Battersway Court

About the service

Battersway Court is a residential care home providing personal care for up to 4 people. At the time of our inspection there were 3 people using the service.

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

Right Support:

Whilst we found the service was generally working within the principles of the MCA, records did not always reflect decisions being made, or why they had been made in relation to manging people’s money. We made a recommendation about this. Staff supported people with their medicines in a way that promoted their independence and achieve the best possible health outcome. People had a choice about their living environment and were able to personalise their rooms. Staff supported people to access specialist health and social care support in the community.

Right Care:

Staff understood how to protect people from poor care and abuse and received training on how to recognise and report abuse and they knew how to apply it. There were enough staff employed at the service to meet people's needs and people were protected from harm as staff were recruited in a safe way. Risks associated with people's care had been assessed including how to support people with risks associated with accessing their community safely and free from unnecessary restrictions.

Right Culture:

The service had an open positive atmosphere and was very much people’s homes. People were empowered to lead inclusive and full lives because of the attitudes and behaviours of the provider and staff. Staff reviewed the quality of support provided to people, involving the person, their families, and other professionals as appropriate.

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 26 January 2018).

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.

Follow up

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

The last inspection took place in October 2016 and the home was rated 'requires improvement' in Safe, Effective, Well Led and overall. Caring and Responsive were rated 'good'. We found breaches of Regulations relating to safe care and treatment, staff recruitment, consent to care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when they would make the necessary improvements to meet regulations. During this inspection, we found that improvements had been made.

Battersway Court is a 'care home' for up to four people. 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. At the time of the inspection, three people were living at the home.

Battersway Court can accommodate up to four people on the upper floor of one adapted building. The home consists of shared living, dining and kitchen area with three bedrooms having their own en-suite facilities.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The home had a registered manager who was also the provider. 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.

Quality auditing systems in the service had been fully reviewed and were now effective. There were systems in place to assess, monitor and improve the quality and safety of care. The provider undertook regular checks to ensure people’s care needs were being met and documentation was being maintained. The deputy manager carried out daily and monthly cleaning audits and monthly health and safety, infection control, environment and food hygiene audits. Care plans were reviewed monthly or if people’s needs changed. Any concerns were highlighted and action was taken. The provider also arranged an annual health and safety audit completed by an external company.

Where accidents and incidents had taken place, these had been reviewed and action had been taken to ensure the risk to people was minimised. Premises and equipment were maintained to ensure people were kept safe and there were arrangements in place to deal with foreseeable emergencies.

People felt they were treated with kindness and said their privacy and dignity was respected. People's care plans contained information about what was important to them and how care should be delivered. People were involved in reviewing care plans and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Risks had been assessed for each person and action had been taken to reduce identified risks. Risk assessments gave staff clear instructions on how to keep people safe whilst maintaining their independence.

People were protected by staff who knew how to recognise possible signs of abuse. Staff told us what signs they would look for and the procedures they would follow to report these. Safeguarding contact numbers were accessible to staff and people who lived at Battersway Court.

Recruitment procedures were in place to ensure only people of good character were employed by the home. Potential staff underwent pre-employment checks to ensure they were suitable to work with people in a care setting.

Appropriate arrangements were in place for the safe administration and storage of medicines. Two people had chosen to manage their own medicines. We saw where people had chosen to manage their own medicines, individual risk assessments had been completed and reviewed regularly. One person was supported by staff to manage their own insulin and diabetes monitoring. We have made a recommendation to the provider about their insulin management.

People were happy with the support they received to eat and drink. People were supported to help prepare their meals and could choose what they wanted to eat. People’s mealtimes were relaxed and changed to meet people’s activity commitments and routines.

Changes in people's health care needs and their support was reviewed when required. If people required input from other healthcare professionals, this was arranged. People felt able to make requests and express their opinions and views. A formal complaints process was in place that people were aware of.

Battersway Court provides accommodation and care for up to four people. People living at the home have learning disabilities. On the day of our inspection, three people were living at the home. The home is located within a quiet residential area. People lived in an apartment above the registered provider's home. Each person had their own bedroom. Communal space consisted of a large lounge area and kitchen with dining area.

The home was not required to have a registered manager as the provider managed the home. 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 and associated Regulations about how the service is run.

People told us they liked living at the home, they were happy, they liked the staff and the staff were kind. Our inspection found that whilst the service offered people a homely environment and their care needs were being supported; there were shortfalls in a number of areas that required improvement. Robust recruitment procedures were not in place, the environment was not always safe, there was no system to support staff development, the provider had failed to submit a safeguarding notification to the Care Quality Commission and the provider did not have governance systems in place to assure quality of care.

Battersway Court was a family run home were the registered provider lived on the premises. Apart from the registered provider the home only employed one full time member of staff, the deputy manager. The deputy manager was responsible for the day to day running of the home. Sickness and absence due to holidays were covered by part time staff who were related to the provider and only covered on a casual voluntary basis. We have made a recommendation that the provider keep staffing levels under review.

People were at risk of receiving care from unsuitable staff because robust recruitment procedures were not being applied. People were supported by the registered provider and deputy manager who had received training and support for their role. However, casual staff had not received any formal training. There was no system in place for ensuring that staff training was kept up to date and training was reviewed in respect of changing needs of the people living in the home. There was no system for ensuring staff received supervision, support or professional development.

Although staff had the knowledge to protect people from abuse there had been a failure to report a safeguarding notification to the Care Quality Commission so that it could be investigated properly.

The provider did not have effective systems in place to make sure the quality of service they provided was regularly monitored and assessed to prevent inappropriate or unsafe care. The home was not actively seeking the views of a range of stakeholders in order to learn and improve.

People were administering their medicines. The home had provided lockable storage facilities within people's bedrooms, assessed people's understanding and carried out risk assessments which were regularly reviewed.

People's rights were protected by the correct use of the Mental Capacity Act (MCA) 2005. People's health care needs were met through regular healthcare appointments and liaison with health care professionals. People were consulted about their choices for meals.

There were systems in place for maintenance of the building and equipment, and to monitor the safety of the home. However, some aspects of the environment were not safe. There were no records of risk assessments carried out in relation to building work at the home and the absence of window restrictors.

People's individual risks were identified and risk assessment reviews were carried out to keep people safe. Staff supported people to reach an appropriate balance between supporting choice, independence and appropriate risk taking.

Care and support plans were personalised and reflected people's needs, wants and interests. People's care plans clearly outlined every aspect of the person's life and reflected their wishes and preferences. This information helped staff to get to know the person better and provide the care and support they required. People were supported to be as independent as possible.

People told us they were supported to pursue a range of hobbies, activities and individual interests. For example, shopping, gardening, making toy models, jigsaw puzzles and attending a variety of services such as coffee mornings, activity clubs and disco’s.

We made one recommendation and found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report. We also made a recommendation about medicines management.

Only one person in the service agreed to talk to us. The others declined to meet us and went out for the day. We also spoke to three support staff, and viewed care records

People's needs had been assessed and their likes and dislikes recorded. Support was then delivered accordingly to maintain each person's independence..

We saw that care records had been well written and described how people were at the centre of all decisions they made. We saw that they were regularly reviewed in order to remain up to date and were signed by the person to denote their agreement to the contents.

From the care records, we saw that people were referred to relevant health professionals, such as doctors and dentists, when necessary.

Staff treated people respectfully. One person in the service told us 'they're all nice people".

The service had systems in place to protect people from abuse. For example, policies and procedures that kept people safe. Support staff were knowledgeable about safeguarding and how they would respond to any concerns that arose.

We saw that there were processes in place to monitor the quality of support being provided at the service.

Staff treated people with respect and were friendly and patient. Battersway Court had a warm, relaxed atmosphere. People were supported to be independent, for example, in completing household tasks. People took part in activities in their community

Assessments of people's needs had been completed and care was planned and delivered accordingly. People's needs were reviewed and appropriate referrals were made to health professionals when needed. Systems were in place to protect people from abuse.

Staff received appropriate training and support. No new staff had been recruited at the service for many years. Staff had undergone enhanced criminal bureau checks.

All records seen were up to date and were stored securely.