Archived: South Bebside Care Home

People’s experience of using this service: People and relatives said staff provided especially good care; they also said staff were very kind and caring.

People, relatives and staff told us the service was safe. Staff knew how keep people safe from abuse. They also knew about the whistle blowing procedure and how to report concerns. There were effective systems for dealing with safeguarding concerns.

Staffing levels were sufficient to meet people’s needs in a timely way. New staff were recruited safely. People received the right medicines at the right times.

Accidents and incidents were monitored closely and the information used to identify trends. Health and safety checks and risk assessments helped to maintain a safe environment.

Staff received good support and completed the training they needed. 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 supported this practice. People received the support they needed to have enough to eat and drink and to access external health care services.

People's needs had been fully assessed to identify how they wanted their care provided; this included providing the opportunity for people to discuss their end of life care needs. The assessment was used as a baseline to develop detailed and personalised care plans. These were reviewed to keep them up-to-date. People could participate in activities if they chose to. Complaints were dealt with effectively.

People, relatives and staff said the home was well managed. The provider operated a structured approach to quality assurance. People, relatives and staff had regular opportunities to give feedback.

More information is in the Detailed Findings section below. For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection: Good (the last report was published on 6 August 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor this service and inspect in line with our reinspection schedule for services rated good.

The inspection took place on 26 May and was unannounced. The inspection was carried out by one inspector.

A registered manager was in post. 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 told us they felt safe in the service and safeguarding policies and procedures were in place. Staff had received training in the safeguarding of vulnerable adults and whistleblowing advice was prominently displayed. Risk assessments were carried out on the safety of the premises and equipment used by people, and contingency plans were in place in case of emergency to ensure the continuity of the service. Records of accidents and incidents were maintained and analysed regularly to monitor for patterns or trends.

Individual risks to people were assessed and regularly reviewed. Appropriate steps were taken where risks were identified, to mitigate these risks and ensure the safety of people and staff. Procedures were followed in relation to the prevention and spread of infection, and staff used person protective equipment appropriately. The home was clean and well maintained and there were no malodours.

Safe recruitment procedures were followed and the registration status of nursing staff was checked regularly. There were suitable numbers of staff on duty, and staff told us they were busy, but had time to care. Induction to the service was thorough and staff told us they felt well supported.

There were safe systems in place for the ordering, receipt, storage and administration of medicines. Staff competency to administer medicines safely was checked on a regular basis.

People had access to a range of healthcare services. Specialist advice was sought where necessary and there was a weekly GP clinic in the service for the discussion of routine concerns. The GP knew staff and people who used the service well and told us they escalated health concerns promptly and sought advice in a timely manner.

Visiting professionals, people, and relatives spoke highly of the manager and staff. They complimented them on their kindness and efficiency. Staff were skilled and experienced and received regular training, supervision, and an annual appraisal.

The service worked within the principles of the Mental Capacity Act 2005 (MCA). Capacity assessments had been carried out and decisions made in the best interests of people were appropriately recorded. Applications had been made to the local authority to deprive people of their liberty in line with legal requirements. The service involved people, family members and care professionals where necessary in discussions about capacity and best interests.

People were supported to maintain a healthy diet and fluid intake. Monitoring tools were in place to highlight malnutrition and specialist advice was sought when necessary. There were a number of compliments about the quality of the meals. Staff supported people sensitively and discreetly at mealtimes. Privacy and dignity was maintained.

Person centred care plans were in place and these were up to date and regularly reviewed. People were included in the care planning process where possible and life story work was carried out as soon as possible to help people to settle into the service.

We observed that staff spoke kindly with people and treated them with respect. We saw a number of examples of compassionate and considerate care. People had good relationships with staff and there was a good deal of humour displayed between people and staff throughout the inspection. A range of activities were available and an activities coordinator was in post who planned and organised very person centred activities and was very committed to their role. We observed people enjoying activities throughout the day and people had access to the community through planned trips and events.

A complaints procedure was in place and was prominently displayed. No formal complaints had been received and the manager had recorded informal minor issues to ensure that these were taken seriously and addressed. There were robust quality assurance systems and a number of checks and audits were carried out by the manager. The views of people, relatives and visiting professionals were captured in a number of ways, including electronically. This gave the service real time feedback about the quality of care provided and enabled the manager to address any concerns swiftly and to share positive feedback with the team.

There were numerous compliments about the management of the service. There were clear lines of responsibility and accountability between all grades of staff and they felt well supported by the manager. Morale was good in the home and staff told us they enjoyed working there.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found '

Is the service caring?

Staff we spoke with were able to describe the type and frequency of care that people received and also talk about their individual backgrounds, likes and dislikes. People who used the service told us, 'This place is lovely. They staff are lovely; its service with a smile'; 'It's lovely here. I like it very much. I would recommend it to anyone'; 'I get all the help I need'; 'All the care workers are nice; you get to have a good laugh with them' and 'The staff are lovely; they help with what I need help with.' Relatives we spoke with told us, 'It's not clinical, it's more homely'; 'The staff are very patient and good with the residents' and 'I'm really happy with things.'

We saw care staff interacted well with people, were warm, supportive and spent individual time with them during meal times. We observed staff delivering care at other times and noted they were patient and compassionate and supported people to be as independent as possible.

Is the service responsive?

We saw from people's care records that the home worked closely with other services to deliver care to people who used the service. For example, we saw that one person had particularly complex health needs which required the involvement from a range of professionals, including diabetic services, wheelchair services and the tissue viability nurses (TVN). The manager told us that they were working closely with the TVN and that the person's pressure areas were improving slowly.

We saw that call bells were answered in a timely manner and that care was delivered when staff responded to people's calls for assistance.

People we spoke with told us that a range of activities took place and that trips out of the home were arranged. People, relatives and staff talked enthusiastically about a recent fair held at the home, which had been on a wartime theme and involved staff dressing up. People told us, 'We do all sorts of games and entertainment; lots of different things' and ' We do keep fit; I enjoy that, get entertainers and I had a lovely day at the fair on Saturday.' One of the staff told us, 'One of the things about (activities co-ordinator) is that she does one to one activities with people, those that can't join in the other stuff.'

Is the service safe?

We walked around the home on arrival for our inspection and found that the premises were clean, tidy and generally well maintained.

Staff we spoke with had a good understanding of infection control issues. Staff were able to talk in details about the need to use personal protective equipment (PPE), such as aprons and gloves, and the need to change PPE between tasks. They were also able to discuss the need for good hand hygiene with the home. We observed staff wore PPE when providing personal care to people and during meal times.

On the day of our inspection a fire alarm test was carried out to ensure the systems worked effectively. We noted that alarms could be heard throughout the building and automatic doors closed when the system was tested.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us that there were no current applications in relation to DoLS. Staff within the home had received training on DoLS and the Mental Capacity Act 2005.

Is the service effective?

We saw that people's general care needs were addressed and that they had appointments with dentists, chiropodists and opticians. We noted that were people's care needs changed then action was taken and care plans updated to acknowledge this change.

We spoke to one of the tissue viability nurses who had visited the home. She told us that she had no concerns about the home and staff worked well with her and always followed the care plans or advice that she gave. She told us, 'The nursing staff are very caring and interested in the patients.'

Is the service well led?

The home had a range of quality assurance system in place to monitor the quality and consistency of care. The manager carried out a range of checks and audits. We saw copies of documents regarding checks on nutrition, equipment fire safety systems, water systems and the general environment within the home.

People that we spoke with told us that they had been given information about making complaints but not raised any formal complaints. People told us, 'I've never had to make a complaint, but if I did have any worries I'd go to the manager first; she would definitely take notice of anything.' Relatives we spoke with told us, 'I've only ever raised one issue and it was dealt with straight away' and 'If I have any issues I just see (the manager) or one of the girls and it is sorted straight away.'

Staff we spoke with told us that there were regular staff meetings and we saw copies of minutes from these meetings. We saw that a range of subjects were discussed including the importance of staff wearing name badges. We saw that all staff at the home were wearing badges to make it easier for people or relatives to identify them.

People told us they were happy with the care they received and staff checked they were in agreement with it. We saw staff consulted people before they provided care and support.

We found people's needs were assessed and care was planned in line with their needs. One relative told us, 'My husband's care is excellent and I am very satisfied with the care he gets. I was recommended to come here and everyone is so friendly and helpful." Care plans were regularly updated and contained clear information about individual's care.

At the time of this visit there were enough qualified, skilled and experienced staff available to meet people's needs. Staff responded promptly to requests for assistance. One person told us, 'Night staff are special to me ' human dynamos.'

People were asked their views about the service provided and these were taken account of. People were aware of the complaints procedure. The provider had systems in place to monitor care delivery and ensure the health, welfare and safety of people who used the service was maintained.

People's personal records were accurate, fit for purpose and held securely. Staff records were kept in an appropriate format.

Relationships between staff and people were good and there was a relaxed atmosphere. People told us that staff spoke to them nicely and we observed good interactions between staff and people during our visit.

One relative told us 'This is the best care home X has been to. I am really pleased with the care and support they have had. I hope they will be able to stay here. The staff are great, they work hard to make sure people get a good service."

People told us they felt safe living at South Bebside. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

Quality monitoring systems were in place and these took account of people's views about the service.

Individual records were detailed and provided clear information about the care and support provided.