were not always managed in a safe way. Risks within the environment had not been identified or managed effectively. Infection control procedures were not robust. Systems for monitoring and improving the service had not always been effective. Please see the action we have told the provider to take at the end of this report.

People's experience of this service

During the visit to the service, we spoke with 8 people who used the service and 3 visiting relatives/friends of people receiving care. We observed how people were being cared for and supported. After the visit we also made calls to 11 relatives to gather their feedback on the service provided. People using the service and their relatives gave mixed feedback about the care they received. Many people felt the standard of care from night staff and agency staff was below expectations. 1 person told us staff on duty at night had refused to give them the care they needed. We shared these concerns with the provider and they have investigated the specific allegation of neglect and taken steps to help reduce the risk of similar incidents happening again. Many people felt there were not always enough staff on duty making it difficult to find staff when they needed them. People were also concerned with the use of agency staff who did not know people’s care needs well and did not seem to have the right skills to care for people with neuro-disability. Neuro-disability refers to a group of life-long conditions that affect the functioning of the brain, leading to difficulties with mobility, cognition and communication. Notwithstanding these concerns many people spoke highly of the care they received, especially from the regular care staff and therapy team. They said they were well treated and had a good relationships with them. During the assessment we saw staff were kind, polite and caring towards people.