Buckingham Lodge is a residential care home providing the regulated activity accommodation for persons who require nursing or personal care to up to 64 people. The service provides support to older people and people with dementia. At the time of our inspection there were 30 people using the service.
Buckingham Lodge is purpose built and accommodates people over three floors. Each unit has its own lounge, kitchenette, dining areas and bathrooms. Alongside this the service has a cinema room, hairdressers and family room. The ground floor unit provides care to people living with dementia, whilst the first floor supports people with residential and dementia care needs. At the time of the inspection two units were in use.
People’s experience of using this service and what we found
People and their relatives were generally happy with the care. They told us staffing levels and communication with them had improved, although there was still some inconsistencies in staff due to agency use and access to activities for people. People and relatives commented “I am happy living here, the carers are all very nice and always very helpful," and “I am really pleased with Buckingham Lodge and can’t speak highly enough of mum’s care, it is second to none and the carers are all good.”
Risk to people were identified and mitigated, with staff aware of people’s risks and how to support them. Systems were in place to safeguard people. However, infection control practices observed did not always mitigate the risks of cross infection. A recommendation has been made to improve practices.
Staff were suitably recruited with training and supervision of staff improved. The provider had been proactive in recruiting staff to provide consistent care to people. Staffing levels had improved with an isolated occasion where the staffing deemed required was not provided due to short notice sickness.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Improvements have been made with decision specific mental capacity assessments and best interest decisions in place. However, we have made a recommendation for the provider to work to best practice in their application of the Mental Capacity Act 2005 and ensure mental capacity assessments and best interest decisions are referred to in relation to the delivery of care.
Staff meeting minutes and email communication with relatives indicated that the service did not encourage negative feedback. This did not promote an open and honest culture to promote positive outcomes for people. We have made a recommendation to address this.
Auditing and monitoring of the service was taking place which enabled the provider to identify shortfalls in the service provided. Improvements have been made to records, however we have recommended further improvements to ensure records are suitably maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 15 September 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since August 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced focused inspection of this service on 15 and 16 June 2021. Breaches of legal requirements were found. 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, safeguarding, staffing, good governance and need for consent.
We undertook this focused inspection to check they 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 and Well-led which contain those requirements and warning notices.
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 inadequate to requires improvement. This is based on the findings at this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Buckingham Lodge on our website at www.cqc.org.uk.
We have made recommendations under safe and well led to further improve practice and sustain improvements.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.