Bidna House

We found the following examples of good practice.

Facilities were in place to wash hands or use hand sanitiser on entering and leaving Bidna House. Visitors were supported to wear a face covering when visiting, and wash hands before/after use. All visitors were screened for symptoms of COVID-19 before being allowed to enter the service. There was prominent signage and instructions to explain what people should do to ensure safety. Information was easily accessible on arrival and before visits to ensure visitors followed guidance, procedures and protocols to ensure compliance with infection prevention control.

The registered manager and staff team communicated with people, staff and health and social care professionals regularly to make sure everyone had an understanding of precautions being taken, and how to keep people safe. The service was following government guidance regards to visitors. Staff supported people to occupy themselves whilst maintaining their safety. People confirmed they felt safe living at Bidna House. Comments included, "I am very happy here and feel safe", "It is excellent here and the staff are lovely" and "The staff help me to do the things I like." Our observations confirmed that measures in place ensured people were protected from infectious illnesses.

Staff were following current infection prevention and control guidance to help people to stay safe. There were suitable risk assessments and an up to date infection control policy and procedure in place. The registered manager ensured staff understood why every measure was essential.

Personal Protective Equipment (PPE) was readily available around the buildings. We saw there was a good supply of PPE for staff to use. Staff were observed to be wearing PPE appropriately and disposed of it in clinical waste bins. Whole home testing was undertaken, with frequency of testing people and staff in line with current guidance.

Staff had received vaccinations as a condition of employment. The service had a process in place to check any visiting professionals had been vaccinated and were testing for COVID-19.

Staff were in the process of refreshing their training to ensure safe infection prevention and control measure were in place. Staff knew how to keep people safe during the COVID-19 pandemic.

Infection prevention and control audits were carried out to ensure the premises was meeting infection control measures. A cleaning schedule for all areas of the service was in place and implemented to ensure the whole service was effectively cleaned on a regular basis.

Bidna House provides care and accommodation for up to 12 people. On the day of our inspection there were 12 people living at the service. The home provides residential care for people with a learning disability or autistic spectrum disorder.

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.

There was a registered manager in post who was also a joint owner. 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.

We checked the service was working in line with ‘Registering the Right Support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, building the right support - and best practice. For example, how the service ensured care was personalised, how people’s discharge if needed, was managed and people’s independence and links with their community.

At the last inspection on the 11 May 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good:

Not all people were able to fully verbalise their views about their experience of living there. We spent time with people seeing how they spent their day and observing the interactions between people and the staff supporting them.

The provider told us in their provider information return (PIR) that, “We are responsive to the needs of the resident and then as they stay with us for longer, we review and adapt our care packages according to their need.”

People remained safe at the service. People were protected from abuse as staff knew what action they would take if they suspected anyone was being abused, mistreated or neglected. Staff were recruited safely and checks carried out with the Disclosure and Barring Service (DBS) ensured they were suitable to work with vulnerable adults. Staff confirmed there were sufficient numbers of staff to meet people’s needs and to help keep them safe.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Staff assessed and understood risks associated with people’s care and lifestyle. Risks were managed effectively to keep people safe whilst maintaining people’s rights and independence. People had their medicines managed safely, and received their medicines as prescribed. Staff completed training and competency checks were carried out to continually test their knowledge and to help ensure their skills in relation to medicines were up to date and in line with best practice.

People received support from staff who had completed training to meet their needs effectively. Staff meetings, one to one supervision of staff practice, and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the equality, diversity, and human right needs of people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's health was monitored by the staff and they had access to a variety of healthcare professionals. The registered manager worked with external health and social care professionals to help ensure a coordinated approach to people’s care.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; considering people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history, and people’s cultural, religious and spiritual needs.

People were treated with kindness and compassion by the staff who valued them. Staff had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The provider had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need.

Staff adapted their communication methods dependent upon people’s needs, for example using simple questions. Information for people with cognitive difficulties and information about the service was available in an easy read version for those people who needed it.

People could make choices about their day to day lives. The provider had a complaints policy in place and it was available in an easy read version. Staff knew people well and used this to gauge how people were feeling.

The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the registered manager and provider were approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

Further information is in the detailed findings below

Bidna House is registered to provide accommodation for 12 people who require nursing and personal care. Most people living in the home have a learning disability or autistic spectrum disorder.

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’. 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 felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were strong, caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place to protect people. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately. Staff spoke positively about communication and how the registered manager worked well with them, encouraged team working and an open culture.

A number of effective methods were used to assess the quality and safety of the service people received.

We considered all the evidence we had gathered under the outcomes we had inspected. We used the information to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people using the service, staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We know the service was safe because people were treated with dignity and respect by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The Registered Manager set the staff rotas, they had taken people's care needs into account when making decisions about staffing numbers, qualifications, skills and experience required. This helped to ensure that people's care needs were always met.

Is the service effective?

People's healthcare needs were assessed with them. Specialist needs and support had been identified in care plans where required to ensure people could be supported to live their lives the way they wanted.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, "The staff support me when I need it."

People using the service, were involved in regular meetings where shortfalls or concerns were raised these had been addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care support had been provided in accordance with people's wishes.

Is the service responsive?

People regularly completed a range of activities in the home. People enjoyed having trips out. We were told other people were offered the choice of outings but declined.

People's lives and choices were respected and staff worked to ensure that they were accommodated.

Is the service well-led?

The service worked well with other agencies and services to make sure that people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities.

Staff demonstrated a good understanding of the need to provide a nutritious and balanced diet for people, ensuring that health needs were taken into account, for example if a person had diabetes.

We saw that the premises were adequately maintained. We saw that health and safety checks were completed on a daily, weekly, monthly and annual basis by staff employed by the organisation and external contractors.

There were effective recruitment and selection processes in place.

We saw the home's complaints procedure. It provided people with details about how to make a complaint. It set out the procedure which would be followed by the registered manager and organisation.

There were 11 people living in the home at the time of our inspection. All were seen to be able to move freely about the home and were comfortable in each others company as well as with the staff who supported them.

We found that the provider had suitable arrangements in place to gain people's consent to care and treatment and saw that people agreed to the support offered to them.

We saw that people received safe and appropriate support that met their needs. The staff demonstrated a good knowledge of people's individual needs and behaviours. We saw that staff had effective skills to manage the changing moods of people living in the home.

People's medication was generally safely managed and administered by a trained and knowledgeable staff group.

Staff told us they were supported and supervised and received appropriate training to enable them to fulfil their role.

The provider had effective systems in place to routinely audit and monitor the services it provided to reduce the risks to people using the service.