Buxton House

Updated 14 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a focused inspection to check whether the provider had met the requirements of the Warning Notices in relation to Regulations 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Buxton House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Buxton House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We reviewed the action plan submitted to CQC following the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Inspection activity started on 18 August 2022 and ended on 23 August 2022. We visited the service 18 August 2022.

We spoke with seven people who used the service to ask about their experience of the care provided and with two visiting relatives. We spoke with 10 members of staff including the operations manager, manager, deputy manager, housekeeping staff, senior care workers and care workers. As most people were living with dementia, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included elements of seven people's care plans and care records and Deprivation of Liberty Safeguards authorisations. We looked at a variety of records relating to the management of the service.

We also held a remote video call with the manager to discuss the governance arrangements at the service and to give inspection feedback to the operations manager, manager and deputy manager.

We received feedback via our website from two relatives and nine staff.

Updated 14 September 2022

About the service

Buxton House is a residential care home providing personal care to up to 61 people. The service provides support to older people including people living with dementia. At the time of our inspection there were 52 people using the service.

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

The provider had made improvements at the service since our last inspection. However, not enough time had passed for the changes to be fully embedded at the service. The Care Quality Commission (CQC) need to be assured going forward the provider's quality monitoring systems and oversight will continue, and effectively identify and resolve all concerns. Therefore, the governance and oversight of the service remains an area for improvement.

The provider had produced an action plan reflecting the improvements required by CQC. This was monitored and updated weekly by the provider’s representatives and management team. This plan had driven the improvements made and those needed moving forward.

There were improvements made in record keeping, communication and governance systems at the service. Notifications about significant events were now being made to CQC. The improved governance systems in place were identifying areas for improvement and these were now acted on.

Risks relating to infection prevention and control (IPC), including in relation to the COVID-19 pandemic, were assessed and managed and safe visiting was supported.

There were enough staff to meet people’s needs and there was a core of staff and regular agency staff who knew people well. Staff understood and anticipated people’s needs which contributed to the calm and homely atmosphere at the home.

Any risks to people were now fully assessed and mitigated. People received the care and support they needed to keep them safe. Medicines were managed safely and effectively by staff who were trained and competent to do so.

Staff received training, support and supervision. Staff told us they felt well supported to carry out their roles and told us everyone worked very well together as a team for the benefit of the people living at Buxton House.

People had improved mealtime experiences and access to drinks and snacks. Staff supported people to eat and drink uninterrupted and in a relaxed and chatty atmosphere.

People were supported to maintain their independence and have maximum choice and control in their lives. Where people lacked mental capacity to make decisions, these were made in line with the Mental Capacity Act 2005 and staff supported people in the least restrictive way; the policies and systems in the service supported this practice.

Care plans were person centred and they detailed how people wished and needed to be cared for.

There was an open and positive culture within the home and people, their relatives, staff and professionals told us the management team were approachable, responsive and helpful.

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 May 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We also served warning notices for the repeated breaches of safe care and treatment and good governance regulations. The provider was required to be compliant with those regulations by 9 August 2022.

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 carried out to follow up on action we told the provider to take at the last inspection.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

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

Follow up

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