Archived: Bishops Croft

Updated 30 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was completed by an inspector.

Service and service type:

Bishops Croft 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.

The service works in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small. The registered manager, staff and people may have been out of the service.

What we did:

Before our inspection we reviewed the information, we held about the service including previous inspection reports. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we reviewed the information provided, spoke to people and staff and gathered information about the management of the service.

This included:

• Notifications we received from the service

• Staff recruitment files

• Training records

• Two people's care records

• Records of accidents, incidents and complaints

• Audits and quality assurance reports

• We spoke two people using the service.

• We spoke with three members of staff, including the registered manager. We also met with quality and operations manager.

Following our inspection, we spoke with two visiting professionals who provided their view on aspects of specialist support provided to people who lived in the service and one relative.

Updated 30 April 2019

About the service:

Bishops Croft provides residential care for up to eight people with Prader-Willi Syndrome (PWS). The main house provides accommodation for up to seven people and a single unit annexe is situated next to the main house. At the time of inspection there were four people living within the main house.

The service worked in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The operations director told us the service was being reviewed along with other services within the organisation and this would take account of all design recommendations made within Registering the Right Support.

People’s experience of using this service:

•Since the previous inspection, improvements had been implemented. Risks to people’s safety were assessed and responded to. Staffing arrangements were suitable and medicines were safely managed. People’s capacity was assessed when decisions were made including those around people’s health. Record keeping and quality monitoring systems had improved.

•However, some records needed further improvement to ensure all information was used to improve quality and practice. We also found communication between the organisation and people’s representatives was not always effective. These areas needed improvement.

•The outcomes for people living at Bishops Croft were positive with person centred care provided by kind and supportive staff. Staff were committed to ensuring people had a full and active life that they enjoyed. People told us they had the opportunity to do lots of activity that they enjoyed. One person told us and showed us pictures of a celebrity that they had recently met during filming of a TV show.

•Staff knew how to keep people safe. They responded to any risks and took measures to reduce these. Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse.

•Staff supported people in the least restrictive way possible. Staff had attended Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) training.

•Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to ensure their health needs were responded to and health needs were reviewed on a regular basis. People had their privacy and dignity protected.

•People's needs were effectively met because staff had the training and skills they needed to do so. Specialist training was provided to ensure people's needs could be met and refresher courses were booked when due. This included in depth training on PWS, which is a genetic disorder where people are constantly hungry.

•Staff attended regular supervision meetings and told us they were well supported. There were listened to and could influence how the service was run.

•The registered manager led by example and had an established a supportive environment for staff and people. She interacted positively with everyone at the service and ensured that a good relationship was maintained with all professionals. Staff felt appreciated and well supported. Complaints were recorded and responded to in an open way. Accidents and incidents were responded to appropriately.

Rating at last inspection:

Requires Improvement. The last inspection report was published on 04 October 2018. There were breaches and two warning notices served.

Why we inspected:

•At our last inspection of the service in June 2018 we found breaches in Regulation 12 in relation to safety, Regulation 18 regarding staffing arrangements, and Regulation 17 in relation to good governance. We issued warning notices in respect of Regulation 12 and 17 as these were repeated breaches.

•This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care services.

•At this inspection we followed up on progress made. The Regulations had been met.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk