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Inspection Summary


Overall summary & rating

Outstanding

Updated 1 August 2017

The inspection took place on 11 May 2017 and was unannounced.

This was a comprehensive inspection carried out at Byway House. At the last inspection on 13 January 2015, the service was rated ‘Good’. At this inspection, we found the service was now ‘Outstanding’.

Byway House is registered to provide accommodation and care for up to 16 people with a variety of healthcare needs, including frailty of old age. At the time of our inspection, 15 people were living at the home. Byway House is a large, detached house situated on the corner of a private road and close to the local shops and coastline of Middleton on Sea. All bedrooms have en-suite facilities comprising a sink and toilet; bathrooms are separate. Communal areas include a lounge and dining area. A passenger lift operates between the ground and second floors and one of the staircases has a stair lift. Accessible gardens provide people with places to sit and have recently been refurbished to provide a pleasant, relaxing outside space.

A registered manager was 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.

Staff were totally committed to providing an exceptional standard of care for people at the home and genuinely cared about people’s wellbeing. One person said, “I have been living in this home for a few years and I really do like living here so much. It really feels like home. Everyone here is so kind and helpful”. Nothing was too much trouble for staff and warm, caring relationships were evident. People were supported in their spiritual beliefs. People, if they wished, were involved in making decisions relating to their care and felt that their views were listened to and acted upon. This helped to ensure people lived their lives in the way they wished and in a way that made them feel valued. People were treated with dignity and respect by staff at all times; their independence was promoted which helped people to maintain their dignity. Staff had signed up to the Dignity in Care initiative which was about improving the quality of care and experiences of people using services. Staff put what they had learned into practice and had been provided with information about becoming Dignity Champions. The atmosphere at Byway House was conducive to ensuring people were happy and contented.

People were involved in developing the service and felt their views were listened to and that they mattered. There were opportunities for people to assist in interviewing new staff, to join staff in training and to attend residents’ meetings. People felt their views and opinions were listened to and the registered manager met people individually every day to see whether they needed anything and to obtain their feedback about living at Byway House. Staff felt supported by management and were passionate about caring for people and their employment at the home. Relatives and visitors spoke highly of the care people received and of the management of the home. The culture was one of openness and transparency and it was clear that people were at the heart of the home. The registered manager was committed to ensuring people received a high quality of care and was an excellent role model for staff. A range of audits had been put in place to maintain the high standards at Byway House and to drive continuous improvement. People spoke highly of the home. One person said, “I would recommend this place to anybody and anyone. It is a great place to live, especially in your latter years”.

People felt safe living at Byway House. Staff had been trained to recognise the signs of potential abuse and knew how to report any concerns relating to people’s safety and wellbeing. People’s risks were identified, assessed and managed appropriately. Clear guidance was in place for staff to mitigate people’s risks. Staffing levels were sufficient to meet people’s needs and staff had time to spend with people. Safe recruitment systems were in place. Medicines were managed safely.

Staff had been trained to a high standard and had a good understanding on areas we questioned them on. New staff completed the Care Certificate, a universally recognised qualification. In addition to essential training that was organised to enable staff to understand and meet people’s care needs, other training opportunities were available to staff. Staff received regular supervisions with the registered manager and attended team meetings. Staff were encouraged to submit any suggestions in the way the home was managed and any improvements to the quality of care for people. Staff had received training on the Mental Capacity Act 2005 and understood how to put the principles under this legislation into practice. No-one living at Byway House was subject to Deprivation of Liberty Safeguards.

People were very complimentary about the food on offer at the home and felt that catering was of a high standard. The lunchtime experience was sociable, with pre-lunch aperitifs on offer if people wished. People could choose what they wanted to eat and their choices were accommodated. Special diets were catered for and, where needed, advice sought from healthcare professionals where dietary advice was needed. People were supported to maintain good health and had access to healthcare professionals and services. The environment at Byway House was clean, warm and friendly. Communal areas were furnished to a high standard and people had personalised their rooms.

Care provided to people was person-centred and responsive to their wishes and needs. Care plans included detailed information about people’s support needs and guidance for staff on how people wished to be supported. People and their relatives were involved in planning their care. A range of activities was on offer within the home and outings into the community were encouraged. People also enjoyed sitting in the gardens surrounding the home and short walks around the home. Complaints were listened to and investigated to the satisfaction of the complainants. People told us they had no complaints about Byway House.

Inspection areas

Safe

Good

Updated 1 August 2017

The service continued to be safe.

People and their relatives felt safe living at Byway House. Staff had been trained in safeguarding adults at risk and knew what action to take if they suspected abuse was taking place.

People were encouraged to be as independent as possible. Risks were identified, assessed and managed safely. Guidance was provided to staff on protecting people from the risk of harm.

Staffing levels were sufficient to meet people’s needs. Safe recruitment practices were in place.

Medicines were managed safely.

People and their relatives commented positively about the cleanliness of the home.

Effective

Good

Updated 1 August 2017

The service continued to be effective.

Staff had been trained in a variety of areas in order to support people effectively. They attended staff meetings and had regular supervision meetings.

Consent to care and treatment was sought in line with legislation and guidance. Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and put this into practice.

Mealtimes were sociable occasions at Byway House. Food was prepared to a high standard and people had a choice of what they wanted to eat.

Healthcare professionals were contacted if needed and people had access to a range of healthcare services.

Rooms were personalised and cosy.

Caring

Outstanding

Updated 1 August 2017

The service was exceptionally caring.

People were supported by staff that were committed to providing high quality care and had an excellent understanding of their needs.

Warm, friendly relationships had developed between people and staff. Staff demonstrated they genuinely cared about people and this extended to their relatives.

Staff involved people in decisions relating to their care and relatives were also encouraged to be involved, if they wished.

People spoke highly of staff and all said they were treated with dignity and respect. Staff had signed up to an initiative relating to this and had a good understanding in this area, which they put into practice.

Responsive

Good

Updated 1 August 2017

The service continued to be responsive.

Care plans provided detailed information and guidance to staff on how to support people’s needs.

Activities were organised within the home and outings arranged into the community.

People knew how to make a complaint and any complaints received were handled to the complainant’s satisfaction.

Well-led

Outstanding

Updated 1 August 2017

The service was very well-led.

People were involved in developing the service through attendance at residents’ meetings, attending staff training and in interviewing new staff.

People, relatives and staff all spoke highly of the way the home was managed. Staff worked well as a team and described a ‘family approach’. Staff felt supported by the management and of a culture that was open, with good communication.

Care provided was of an extremely high standard. Care was person-centred and comments from people and relatives unanimously praised the caring attitude of staff and that Byway House felt like home.

External healthcare professionals gave positive feedback about the care people received and that staff would seek help from them as needed.

A range of audits was in place to drive continuous improvement.