Buckingham House

Updated 2 December 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.

Inspection team

The inspection team consisted of 2 inspectors and a specialist nurse advisor on the first day, 2 inspectors and an Expert by Experience expert by experience on the second day and 2 inspectors on the subsequent 2 days.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Buckingham House 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. Buckingham House is a care home with 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.

There was also a home manager who was not registered with CQC but oversaw the day to day running of the service. This manager is referred to as the ‘home manager’ in this report.

Notice of the inspection

This inspection was unannounced.

Inspection activity started on 13 September 2023 and ended on 26 September 2023. We visited the location’s service on 13, 14, 20 and 26 September 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 7 people who used the service and observed how other people were being supported. We spoke with 9 members of staff including senior operational staff, the registered manager, nursing and care staff. We also spoke with an agency nurse and a health professional who was visiting the service. We reviewed a range of records. This included 9 people’s care records and multiple medication records. We looked at 3 agency staff profiles and 3 staff files in relation to safe recruitment. We reviewed a variety of records relating to the management of the service, including policies, procedures and safeguarding incident records.

Updated 2 December 2023

About the service

Buckingham House is a nursing home providing personal and nursing care for up to 60 people. At the time of inspection there were 46 people using the service.

People’s experience of using this service and what we found

People did not receive safe care and treatment. Risks and care needs were not always identified and actions to lessen risks not taken.

People did not always have their clinical needs met effectively. Instruction from health professionals was not always followed leaving people at risk of further health complications.

The environment was not always safely maintained and risks to people’s safety not always identified or rectified.

People did not always receive care that was personalised to their individual needs.

Infection control was not effectively managed.

There was no clear management governance or oversight of the service.

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 this service was good (published 24 April 2019).

Why we inspected

The inspection was prompted in part due to concerns received about how people’s needs were being managed. A decision was made for us to inspect and examine those risks.

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.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Buckingham House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding people from abuse, person centred care, management of risks, safe premises and management and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.