Bletchingley

Bletchingley was registered by the Care Quality Commission (CQC) on 13 July 2017. This was the first inspection of the service. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led when registering.

Bletchingley is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection, Bletchingley accommodated 21 people. Bletchingley is registered to provide nursing care and residential care for 26 people with a range of care needs, including frailty of old age, specific health conditions and people living with dementia.

Bletchingley is a purpose-built building. The ground floor accommodated people who live at Bletchingley permanently. On the first floor the service had eight beds that were purchased by the local authority for reablement called Discharge to Assess (D2A). This programme provides people with care and rehabilitation support for up to six-weeks following discharge from hospital. The aim is to enable people to regain skills and confidence so they can return home with a package of care. The floors are accessible by a lift and stairway.

The service had a registered manager in place. The registered manager is also the manager of another service for the organisation, the other service is next door and the registered manager shared their time equally across both services. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Systems, processes and practices safeguarded people from abuse. Risks to people's safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. There were sufficient numbers of suitable staff to keep people safe and meet their needs. Background checks had been completed before care staff had been appointed. People were protected from infection and lessons had been learnt when things had gone wrong.

Suitable arrangements had been made to obtain consent to care and treatment, in line with legislation and guidance. Care and nursing staff had been guided to deliver care following current best practice guidance. People had sufficient to eat and drink to maintain a balanced diet. People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. People benefited from living in purpose-built accommodation that had been adapted and

designed in a way that met their needs.

People were treated with kindness, respect and compassion by staff that knew them well. We observed that staff were caring, patient and gave time for supportive interactions. A person told us "It's like a holiday camp, it's first class." Another person told us, "I'm really impressed. The food is good and plentiful. I've met the manager and spoken with the nursing staff. I've joined in a sing-song downstairs. It's been explained how to go out into the garden."

People received personalised care that was responsive to their needs. They were also supported to express their views and be actively involved in making decisions about their care, as far as possible. Staff encouraged and promoted independence. People had maximum choice and control of their lives and staff support them in the least restrictive way possible; this practice reflected policies and systems in the home. Confidential information was kept private.

People's concerns and complaints were listened and responded to and used to improve the quality of care.

An activities coordinator had recently been recruited, to increase and vary the activities provided for people and include opportunities for them to go out into the community.

At the time of the inspection there were no people in receipt of end of life care. The registered manager had considered end of life care for people and was committed to ensuring people's rights to die in their home were upheld, if they were able to continue to meet the person's needs. Suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a positive culture in the service that was open and inclusive. People benefited from there being a management framework to ensure that staff understood their responsibilities so that risks and regulatory requirements were met. People who lived in the service, relatives and staff were asked for their feedback on the service and the provider acted on the responses to improve the quality of the service.

Checks had been completed to resolve issues identified and to innovate so that people received safe care. Staff worked well together and staff were supported to speak out if they had any concerns about people not being treated in the right way. The management team worked in partnership with other agencies and external professionals.

The five questions we ask about services and what we found