Background to this inspection
Updated
9 November 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by an inspector, a further inspector conducted telephone calls to people’s relatives for their feedback.
Service and service type
Brighton & Hove Bethesda Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brighton & Hove Bethesda Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from Healthwatch, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people who used the service and 5 relatives of people who use the service about their experience of the care provided. We approached 5 health and social care professionals for their feedback and spoke with 10 members of staff including the registered manager, the deputy manager, the office manager, care workers, kitchen staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 6 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
Updated
9 November 2023
About the service
Brighton & Hove Bethesda Home is a residential care home providing personal care to up to 22 people. The service provides support to older people with age related frailties and people living with dementia. At the time of our inspection there were 12 people using the service. A condition of residency is people are members of the Gospel Standard Churches, or they regularly attend their chapels.
People’s experience of using this service and what we found
People told us they felt safe and happy at the service and were comfortable to speak with staff or management if they had any worries or concerns. A person told us, “Yes I do feel safe because of the staff and the residents, I like all of them.” Staff received safeguarding training and understood how to prevent and report allegations of abuse. Staff told us they were confident the registered manager would act on any disclosures.
People received medicines from trained and competent staff. The service was clean, and staff practised good infection control to help protect people from the risk of infectious diseases. A relative told us, “The home is lovely and clean.” Our observations confirmed this.
People’s health risks were assessed and managed safely. Where people required equipment to move and position, staff followed care plans to ensure they were supported safely. Detailed guidance was in place for staff to follow, for example, where people required catheter care.
People were supported by enough staff who were trained to meet their needs. Staff were consistent and knew people well. A person told us, “The staff are very good, they are very kind to me.” A relative said, “Staff are pretty good. They know what they are doing.”
People were treated with dignity and respect. We observed kind interactions throughout the inspection. Staff spoke with people respectfully, addressing them by their preferred name. A person told us, “Staff are good at making sure I have privacy and if my family visit they give us space too.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We observed, staff frequently asking for consent before supporting people whilst respecting their autonomy. A person said, “I cannot find fault in anything. I am treated well, the way anyone would want to be treated.”
People and where required, their relatives were involved in planning their care, this included life stories so staff could understand people. Care was reviewed regularly and updated when people’s needs changed. Staff engaged with visiting health and social care professionals to achieve good outcomes for people. A visiting healthcare professional told us, “I am completely confident staff follow our instructions, we put a care plan in for carers.”
People, their relatives and staff told us they we able to make suggestions and raise concerns if needed. A person said, “I haven't had cause to complain but I would feel able to voice my opinions and I feel my concerns would be listened to and dealt with accordingly.”
People and their relatives were invited to contribute towards the running of the service, their views were listened to. Staff and management kept relatives up to date with changes to their loved ones, relatives told us they could approach the registered manager at any time.
Quality assurance processes were effective in identifying areas for improvement, shortfalls were addressed at the time or shortly following audits. Management listened to staff feedback, for example, housekeeping staff requested a new format for the cleaning schedule, this was completed following an audit. The provider was in the process of updating audit forms and policies for staff to follow, this was being completed at the time of our inspection, the staggered approach of introducing the documents ensured no disruption to the running of the service.
Staff and the management team worked with health and social care professionals to improve people’s care and well-being. Staff spoke of a good working relationship with external agencies and visiting professionals spoke highly of the service. Comments included, “[Registered manager] is absolutely lovely, a good leader, they listen to their staff and community. The residents are fully engaged in decisions, it is seen as their (people’s) home, [registered manager] is excellent.” And, “They contact us for support if people are acutely unwell. It’s very much about partnership working.”
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 the service under the previous provider was good, (published 14 September 2017).
Why we inspected
This is the first inspection for this newly registered 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.