Bowbrook House

Bowbrook House provides accommodation and personal care for up to 30 people. At the time of this inspection 28 people were living there. Some of whom were living with dementia.

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

People were safe as the provider had assessed the risks to people associated with their care and support. Staff were knowledgeable about these risks and knew what to do to minimise the potential for harm to people.

People were protected from the risks of ill-treatment and abuse. Staff had been trained to recognise potential signs of abuse and understood what to do if they had, or suspected, any concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was ‘good’ (published 8 June 2019).

Why we inspected

The inspection was prompted due to information received about an incident which occurred outside of Bowbook House. A decision was made for us to inspect and examine any potential risks to people receiving a regulated activity there.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the ‘safe’ section of this report.

CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bowbrook House on our website at www.cqc.org.uk

Follow up

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

We found the following examples of good practice.

• People were supported by staff to communicate with their relatives by sharing photographs and comments privately on a family and friends portal application. The application enabled people to record their reaction using emotion icons such as a happy face so their families knew how viewing the photographs had made them feel.

• People had personalised social and visiting wellbeing plans in place which included ways to support their individual wellbeing and any potential difficulties they may face. Each plan also highlighted the person’s favoured method of communication with their relatives and their visiting priorities.

• The registered manager had plans in place to cohort people and staff who supported them in the event of a COVID-19 outbreak in order to reduce the risk of transmission of infection.

• People were supported to communicate in alternative ways where the use of Personal Protective Equipment (PPE) hindered verbal communication. One person had a hearing impairment so visual signs had been created with generic questions and responses which were used to aid communication as well as writing things down.

• The home was clean and hygienic. An additional 30 hours per week had been allocated to cleaning tasks since the pandemic to ensure increased cleaning regimes could be undertaken.

• Cleaning schedules were in place and complied with. Cleaning tasks completed were recorded electronically and where they had not been completed when required, the database alerted senior management who addressed this immediately.

• Staff had access to a support line they could contact should they require support with their mental health.

• Staff could use the provider’s food supplier to get their shopping delivered to reduce how regularly they needed to undertake their own personal shop.

People’s experience of using this service: People were safeguarded from harm and supported by sufficient staff to meet their needs. Staff were recruited using safe recruitment procedures. Risks to people’s wellbeing were assessed and plans were in place to mitigate any area’s highlighted. People received their medicine on time. Lessons were learnt when things went wrong, and plans were in place to manage any infectious outbreak.

People’s care needs were assessed in line with best practice and staff received the necessary training to fulfil their role. People were supported to maintain a balanced diet and access health care whenever needed. The principals of the Mental Capacity Act (2005) were adhered to. The home was adapted to meet the needs of the current group of residents.

People were treated with kindness and involved in decisions about their care. People’s privacy was respected.

People had access to activities they enjoyed and there was a complaints process if they were unhappy. People’s end of life wishes were supported.

People felt that the home was well-led, and the staff understood their roles. The quality in the home was monitored and improvements made when identified. The provider worked with others and looked at continuous improvements.

We feel the home has met the criteria for good; more information is in the full report.

Rating at last inspection: At the last inspection we rated the service as good (Report published 27 October 2016)

Why we inspected: The service was inspected in line with our current methodology and previous rating of good. We were aware that there had been a recent fire at the property which remains under review by the fire brigade. We did not investigate the incident however we did review the actions taken.

Follow up: We will continue to monitor the service and review any intelligence received to inform future inspections.

Bowbrook House provides personal care for up to 30 people. At this inspection they were providing care and support for 29 people.

A registered manager was in post and present at this inspection. 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. The registered manager was supported day to day by a care manager who was not available at this inspection.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care. Staff knew what to do in order to minimise the potential for harm.

People were supported by enough staff to safely meet their needs. People received help with their medicines from staff who were trained to safely support them. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work.

The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

Staff members had the skills and knowledge to meet their needs of those they supported. Staff members new to the role received an induction period of training. Staff attended training that was relevant to the people they supported and any additional training needed to meet people’s requirements was provided.

Staff members were aware of the guidance and legislation that governed their practice. People were supported in a way that maintained their individual rights. People were involved in decisions about their care and had information they needed in a way they understood. When people were not able to make decisions themselves staff members knew what to do to ensure any decisions made were in people’s best interests.

Staff received support and guidance from the registered manager and care manager who they found approachable. People and staff felt able to express their views and felt their opinions mattered.

People had positive and caring relationships with the staff members who supported them. People’s likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by those supporting them. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.

The provider undertook regular quality checks in order to drive improvements. People and their relatives felt their opinions mattered to the provider and any suggestions they made were valued. The provider had systems in place to respond to the suggestions of others.

We observed that people received caring support from staff on duty. We saw care that was not rushed and the staff knew the people and their individual personal needs well.

We considered that people who lacked the ability to manage their own care received caring support that was responsive to their changing mood and need. Care records were in place that provided staff with instructions on how people should be cared for and why. This meant that the care was responsive to people's needs.

People considered the staff met their current needs and felt assured that if they became unwell that staff would respond.

People believed staff were well trained to do their job and one person said, "They are very adept at understanding how to assist me. They listen and that's important". They thought that compassionate care was provided by staff. People considered the service was well led.

Staff provided health and social care support well. Community services were accessed to support people when necessary.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. They told us about the training that the service had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. People's relatives told us that staff were around and available to talk to when they visited. They said that the staff were friendly and always acted professionally. One person said that they were 'Very, very happy here', and another said 'The staff are very good'.

People we talked with said their comments were listened to. A visitor said that they would not hesitate to talk to staff if something was wrong. The home's management regularly talked with the people to find out what they thought about how their care was delivered.