21 December 2022
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.
This was a targeted inspection to check on a concern we had about staffing.
The inspection was carried out by two inspectors.
Service and service type
Bamfield Lodge 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. Bamfield Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 since the last inspection. This included all complaints and whistle blower concerns.
We considered the statutory notifications the provider had sent to CQC. A notification includes information about important events which the service is required to send us by law. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager and regional director about the specific concern we were inspecting. We spoke with 10 people who lived at the service, and spent time observing care to help us understand the experience of others. We spoke with six staff and the relatives or friends of two people who lived at Bamfield Lodge.
We considered all of this information to help us to make a judgement about the service.
21 December 2022
Bamfield Lodge provides personal and nursing care for up to 60 people. The service is provided in purpose built accommodation over three floors. At the time of the inspection, 52 people were living at the home.
People's experience of using this service and what we found
There had been significant improvements following the inspection of 3 and 4 November 2021 and 29 and 30 August 2018. Positive changes had been made so enough competent staff were safely deployed. The provider had looked at staffing levels overall within the home and had increased this. Agency use had significantly reduced, and the home now had its own pool of bank staff who helped to support staff to cover shifts. The provider had looked at the dependency levels within the home and had reduced admissions for people with complex needs.
Risks to people were assessed and monitored. The number of people on food and fluid charts had reduced. Food and fluid charts and monitoring records were filled out accurately. A new manager and deputy were in post who were supported by the regional director. Staff and people were positive about the changes that had been made at the home. Learning had taken place since the last inspection with improvements made to governance audits and the overall monitoring of the home.
Staff demonstrated a good level of understanding in relation to safeguarding. Appropriate referrals to the local safeguarding team had been made. Staff were trained in safeguarding and understood their responsibility to protect people from harm. Staff were recruited safely and there were enough staff to provide safe and effective care. People received their medicines safely. Safety checks of the premises and equipment had been undertaken. People had personal emergency evacuation plans (PEEPs) in place.
The manager provided clear direction and good leadership. Feedback about the home was positive. Staff felt valued and supported, and were confident people received good care. Systems and processes for monitoring quality and safety were effective. There was a programme of audits in place to assist the management team to identify and address shortfalls.
Rating at last inspection
The last rating for this service was Requires Improvement (published 15 December 2021). At our last inspection 3 and 4 November 2021 we found people were not always protected from risk because the provider failed to deploy enough suitably qualified, competent and experienced staff. Improvements were required to ensure risks were assessed and monitored to prevent people from receiving unsafe care and treatment. The provider had failed to ensure consistency so that people received quality person centred care, promoted learning and improved service delivery and promoted an open and fair culture. At the inspection of August 2018 we found staffing levels had affected the delivery of person centred care. At this inspection we found improvements had been made.
Why we inspected
We carried out an inspection of this service on 3 and 4 November 2021 and 29 and 30 August 2018. We rated the service requires improvement in Safe, Responsive and Well Led due to the shortfalls we identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Responsive and Well-led.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bamfield Lodge on our website at www.cqc.org.uk.