Archived: BDC-Northern House

BDC Northern House provides accommodation and personal support for up to eight people with learning disabilities. Accommodation is provided over two floors and there is wheelchair access on the ground floor. There were seven women using the service at the time of our inspection.

When we inspected, a new manager had been appointed. They were in process of applying to register and were already registered for a second care home owned by the registered provider. The second care home was next door to BDC Northern House. 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.

People and their relatives told us they felt safe at BDC Northern House. Care records reflected people’s identified needs and the associated risks to their health and welfare. Staff knew how to manage these risks and the correct procedures to follow if they considered someone was at risk of harm or abuse. The provider was open and honest when safeguarding concerns had been raised and worked with professionals to improve.

People were supported by adequate numbers of staff who had been safely recruited. Staff were provided with relevant training to meet people’s individual needs. They were supported to maintain and develop their knowledge and skills through regular supervision.

The home was well maintained and equipped with appropriate aids and adaptations to meet people’s individual needs. Health and safety checks were carried out to make sure the premises and equipment was safe for people to use.

People were supported to keep healthy and received the assistance they needed to eat and drink well. Any changes to their health or wellbeing were responded to quickly. Staff worked effectively with other professionals to ensure people received the care and support they needed. Medicines were managed, stored and disposed of appropriately. There were systems for checking that people received their medicines correctly and that staff administered medicines safely.

Staff treated people with dignity, respect and kindness. They knew people well and were aware of their needs, likes and dislikes and preferred methods of communication. Care records were up to date and gave staff information about how to support people in the right way.

People’s care records recognised their rights and were person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People took part in activities that interested them and were supported to maintain relationships with those close to them. Relatives and friends were welcome to visit when they wished and invited to participate in social events at the home.

There was an open and inclusive atmosphere in the service and the manager showed effective leadership. The manager knew what was working well and what needed improving in the home. Audits and checks were used to monitor the quality of care people received. People and their relatives were encouraged to share their views and experiences and were involved in developing the service.

This inspection was carried out by one inspector who helped answer two of our five questions, is the service safe and well-led?

At the time of our visit, there were eight people using the service. We met with three of them, the registered manager and two care staff. Following our inspection, we also telephoned a social care professional involved with the service for feedback.

Is the service safe?

At this inspection we found that the manager had improved the care records and information held about people using the service. People using the service had personalised support plans, which were current and outlined their agreed care arrangements. Everyone's care plans had been reviewed and showed that staff responded to changes in people's needs or circumstances. There were up to date risk assessments which set out what to do to keep people safe. This meant staff had accurate information on how to meet people's individual needs.

Is the service well-led?

Since our last inspection, quality monitoring systems had been strengthened. Further audits and checks had been introduced which meant that the manager knew what was working well and what needed improving in the home. It also showed that the quality of service was regularly checked .

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. Due to their needs, people using the service were unable to share their direct views about the standards of care. We therefore used observations and looked at care records to help us understand their experiences. We looked at six people's care files, staff training records, many of the home's policies and procedures, and looked around the premises. We spoke with the registered manager, three members of staff and telephoned three people's relatives following our visit. We also spoke with two healthcare professionals involved with the service.

Prior to our inspection, we had also received some information of concern about the care and welfare of some people using the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw people were being cared for in an environment that was safe, clean and hygienic.

People were safe because staff knew what to do when safeguarding concerns were raised. Staff had been trained to recognise and respond to abuse and they followed appropriate procedures. One relative told us their family member was 'very, very safe there.'

There were enough qualified, skilled and experienced staff to meet people's needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place and the registered manager and staff were due to refresh their training Where people did not have the mental capacity to consent, care was provided in their best interests.

We found that accurate up to date records of people's care and support needs were not being regularly maintained, reviewed and monitored. This meant that people were not always protected from the risks of unsafe or inappropriate care and treatment. A compliance action has been set for this and the provider must tell us how they plan to improve.

Is the service effective?

Staff we spoke with had a detailed knowledge of people's needs and knew how to provide care and support for them. The three relatives we spoke with felt that the staff understood their family members' needs. We saw that staff had attended mandatory training and more specialist training based on the needs of the people using the service. Although there were some gaps in the training records, the manager had identified these gaps and arranged for training to be delivered in the next few months.

We saw that there was good liaison and communication with other professionals and agencies to ensure people's care needs were met. The service had made timely referrals for health and social care support when they identified concerns in people's wellbeing. Records showed that staff had followed the advice and guidance provided by health and social care professionals.

Healthcare professionals we spoke with told us that the service acted upon their advice and instructions for people's care and treatment. One told us, 'I have always found them [staff] really attentive and they listen carefully to advice.'

Is the service caring?

People living in the home have learning disabilities, some of whom have physical disabilities and limited communication abilities. During our observations we saw positive interactions between staff and people who use the service. Staff were attentive to individuals and were able to identify with the gestures and reactions that people gave, what these were likely to indicate and respond appropriately. We saw that people were relaxed and comfortable around the staff.

One relative told us, 'I'm very happy as [my family member] is very happy there.' Another relative commented, 'they look after [my family member] very well'

A professional said that the manager and staff 'seem caring and efficient.'

Is the service responsive?

Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were meaningful to them and had been supported to maintain relationships with their families.

Overall, care records provided up to date information about people's needs which meant that staff understood how to support each person and provide consistent care. Others close to them, such as their family members, were also involved in decisions about their care. One relative told us, 'I speak on the phone with them every day.'

Is the service well-led?

There was a registered manager in post and all other conditions of registration were being met at the time of our inspection.

The provider did not have sufficient quality assurance systems in place to check that the quality of the service was meeting people's needs and ensure that people were well cared for and safe. The arrangements to monitor service provision through audits and feedback from people using the service and their representatives were limited. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

External professionals were involved in people's care so that each person's health and social care needs were monitored and met. The service worked well with other agencies and services to make sure people received care in a coherent way.

On the day of our inspection we met with everyone who lived at the home and observed how staff supported and cared for individuals. We saw that the registered manager and staff respected people's privacy and dignity, and took account of what people expressed and said in relation to the way their care and support was provided. For example, we saw people who use the service had a communication profile in their records which indicated individual's method of communication that they and members of staff understood.

We saw the service had adopted various ways to ensure that people who use the service were supported fully and individual's needs were being met. These included weekly meetings with everyone who used the service and annual satisfaction surveys that were completed and put into action.