Bolters Corner Nursing Home

About the service

Bolters Corner Nursing Home is a residential care home providing personal and nursing care to 32 people at the time of the inspection. The service can support up to 35 people.

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

Right Support: People’s independence was encouraged by staff and the culture of the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People received support with their nutrition and hydration and enjoyed the wide range of activities the home provided.

Right Care: People received care that was person-centred and in line with their preferences, likes and dislikes. Staff respected people’s dignity and privacy and treated people with kindness. Staff also knew people’s individual risks and how to manage these to ensure people received safe care. People were supported with their medicines when they needed them and staff had received correct training to safely carry out their roles.

Right Culture: There were clear quality assurance processes that were followed. These ensured staff continued to maintain a high level of care. People, staff and relatives felt involved in the running of the home and the management team strived for people to feel included and empowered in their everyday lives. The provider worked very well with all health and social care professionals, we saw examples of impressive partnership working that had positive results on people’s health and wellbeing.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 April 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Bolters Corner is a care home providing personal and nursing care to people with a range of needs such as dementia and Parkinson’s Disease. The care home accommodates up to 35 people in one adapted building. At the time of the inspection, the service was supporting 33 people.

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

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Although risks were managed due to staff knowing people well, risks were not always appropriately recorded or visible for staff to refer to. Medicine administration and recording practices were not always safe, leaving people at risk of not receiving their medicines correctly. Records were not always robust or contemporaneous, which meant the registered manager could not always demonstrate full management oversight in areas such as auditing and accident and incident mitigation.

Recruitment checks were not always thorough. We addressed this with the registered manager who has since ensured full employment history and references have been gathered. Individual staff supervision meetings were not always being completed throughout the year. However, staff informed us the registered manager was always available to speak to and they had attended group supervisions.

People, relatives and staff all praised the management of the service, commenting on its “family feel” and positive ethos of ensuring people received a high- quality life. People and relatives felt able to raise concerns and staff felt highly supported by the registered manager. Feedback was sought from people, relatives and staff through meetings and surveys.

There were a sufficient number of appropriately trained staff to meet people’s needs. Staff knew people well,, and took time to engage them in activities that were personal and joyful to them. People and relatives felt staff were kind and compassionate towards them, and we observed interactions which confirmed this throughout our inspection. People were encouraged to maintain their independence where possible, and had their dignity and privacy respected.

People were supported to maintain their nutritional and hydration needs through staff support and adapted equipment. Referrals to healthcare professionals were completed where required, and a visiting healthcare professional commented on the high level of communication from staff as well as their willingness to follow any advice. This included working alongside outside organisations to ensure people received the care they needed, such as the local hospice during the end stages of people’s lives. The environment was set up to meet the needs of people with cognitive impairments.

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 5 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to people’s rights and liberties not being protected in line with the principles of MCA 2005, risks to people not always being recorded, medicine recording and administration not always being safe, and records not being completed in full at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We have made recommendations around recruitment checks for new staff. We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection on 29 October 2015 the service was rated ‘Good.’ At this inspection we found the service remained ‘Good.’

People were continued to be safe at Bolters Corner Nursing Home because staff were aware of their responsibilities to keep people safe. Staff were knowledgeable about the processes to follow when they suspected abuse. The provider followed safe recruitment practices that ensured only suitable staff worked at the home. Risks to people had been identified and risk assessments were in place to enable people to remain safe. These provided guidance to staff about the risks and how to maintain people’s safety.

Records of accidents and incidents were maintained and actions to help to prevent the re-occurrence of these had been implemented. There were sufficient numbers of staff to attend to the assessed needs of people. Medicines were managed and stored safely and people received their medicines on time and as prescribed by their GP.

People continued to receive effective care from staff who had received training that enabled them to carry out their roles. Staff were supported by the registered manager through regular supervision and appraisals of their work. 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 support this practice. People were provided with sufficient food and drink. People were complimentary about the food and how it was cooked. People’s healthcare needs continued to be met and they were able to access all healthcare professionals as and when required.

People’s privacy and dignity was respected and they were involved in making decisions about their care and treatment. People were treated with kindness and compassion in their day-to-day care. People received care that was personalised to their individual needs. Care plans included information about how people preferred their needs to be attended to by staff. People and their family members were involved in the writing and review of their care plans. People had a range of activities they could choose to be involved in. A complaints system was in place that enabled people, relatives and visitors to raise any concerns. No complaints had been received since our last inspection.

The registered manager and provider were visible at the home and all staff stated that they felt supported by the registered manager. The management team in place were aware of their roles and responsibilities within the home. There was a system in place to monitor the quality of care and treatment provided at the home.

Further information is in the detailed findings below.

We noted that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

People told us that there were enough staff and they liked the home and their rooms.

We found the home to be well maintained hygienic, fresh and clean.

We found that the provider did notify the Care Quality Commission (CQC) of any incidents involving people who use the service that involved abuse or allegations of abuse.