Bafford House

The service accommodates people over 3 floors in one adapted building. Some bedrooms have en-suite toilet and washing facilities. People had access to a lounge on the ground floor, a dining room on the lower ground floor and a large garden. A lift enabled wheelchair access to all floors.

Right Care: While there had been improvements since our last inspection, we found people living at Bafford House were not always protected from risks related to the premises, potential risks from others, or risks related to choking. Staff had received training in some key areas including fire, infection control, first aid, moving and handling and dementia awareness. However, gaps in staff training and support remained which may adversely impact the safety and quality of care people receive.

Further improvement was needed to ensure the safety and quality of the service met expected standards.

People's medicines, incidents and behaviours were reviewed with health and social care professionals to ensure any restrictions were in people's best interests and people's care and treatment remained appropriate. People's ongoing physical needs such as chiropody, optical and dental care were met. Advice was sought from health care professionals to ensure people's more complex needs were met. Professionals told us their advice was followed.

Right Support: People living at Bafford House had choices about how they spent their day, and while they were encouraged to spend time with others, to eat and socialise, their wish to be alone was respected. 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.

Several people had asked to go out, to the shop, library, hairdresser and bank, and these requests were met. However, wider opportunities for people to follow their interests and participate in meaningful activities

were very limited, as there was no dedicated staff time for meeting people's social and mental stimulation needs. Activities requiring little planning, such as ball games, skittles, arts and crafts and singing, were provided. Staff, relatives and professionals expressed concern about the impact this may have on people living with dementia or a learning disability.

Right Culture: People told us they liked living at Bafford House and felt safe there, some people described staff as friends. A relative said, "It is a very loving and caring place." The provider and deputy manager spent a lot of time in the service and were well known to people, relatives, staff and professionals. The provider worked openly and cooperatively with others and people were involved in key decisions that affected them, for example, discussions about end of life, or moving rooms.

The provider had employed a cook, cleaner and housekeeper since our last inspection and this had a positive impact on people and staff. The provider had also employed an external consultant, worked with the local authority medicines team and NHS infection prevention and control team to improve the service. They had taken initial steps to improve internal monitoring and oversight of the service, however, these systems were not yet effective in identifying and addressing shortfalls.