About the service OSJCT Buckland Court is a care home without nursing for up to 50 people. People had their own rooms and access to communal rooms such as bathrooms, dining rooms and lounges. People had access to outside space as the home had large gardens around the building. At the time of the inspection there were 37 people living at the home, some of whom had dementia.
People’s experience of using this service and what we found
At our last inspection we found the service was in breach of two regulations. At this inspection this had not improved, and the service remained in breach of the same two regulations.
People’s medicines were not always managed safely. We found numbers of recording gaps on people’s medicines records. This meant the provider could not be assured people had their prescribed medicine as required. We also observed one person had not been given their medicine for four days as the service had ran out of stock. The registered manager provided us assurance the stock would be due in on the day of our inspection. Staff had received training on medicines administration and had checks on their competence annually.
Quality monitoring systems were still not effective in identifying shortfalls found during the inspection. The medicines audit completed prior to our visit had not identified the recording gaps seen on medicines records.
Incidents and accidents were recorded on forms on the provider’s electronic system. Whilst we could see what immediate action staff had taken in response to the incidents, the action for lessons learned was not recorded or always clear. Action recorded to prevent reoccurrence was not robust. We found two falls which had not been shared with the local authority or notified to CQC.
Staff had been recruited safely and there were sufficient numbers of staff to meet people’s needs. The registered manager regularly monitored people’s needs and used a staff dependency tool to calculate numbers. Agency staff were used to fill gaps when there was staff absence.
The home was clean throughout. On the day of inspection, we observed domestic staff cleaning and taking care of people’s laundry. Staff were wearing appropriate personal protective equipment (PPE). We were told the provider had good stock of PPE and staff had never been without supplies through COVID-19.
People had visitors when they wished, and people told us they liked living at the home. People told us staff were caring and they had no concerns. There were regular ‘resident meetings’ to talk about what was going on in the home and seek people’s views. The provider had organised virtual relatives’ meetings and the registered manager told us she would be holding local ones soon.
Staff were able to attend staff meetings and handovers to hear about changes and new guidance for working safely. Meeting minutes were kept and shared with all staff who were not able to attend.
Risks to people’s safety had been identified and risk management plans were in place to give staff guidance where needed. Staff reviewed them regularly and updated them when needed. Systems were in place to make sure health and safety checks were carried out. This was done at a local and provider level.
Staff worked in partnership with many local professionals to make sure people’s health needs were met. The registered manager knew who to contact in the local authority if they needed guidance on COVID-19.
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 4 March 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 the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 17 December 2019. Two breaches of legal requirements were found.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for OSJCT Buckland Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to medicines management and systems for governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.