The inspection was unannounced and took place on 28 February 2017 and on 1 and 2 of March 2017.Badger's Holt Care Home provides accommodation and support for up to 25 people. At the time of our inspection 24 people were using the service.
There was a registered manager in place. 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 received care and support in an exceptionally personalised way. Staff knew people extremely well, understood their needs and the way they communicated. Care was totally focused on people's wishes and preferences.
People received outstanding levels of care. Staff developed exceptionally positive and caring relationships with people and their families. Staff were highly motivated and demonstrated a commitment to providing the best quality care to people in an individualised and compassionate way. People’s privacy and dignity was maintained at all times.
People's independence and wellbeing had been enhanced by improvements made in the internal and external environment of the home. Staff used their knowledge of best practice guidance to ensure the environment was suited to the needs of people including those living with dementia.
People, relatives and professionals consistently told us about the excellent care provided by well trained, committed staff who they said demonstrated outstanding levels of knowledge and skills. This had a very positive impact on people's health and wellbeing. People received outstanding effective care from staff who understood the needs of people living with dementia. This supported people’s decision making and allowed them to express their views from staff who understood them.
The provider had safe recruitment procedures in place. There were enough staff to meet people’s needs. Staffing levels were based on people’s individual needs and this made sure their personal care, social and emotional wellbeing needs were met. The skill mix of staff available in the home promoted a family and very homely environment.
The provider and registered manager used best practice guidance to drive improvement. Robust quality assurance systems were in place to ensure the homes environment was suitable to meet the needs of people who were living with dementia. Best practice guidance for each diagnosed condition had been implemented in people’s care plans and champions and lead roles were responsible for driving improvement.
People were supported to express their views and were involved in decision making about their care and were offered day to day choices. Staff sought people's consent for care and treatment and ensured they were supported to make as many decisions as possible. Staff confidently used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, relatives, friends and relevant professionals were involved in best interest’s decision making.
People received end of life care to an exceptionally high standard and the staff had strong working relationships with external healthcare professionals.
People told us they felt safe at the home. Some people living with dementia were not able to tell us their experiences. We saw those people sought reassurance from staff and were relaxed with them. This indicated they felt comfortable and safe with staff. Relatives told us they felt their family members were safe at the home. Staff knew how to recognise any signs of abuse and how they could report any allegations.
Risks to people’s safety were assessed and managed to minimise risks. Staff followed any risk management plans in place for people. Medicines were managed safely and stored securely. People received their medicines as prescribed by their GP.
The registered manager and all levels of the management team displayed clear and appropriate values and provided strong leadership to their staff. Staff members told us they knew what was expected of them, and were given the support, encouragement and training they needed to meet people’s needs in a timely and caring way. Staff at all levels showed, by their words and actions, an impressive drive to provide a dynamic, pro-active and continually developing service that was clearly focussed on enhancing the lives of the individuals receiving services. The service was open and responsive to feedback and new ideas, and had robust systems in place for monitoring its progress in meeting its goals.