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Bamfield Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 October 2018

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

Bamfield Lodge provides accommodation with nursing and personal care for up to 60 people. At the time of our inspection 47 people were living in the home. The home comprises four units over three floors. Crocus, on the ground floor, provides personal care, Bluebell and Daffodil on the first floor provide nursing care and Snowdrop on the second floor provides care for people living with dementia.

At the last inspection on 26 September 2017 the service was rated Requires Improvement. We found repeated breaches of the regulations relating to management of medicines, risk management and quality assurance systems. We imposed a condition on the provider’s registration. We also found a breach of the regulation relating to staff supervision and training and we issued a requirement action. Following the inspection, the provider was required to send us an action plan each month telling us how they were making the required improvements.

We carried out a comprehensive inspection on 29 & 30 August 2018. At this inspection, we found improvements had been made and the legal requirements had been met. However, further improvements were needed to make sure all shortfalls were promptly identified and where changes had been made, these were consistent and sustained.

At the time of our inspection, an incident relating to medicines management for medicines that required additional security had been reported to the police and to the Local Authority safeguarding team. A safeguarding investigation was being undertaken.

Overall, the service has remained Requires Improvement.

There was a registered manager in post. They completed the registration process soon after our inspection visit. 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.

Sufficient numbers of staff were not deployed on the first day of our inspection. Sufficient staff were deployed on the second day of our inspection.

Staff were safely recruited. Staff received sufficient supervision and training to ensure they could meet people’s needs.

There were improvements in the management of medicines and shortfalls were acted upon with actions agreed. Further improvements were needed to make sure the improvements were consistently implemented.

Staff demonstrated a good understanding of safeguarding and whistle-blowing and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions. The principles of the Mental Capacity Act (MCA) 2005 had been followed.

Risk assessments and risk management plans were in place. Improvements were needed to make sure care was consistently delivered in line with assessed and current needs.

Incidents and accidents were recorded and showed that actions were taken to minimise the risk of reoccurrence.

People’s dietary requirements and preferences were recorded. People did not always receive the support they needed at mealtimes.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

An activities programme provided a range of activities and entertainment.

Systems were in place for monitoring quality and safety. Improvements were needed to make sure shortfalls were identified and actions taken consistently to make improvements.

In line with our procedures for services that have been repeatedly rated as Requires Improvement, we will meet with the registered

Inspection areas

Safe

Requires improvement

Updated 25 October 2018

The service remains requires improvement.

Improvements had been made to the management of medicines. Further improvements were needed to make sure changes and improvements were consistent.

People were protected from abuse because staff had received training and knew how to identify and act on concerns.

On the first day of our inspection, the deployment of staff was not sufficient to meet the needs of people living in the home. On the second day, sufficient staff were deployed.

Accidents and incidents were reported and actions taken to reduce recurrences.

Recruitment procedures were in place and appropriate checks were completed before staff started in post.

Effective

Requires improvement

Updated 25 October 2018

The service remains requires improvement.

The service complied with the requirements of the Mental Capacity Act 2005 (MCA). People were asked for consent before care was provided. Where best interest decisions were made, these were recorded.

Nutritional needs and preferences were recorded and actions taken when people’s weight changed. Improvements were needed to make sure the dining experience met the needs of people in all areas of the home.

Staff received training and support to enable them to meet people’s needs.

People had access to a GP and other health care professionals.

Caring

Good

Updated 25 October 2018

The service remains good.

Responsive

Requires improvement

Updated 25 October 2018

The service remains requires improvement.

Improvements had been made and care records were personalised. Further improvements were needed to make sure care was delivered as planned.

People had the opportunity to express their views and the complaints procedure was easily accessible.

Well-led

Requires improvement

Updated 25 October 2018

The service remains requires improvement.

Systems were in place to assess, monitor and mitigate risks to people. Systems needed to be strengthened to make sure shortfalls were promptly identified and consistently acted upon.

A registered manager was in post. People spoke positively about the new leadership in the home and could provide feedback and express their views.

The registered manager recognised their responsibilities regarding notifications required by the Commission.