We carried out a review of the data available to us about Buckfield House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Buckfield House, you can give feedback on this service.
About the service
Buckfield House accommodates six people in one adapted building over three floors. People have access to a large lounge, snug, dining room and kitchen along with freely available access to a large garden. At the time of the inspection five people were living at the home.
People’s experience of using this service and what we found
Right Support
The staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
The provider gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
People had a choice about their living environment and were able to personalise their rooms. People benefitted from the interactive and stimulating environment.
Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. Staff enabled people to access specialist health and social care support in the community.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs .People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their treatment/care and support because staff had the necessary skills to understand them.
People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
The registered manager was in the process of recruiting new permanent staff, in order to support people with consistent care from staff. Staff placed people’s wishes, needs and rights at the heart of everything they did.
People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The provider enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.
Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
Since our last inspection there had been a change of ownership of the home, so we undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Buckfield House is a residential care home providing personal to six people who may have a learning disability and/or autism.
Buckfield House accommodates six people in one adapted building over three floors. People have access to a large lounge, snug, dining room and kitchen along with freely available access to a large garden.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People’s experience of using this service and what we found
People looked relaxed and comfortable in their home environment. Relatives felt their family member was safe from harm. Staff had a good understanding of how they protected people from harm and recognised different types of abuse and how to report it.
Potential risks to people had been identified and staff had consistent knowledge in how to reduce the risk of harm. There were enough staff on duty to keep people safe and meet their needs. People’s medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.
People’s care continued to be assessed and reviewed with the person and their family member involved throughout. People were supported to have a healthy balanced diet which reflected their individual dietary requirements. Where able, people were supported to prepare their own meals and drinks. Staff engaged and worked well with external health and social care professionals and followed their guidance and advice about how to support people following best practice.
Staff cared for people in a kind and considerate manner. People were treated with respect and their dignity and privacy was maintained. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened to and acted upon.
People’s care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported and encouraged to maintain their hobbies and interests. People and relatives had access to information about how to raise a complaint.
The registered managers were visible in the home and listened and responded to those who lived in the home and the staff who worked there. The culture of the service was open and transparent. People, relatives and staff were listened to and had the opportunity to raise their suggestions and ideas about how the service was run. Staff worked well as a team and were supported by the provider to carry out their roles and responsibilities effectively, through training and regular contact with the registered managers and providers. The checks made by the management team ensured the service was meeting people’s needs and focused upon people’s experiences.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was Good. The last report was published 13 June 2017.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There were two registered managers in post at the time of our inspection. 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.
People were supported to maintain some independence and to take positive risks. Staff knew how to recognise and report any concerns about people’s safety. Staff understood risks associated with people’s needs and how to keep them safe. There were enough staff on duty to respond to people’s health needs at the times when they needed support. The provider completed checks to ensure staff were suitable and safe to work at the home.
People had good relationships with the staff. It was a relaxed atmosphere with staff spending quality time with people. People were treated with kindness, compassion, dignity and respect. People received care and support to meet their diverse needs including people who had complex health needs.
People’s health needs were responded to effectively with people being supported to access doctors and other health professionals when required. People had daily access to health professionals like speech and language therapists, occupational therapists and doctors. People were supported to have their medicines when needed. Medicines were stored and administered appropriately.
People had access to a varied diet of food and drink. People were supported to have their food and drink safely. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon by staff.
Staff understood people’s individual communication styles and were able to communicate effectively with people. People’s permission was sought before any care or support was given. Time was taken to make sure that people could make choices and decisions about the care and support they received.
People were supported by staff that had the knowledge and skills to understand and meet their health needs. Staff were well supported and had access to additional training specific to people’s needs. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance.
Relatives and staff views on the care and support provided was gathered on a regular basis. The registered managers were approachable and willing to listen to views and opinions. A range of audits and checks were completed regularly to ensure that good standards were maintained.
This was an unannounced inspection on 14 October 2014. The home provides accommodation for up to five people who have a learning disability. There were five people living at the home when we visited and there was a registered manager in post. 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’.
At the previous inspection no improvements were identified as being necessary.
People were not able to talk with us about their care and treatment due to their communication needs. We observed how people interacted with staff. We saw that people were comfortable and confident when they did so. Staff showed they understood people’s needs and preferences and could talk to us about each person in detail.
Staff were able to tell us about how they kept people safe. During our inspection we observed that staff were available to meet people’s care and social needs.
We saw that people’s privacy and dignity were respected. We saw that the care provided took into account people’s preferences as well as their relative’s suggestions. The provider had taken guidance and advice from other professionals such as social workers.
The provider acted in accordance with the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the care or treatment they receive. At the time of our inspection one person was being assessed for DoLS.
We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to healthcare professionals such as doctor and dentists .
People were supported to eat and drink enough to keep them healthy. They had access to snacks and drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.
Staff were provided with training that reflected the care needs of people who lived at the home. Staff told us that they would raise concerns with the registered manager and were confident that any concerns were dealt with appropriately.
The provider had taken steps to assess and monitor the home which took account of people’s preferences and the views of relatives and other professionals. These had been used to make changes that benefitted the people living at the home.
As we watched we saw the staff were very attentive towards them. We saw that the staff always asked them how they would like things to be done, were always mindful of their privacy and treated them with respect. We saw that staff talked with them as they provided their support.
Staff told us that they felt able to raise any issues with the manager or senior staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.
We saw staff were always available when people needed help.
The provider had developed a system whereby they can monitor how well the home is meeting the needs of the people who live there.
We observed positive staff interaction with people who used the service during and after a mealtime. Staff supported people to make choices. People could do things when they wanted to. People ate well and their preferences were catered for. Privacy and dignity was respected. Five young adults led active lives, with suitable exercise, stimulation and personal development. Staff intervened gently when necessary to make sure people were safe.
We looked at care and health records about two people, medication records for other people, records about staff and the running of the home. We spoke with four staff, the manager and a provider manager.
Best interest decisions about care and treatment were made with relatives and other professionals. People had health checks and usually had their prescribed medication. The manager took steps during the inspection to improve the safety of the medication system. The home was clean and good hygiene standards protected people from infections.
Staff had advice from company specialists to provide a consistent approach to managing behaviour, health and safety. There were effective systems in place to investigate and learn from incidents and complaints.
We did the visit to check what improvements had been made in the six areas outlined and found that the home was more organised and that the support and care to people living there had improved. The health and safety manager came to the home to represent the management team because the manager was on leave. He told us that they had learned a great deal from the problems that occurred in 2010 when they opened.
We were not able to have conversations with the people who live at the service due to their communication needs. We watched how they spent their day, how they were dressed and how the support workers were with them and how they responded. This showed us that the people living there were supported well by a team who knew them well and understood their needs. We saw examples of good practice where individual support workers showed respect and warmth for the people they were supporting. We observed that the people living at Buckfield House had been helped to dress well in clothes suitable for their age group and had modern haircuts. All of them went out during the day to various activities and whether they were at home or out they had enough staff with them to provide safe levels of support.
Relatives we spoke to were pleased with the care and support at the service. One of them told us that their son's health had improved due to having an improved diet and a more active lifestyle. Another parent said that they thought their son's care had improved and were pleased with the good communication with his keyworker.
Professionals we spoke to told us that they consider the service to be safe and providing good care.
We found that medication was being managed safely. One family had questioned the use of medication for their son but family was pleased that their son was able to stop taking any medicines since moving to Buckfield House.
During 2010 some people at the home experienced poor outcomes because their care was not effectively managed and the provider was not paying enough attention to things at the home. One person had serious health problems because of this. We found that the providers still need to make improvements so staff have all the information they need to give the right care and support. We also found that the provider could support staff more and help them develop consistent approaches by making supervision and team meetings more regular.
The families who gave us information were happy with the house and felt it was pleasant and suitable for their relatives but they would like to see more work done to develop the outside space. The provider is being quicker to make changes to the building when people's needs change.
We found some concerns about the skills, experience and age mix of the care workers. We consider that this has sometimes affected what people living at Buckfield House experienced. Families had noticed this too; for example a family commented on staff turnover, lack of experience of some staff and poor communication on some occasions. They said staff are now 'trained, friendly, enthusiastic and dedicated'. They said that for the most part their son has seemed happy and well cared for. Another family were also positive about the care workers and told us that their son's key worker is 'fantastic' and that they have 100% confidence in the directors of Inspiration Care Ltd. One relative told us they had needed to raise a concern about some staffing and communication issues but that this had been dealt with well by the provider.
Families and staff we spoke to as part of this review gave a positive overall view that the provider is making improvements. Some people said they had always been happy with the service.
The provider gave us information showing that they are doing things to improve the service and are now checking what is happening at Buckfield House in a more thorough and organised way.