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Inspection Summary


Overall summary & rating

Good

Updated 8 February 2018

This inspection took place on 23 November 2017 and was unannounced. At the last inspection carried out on 14 September 2015 we found that the provider was meeting all of the legal requirements set out by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and those associated with their registration and was rated as ‘Good’. At this inspection, we found that the provider continued to provide a good standard of care to people, but there were some areas that required improvements.

Bloomsbury House 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. The care home is registered to provide accommodation and personal care to up to 24 people. The home provides care for older people, including those living with dementia. At the time of our inspection we were told that there were 21 people living at the home.

Bloomsbury House is required to have 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’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. At the time of this inspection a registered manager was in post. People knew who the registered manager was and felt able to speak with them to raise any comments or concerns they had.

There were some systems in place to monitor the quality of the service; however we found that some improvements were required to the oversight and management of the service. This included the need for continuous development, in accordance with evidence based practice, particularly relating to specialist dementia care.

We found that people were protected from the risk of abuse and avoidable harm because safeguarding systems and processes were in place and implemented effectively. People were supported by sufficient numbers of staff who had the knowledge and the skills they required to care for people safely and effectively.

People were also protected against any risks associated with their health and care needs because risk assessments and associated care plans were developed holistically, reviewed and monitored. This ensured that people received the support they required to remain safe. People and their relatives were involved in this process alongside any key professionals and care staff. This ensured that care was person-centred and any decisions made in respect of their care and support needs, were done so within their best interests and in accordance with the Mental Capacity Act 2005. Where people were assessed to lack the capacity to consent to the support they received, the provider had followed key processes to ensure that care was provided in the least restrictive ways possible. Applications had been made to safeguard people against the unlawful deprivation of their liberty, where necessary. People’s privacy, dignity and independence were respected at all times.

The premises and equipment were well maintained and clean but would benefit from being adapted to ensure people were supported to remain as independent as possible, particularly those living with dementia.

People received support from staff to take their prescribed medicines as and when required. Systems and processes were in place to ensure medicines were managed safely and only senior members of staff who had undergone specific training and supervision were permitted to administer medicines within the home.

People were supported to maintain a healthy diet and all health needs were met with the support from staff. It was evident that people had developed positive relationships with staff and there was a friendly, calm, relaxed atmosphere within the home. Staff knew people’s likes, dislikes and preferences well and the deployment of an activity co-coordinator meant that people had the opportunity to engage in activity. However, improvements were required to ensure that activities were age-appropriate and relevant to people’s hobbies and interests.

Systems and processes in place to monitor the safety and quality of the service included the involvement of people and relatives. The provider ensured that information was available in different formats to meet the needs of people and promoted their involvement in providing feedback on the care and support they received. Everyone we spoke with knew how to complain and were confident that any concerns they rose would be dealt with efficiently and effectively. Staff were complimentary of the leadership and management style of the registered manager and provider; they found them to be supportive and approachable with an ‘open-door’ policy.

Inspection areas

Safe

Good

Updated 8 February 2018

The service was safe.

People were supported by enough members of staff, who had been safely recruited, to ensure that they were kept safe and their needs were met.

People were protected from the risk of abuse and avoidable harm because staff were aware of the processes they needed to follow.

People received their prescribed medicines as required.

Effective

Good

Updated 8 February 2018

The service was effective.

People received care and support with their consent, where possible and people’s rights were protected because key processes had been followed to ensure that people were not unlawfully restricted.

People received care from staff who had received training and had the knowledge and skills they required to do their job effectively.

People’s nutritional needs were assessed and they had food that they enjoyed.

People were supported to maintain good health because they had access to other health and social care professionals when necessary.

Caring

Good

Updated 8 February 2018

The service was caring.

People were supported by staff who were kind, respectful and caring.

People received the care they wanted based on their personal preferences, likes and dislikes because staff spent time getting to know people.

People were cared for by staff who protected their privacy and dignity.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives including the care and support that was provided to them, as far as reasonably possible.

Responsive

Good

Updated 8 February 2018

The service was responsive.

People felt involved in the planning and review of their care because staff communicated with them in ways they could understand.

People were supported to maintain positive relationships with their friends and relatives.

People were encouraged to offer feedback on the quality of the service and knew how to complain.

People were encouraged and supported to engage in activities but these were not always considered age appropriate or tailored to people’s interests.

Well-led

Requires improvement

Updated 8 February 2018

The service was not always well-led.

The registered manager or provider had not always ensured that they had kept up to date with their knowledge and skills to ensure that the service was continuously developing in accordance with best practice guidelines, particularly in relation to dementia care.

The provider had systems and processes in place to monitor the safety and quality of the service, although some improvements were required.

Everyone we spoke with were complimentary of the management team and reported there to be an open and inclusive leadership culture within the home.

Staff felt supported and appreciated within their work and reported both the registered manager and provider to be approachable.