BH Residential Care Home

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider was in breach of legal regulation in relation to medicines management, staff training and supervision and record keeping. The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. The provider did not always make sure medicines were managed safely, people received their medicines as prescribed and records were kept accurately and consistently. Although safeguarding, accident and incidents were documented, lessons were not always learnt to continually identify and embed good practice. People felt safe living at the home and in receipt of care. Systems and processes were in place to support people to transition safely and effectively into the home. Checks of the environment and equipment were completed in line with guidance to ensure people were kept safe. The home was clean with effective infection control practices in place.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to nutrition and hydration and record keeping. Systems and processes relating to nutrition and hydration were not always effective. Fluid intake requirements were not clear and food logs varied in quality and accuracy. Guidance for staff on how to ensure people’s health needs were met were not always present or clear. The provider had not always involved people in reviewing their care, to ensure it still met their needs. People told us staff sought their consent before providing care. However, consent forms in care records required improvement. Detailed assessments were completed prior to admission to ensure the home was suitable. The provider worked with staff and wider teams, such as social workers to ensure care was effective and information when people needed to be transition out of the home, for example to hospital, was up to date. People had access to medical professionals as required, with the provider ensuring referrals were submitted promptly.

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this service. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was in breach of legal regulation in relation to person centred care and the provision of activities. The provider had not sought and documented people’s showering or bathing preferences, and as a result could not evidence people’s wishes were being met. Activity provision required improving. People told us there was little to do during the day, except what they arranged for themselves. We observed very few activities during the 3 site visits we completed. Overall observations of care were positive and people said they were treated with kindness and respect. People’s rights were upheld and any protected characteristics respected. Staff enjoyed working at the home and felt supported.

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first assessment for this service. This key question has been rated requires improvement. This meant people’s needs were not always met.

The provider was in breach of legal regulation in relation to person centred care, including people’s involvement in their care and ensuring records were up to date and accurate. Although each person had a care plan, neither they or their relatives could recall being involved in its completion. Care plans viewed also contained some contradictory information, which had not been picked up during care plan reviews. Resident meetings had recently been introduced with one held to date. Surveys were also used to gather people’s views, although a better process was needed for reporting on actions taken as a result of feedback. Complaints received had not been logged or stored in the complaints file. The provider was working to ensure information was provided in formats which were tailored to individual needs. The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Well-Led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this service. This key question has been rated requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was in breach of legal regulation in relation to governance of the service. The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. Staff felt comfortable raising concerns, although information about speaking up needed to be more accessible. The home had undergone numerous managerial changes since registering with CQC, which had affected the running and oversight of the home. The current manager was experienced, and staff were complimentary about how they were settling into the home. The manager understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.