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Bourne Hill Care Home Requires improvement

We are carrying out a review of quality at Bourne Hill Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 September 2018

This inspection took place on 29 August 2018 and was announced. The provider was given 24 hours’ notice because the location provides a service for people who may be out during the day, we needed to be sure that someone would be in. At our previous inspection in July 2017 we rated this service “Good” however we found one breach of regulations with regards to notifying the CQC of significant events. We found that the provider had taken satisfactory actions in response to the last inspection report.

Bourne Hill Care Home 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. Bourne Hill Care Home provides care and support for up to five people with learning disabilities. At the time of our inspection there were four people using the service. The care service has 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.

There was a registered manager at the service at the time of our inspection. 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.

We found there was a procedure to identify and manage risks however assessments were not always updated regularly or when people’s needs changed. Staff told us they felt supported however they did not always receive their on-going professional development. Staff were not receiving annual appraisals. Staff did not always receive formal supervision.

People and a relative told us they felt safe with staff and there were enough staff to meet their needs. Staff were trained in safeguarding and knew how to safeguard people against harm and abuse. Staff kept detailed records of people’s accidents and incidents. Staff wore appropriate protection equipment to prevent the risk of spread of infection. Medicines were stored and administered safely. People’s finances were handled safely. The home environment was clean.

Staff undertook regular training to help support them to provide effective care. The registered manager had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). However, staff did not have a good understanding of MCA and DoLS. MCA and DoLS is legislation protecting people who are unable to make decisions for themselves or whom the state has decided need to be deprived of their liberty in their best interest. We have made a recommendation about staff training on the subject of MCA and DoLS.

We saw people had choices about their life. The service was well decorated and adapted to meet the needs of people using the service.

People told us that they were well treated and the staff were caring. We found that care records were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service. People had access to a variety of activities. People’s end of life wishes was explored. The service had a complaints procedure in place and relatives knew how to make a complaint.

Staff told us the registered manager was supportive. The service had various quality assurance and monitoring mechanisms in place however had failed to id

Inspection areas

Safe

Requires improvement

Updated 20 September 2018

The service was not always safe. Risk assessments were not always updated regularly or when people’s needs changed.

Staff were able to explain to us what constituted abuse and the action they would take to escalate concerns.

Medicines were recorded and administered safely.

Staff were recruited appropriately and adequate numbers were on duty to meet people’s needs.

People’s finances were managed safely.

People were protected by the prevention and control of infection.

Effective

Requires improvement

Updated 20 September 2018

The service was not always effective. Staff did not receive regular supervision and appraisals. Staff undertook regular training.

The provider meet the requirements of the Mental Capacity Act (2005) to help ensure people’s rights were protected. The registered manager had a good understanding of Deprivation of Liberty Safeguards (DoLS). However, staff did not have a good understanding of MCA and DoLS

People were supported to drink sufficient amounts and eat nutritious meals that met their individual dietary needs.

People’s health and support needs were assessed and appropriately reflected in care records. People were supported to maintain good health and to access health care services and professionals when they needed them.

Caring

Good

Updated 20 September 2018

The service was caring. People and a relative told us that they were well treated and the staff were caring. People could make choices about how they wanted to be supported and staff listened to what they had to say.

People were treated with respect and the staff understood how to provide care in a dignified manner and respected people’s right to privacy.

Responsive

Good

Updated 20 September 2018

The service was responsive. People’s needs were assessed and care plans to meet their needs were developed. Staff demonstrated a good understanding of people’s individual needs and preferences.

People had opportunities to engage in a range of activities.

The service had a complaint process in place.

The service had an end of life policy for people who used the service. The service explored people’s end of life wishes.

Well-led

Requires improvement

Updated 20 September 2018

The service was not always well-led. Quality assurance checks were not always identifying problems with the service provision.

Staff told us they found the manager approachable and supportive.

The service linked in partnership with other agencies to help support people.