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Inspection Summary


Overall summary & rating

Good

Updated 4 October 2018

The inspection took place on 3 and 4 September 2018. This inspection was unannounced on the first date and announced on the second date to ensure the provider was available to discuss feedback.

Stamford Bridge Beaumont is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 107 people across five separate areas, during this inspection 55 people were living at the service.

A new registered manager had applied to register with the Care Quality Commission (CQC) since our last inspection and their application had been accepted on 3 August 2018. They had worked for Barchester Healthcare Homes Limited for eleven years, some of which were spent managing and overseeing other Barchester run homes in the East Riding of Yorkshire. The registered manager had previously supported Stamford Bridge Beaumont and they were knowledgeable in terms of the current issues, work underway and plans to maintain sustained improvements across the service.

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.

At the last inspection in April 2018 we found the provider to be in breach of seven of the Health and Social Care Act 2008 (Regulated Activities) 2014 in Regulation 9 Person centred care, Regulation 10 Dignity and Respect, Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 17 Good governance and Regulation 18 Staffing.

We also identified one breach of the Care Quality Commission Registration Regulations 2009. This related to the failure to notify us of other events and incidents which had occurred at the service as the law requires.

The service was rated Requires improvement. The provider continued to complete an action plan to show what they would do and by when to improve the key questions Safe to at least requires improvement.

We found during this inspection that the provider had made significant improvements, which achieved compliance to meet the requirements of Regulations 9, 10, 11, 12, 13, 17 and 18.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At this inspection we rated the service Good. Although some areas of guidance and documentation needed embedding into day to day staff practice, overall there had been significant progress and improvement made throughout the service.

Management of medicines had improved since our last inspection. However, some areas of guidance and documentation required further attention. The impact to people was low as these were recording issues rather than errors in administration of medicines.

Quality assurance systems and audits identified where improvements needed to be made and noted good practice throughout the service so this could be communicated and celebrated with staff. However, some medicines audits required more detail to confirm which people’s medicines had been checked.

Staff deployment across the service had taken staff experience and skill mix into account to meet the dependency levels of people living at the service. Although we did observe a couple of minor concerns, overall this area had greatly i

Inspection areas

Safe

Good

Updated 4 October 2018

The service was safe.

The management of medicines had improved considerably. We identified some areas that required further improvement, which the provider advised would be addressed immediately.

Deployment of staff across the service had improved. The use of agency staff had further reduced since our last inspection as the service had recruited additional permanent staff to maintain consistency.

Staff felt confident to raise their concerns with the management team and gave examples of issues already addressed by the new registered manager.

Risk assessments were in place for risks associated to people’s specific health conditions and guidance for staff on how best to support them. Accidents and incidents had been identified and actions taken.

Effective

Good

Updated 4 October 2018

The service was effective.

Staff understood the importance of gaining people’s consent and best interest decisions were in place. Although we found some areas for attention staff understood the importance of consent and best interest decisions were in place.

People’s needs were assessed on admission to the service and documentation was clear and up to date to support staff to meet people’s current needs. Staff encouraged people to eat and drink at regular intervals and encouraged people to maintain healthy diets where possible.

The provider had designed their induction to incorporate the care standards and values of the organisation. Staff received regular training and were offered additional courses to develop their skills and expertise. We found staff to be knowledgeable about people’s needs and how to best support them.

Supervisions and appraisals were completed at regular intervals in line with the providers policies. Staff told us they felt supported by the management team and although some supervisions were brief, others were developmental and encouraged reflective practice.

Caring

Good

Updated 4 October 2018

The service was caring.

The management team spoke proudly about the staff team and how they had worked hard to achieve better outcomes for people.

Staff spoke passionately about their role at Barchester. Staff morale was high which had improved team working across the service. Staff had a proactive approach speaking with people and their relatives to capture diverse information to enable them to enrich people’s lives and promote their well-being.

People and their relatives told us that staff always respected people’s dignity and privacy. We observed meaningful interactions between staff and people throughout the inspection.

Staff were knowledgeable about people’s needs and supported them wherever possible to be as independent as they could be. People told us that staff offered them choices and respected their wishes or preferences.

Responsive

Good

Updated 4 October 2018

The service was responsive.

Care plans were detailed and person-centred and tailored towards each individual’s needs. They contained information about people’s histories including their likes and preferences.

Group activities were regularly scheduled and a new activities co-ordinator had been working to improve one to one interactions for people who may be isolated due to mobility or cognitive impairment.

People and their relatives knew how to complain. Where complaints or concerns had been raised people told us they had been immediately addressed to their satisfaction.

The provider had considered the Accessible Information Standards (AIS) to advise people they could request information in different formats to suit their needs if required.

Well-led

Requires improvement

Updated 4 October 2018

The service was well-led.

We found some recording issues that required further attention. However, the impact to people was low and the management team took steps to address some of these issues during the inspection.

The provider had improved their quality assurance systems. Audits and quality assurance documents showed significant improvements had been implemented across the service. Accidents and incidents had been recorded in a timely manner and appropriate measures put in place to mitigate any risks to people.

The registered manager was knowledgeable about their responsibilities under the CQC registration requirements and had submitted notifications in line with CQC guidelines.

Staff told us the management team were extremely supportive and they felt confident issues were being addressed appropriately and openly. Staff enjoyed working at Stamford Bridge Beaumont and felt the changes made by management had impacted positively on the well-being of people living at the service.