Buckingham Care Home

The provider was finding it difficult to recruit staff to work at the service. This had led to a large number of staff vacancies. The provider had therefore used agency staff and had sponsored oversees workers. This had created a training and development need and the skills mix of the staff team was not always meeting the needs of people using the service. A large number of incidents had been reported to the local authority in January 2024. Action had been taken to mitigate future risks such as liaison with professionals such as the falls team. Some care records required further information to ensure they directed staff to meet people's needs. This was shared with the registered manager. The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person. The provider had systems in place to record and analyse accidents and incidents. People were supported to receive their medicines safely. People were protected as much as possible from the risk of infection because premises and equipment were kept clean and hygienic. The premises were well maintained and a range of detailed environmental checks were in place. Equipment checks were undertaken to support the delivery of safe care. Systems were in place to share information with professionals involved in people’s care to help ensure they received effective care and treatment.

People’s care plans reflected their physical, mental, emotional and social needs. This included any protected characteristics under the Equality Act 2010. Relatives told us they were actively involved in their family member's care planning. Where people were assessed as lacking capacity to make a particular decision, the provider followed best interest processes to protect people's rights. People had been referred to other health professionals as required such as the district nursing service. However, the newly appointed staff formed the majority of the staffing compliment and they needed guidance and support to ensure they followed the directions from health care professionals. The service used a system known locally as ‘right care’ for referring people to appropriate health care professionals. The registered manager told us the system was operated well and response times were good. The service had systems in place to monitor people’s individual wellbeing. However, the staffing situation at the service showed there was a risk people may not receive care and support that was evidence based and in line with good practice standards.

People and their relatives were actively involved in developing their care plans. People’s care plans contained information about the type of decisions they were able to make and how best to support them to make these decisions. The issue regarding the staffing compliment was affecting most areas of the service. However, people were given an option of meals and we heard some staff ask people where they would like to spend their day. People’s family and friends were free to visit when they wished. We received positive feedback about the activities provided at the service which supported people’s health and wellbeing. Some people expressed the wish to have more activities in the local community or trips. There was a range of equipment available to support and maximise people’s independence and outcomes from care and treatment.

The service complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes. People’s care records contained current information about their social, cultural and spiritual needs and what activities they liked. The provider actively sought out the views of people and relatives to continuously improve the service.

The management team were clear about their roles and responsibilities and had an understanding of quality assurance. They had identified concerns about the staff compliment and put a plan in place to upskill the staff team. The registered manager and deputy manager would be working alongside staff to identify any concerns with the support from the regional manager. This would be a mixture of hours covering all 24 hours to gain insight of the whole staff team. The manager’s priority would be upskilling the staff team and providing staff with development plans.

The registered manager actively sought peoples and their relative’s views by holding regular meetings and audits at the service. Most relatives felt the service was managed well and were kept fully informed. A few staff felt their concerns had not been acknowledged by the management team.