Archived: Begbrook House Care Home

People's experience of using this service and what we found

Although the staff we spoke with understood their responsibility to report and raise safeguarding concerns recent incidents at the service highlighted that policy and procedure were not always followed. The appropriate action had not been taken by some senior staff when they had been alerted to recent concerns. Equally staff who had raised the concerns had not escalated these to management or the local authority when their concerns had been ignored.

There were enough staff to meet people's needs. The manager used a dependency tool to calculate staffing levels. This was increased when people’s needs changed and in line with the occupancy of the home. The home followed appropriate recruitment practices and ensured staff were properly checked before they began working at the home.

People and staff felt positive about the management of the home. Effective quality assurance systems were in place to monitor the quality and safety of people’s care. Audits helped to identify any shortfalls. The manager was being supported by the regional support manager. They were temporarily based at the home. The regional director had good oversight of the home. They visited regularly and carried out checks of the home. Out of hours checks on the home took place unannounced and were carried out by senior management.

Rating at last inspection

The service was taken over by another provider and registered with us April 2020. We have not rated the service at this inspection.

Why we inspected

The inspection was prompted due to safeguarding concerns which had been reported to us by the service and the local authority safeguarding team. This was in relation to safeguarding people from abuse and the process which staff followed to report such concerns. At the time of this inspection the concerns were being investigated by the service and other agencies involved. We inspected to examine those areas of risk and to check that people were safe. This was a targeted inspection to look at key areas of the safe and well-led key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

Begbrook House is a care home that providers personal care and accommodation for up to 32 people. At the time of our inspection, 20 people were living at the service.

We found the following examples of good practice.

There were measures in place to manage and reduce the spread of infection on arrival at the service. This included clear information and personal protective equipment provided at the entrance to the building. Before entering the building, visitors were required to show evidence of a negative lateral flow test result on the day of their visit

Visits were booked in advance to ensure safe visiting practices could be maintained. Visitors were able to access a visiting pod without coming into the building, but visits could also be carried out in the person’s bedroom.

Some friends or family members had been nominated as essential care givers. These individuals may visit the home to offer companionship or help with care needs. They were able to continue visiting even during a Covid 19 outbreak because they followed the same guidance as staff with regard to testing and the use of personal protective equipment (PPE).

Staff maintained social distancing where possible. They were able to be physically distant from each other during handovers and breaks. It was not always possible for staff to remain socially distanced from people who lived at the service, but they always wore appropriate PPE and followed good hand hygiene. When carrying out personal care, staff wore gloves, apron and mask. Staff had received training in infection prevention and control and were confident in the safe use of PPE.

The service was very clean, and there were effective systems in place to ensure cleaning tasks were completed and recorded. This supported the maintenance of high standards and reduced the potential spread of infection. The head housekeeper was the service lead for infection prevention and control.

Regular testing was in place for staff and people who lived at the home. All staff were fully vaccinated against Covid 19 and staff were well supported. The managers spoke highly of the staff team and told us morale was good. The provider had given incentives and bonuses to boost and retain staff.

Checks and records were in place to ensure standards were maintained. The management team had plans in place to develop and improve the service to maintain quality and continue to keep people safe.

We found the following examples of good practice.

Prior to any visiting people were informed of the procedures they should expect on arrival. People were asked not to visit the service if they displayed any symptoms related to Covid19. On our arrival we were greeted by the manager and had our temperature taken, we were asked to sanitise our hands and to wear a mask. Everyone visiting provided contact details to support the track and trace system. Visitors were shown to the area of the home they were visiting, by the shortest and most direct route.

The emotional wellbeing of people and their families had been supported throughout the pandemic. The whole team ensured contact and support was maintained through various initiatives. Staff were sensitive to people’s feelings including anxiety, sadness and loss. Activity was provided by two staff members seven days a week. During the pandemic innovative ways to consider wellbeing through activity had been provided to find alternatives during lockdown. People enjoyed virtual daytrips to places like Longleat and famous museums. The manager told us the activity programme focused on emotional therapy and wellbeing. Virtual video events were held with the providers other homes including celebrating special events. One to one therapy was personalised and had been well received.

All staff recognised their responsibility to protect the people they cared for and how crucial it was that when they were not at work, they respected and followed government guidelines to reduce their own exposure to risks. The provider and management team recognised and celebrated staff commitment, their efforts and sacrifices during the pandemic. The manager and staff had worked closely together to support the vaccination programme for staff. The provider had used various sources to educate staff on the Covid19 vaccination including a weekly webinar where staff could speak with an independent science expert to discuss their concerns and be better informed. In addition, the manager had also worked very closely with staff to relieve any of their anxieties and had been undecided. All staff had now received the vaccine.

Supportive communication systems were in place between the directors, all managers and staff. The provider made themselves visible to all staff members. Every Monday they met virtually with all levels of management. They also ran virtual support surgeries for staff. The learning and development academy was also a useful source of information and support for their personal wellbeing including working through stress and isolation. A Covid19 support line was also available so staff could speak with someone confidentially with any concerns either in the workplace or personal circumstances.

People continued to receive prompt medical attention when they became unwell and relationships with health professionals remained supportive and effective. When people were admitted to the home, risk assessments were completed, and people were isolated for 14 days. Social distancing was encouraged throughout the home. Where this was not achievable, staff were aware of the need for enhanced cleaning of frequently touched surfaces and people were supported to wash their hands regularly.

There were clear policies, procedures and contingency plans in place. Audits were undertaken, and actions were taken to ensure improvements were made. Staff had received IPC training and regular updates were provided. Spot checks took place to check staff understanding and compliance with the use of PPE and infection prevention and control practices.