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Inspection Summary


Overall summary & rating

Good

Updated 16 October 2018

The inspection took place on the 10 and 13 September 2018 and was unannounced.

At our last inspection on 5 May and 23 June 2017, we found that the service was in breach of regulations relating to safeguarding, the management of risk and good governance. The service was rated overall as ‘requires improvement.’ We took action by requiring the provider to send us an action plan setting out how they would address these issues. During this inspection we found improvements had been made and the provider was no longer in breach of these regulations. We found that overall the service had improved and is now rated as “good”. However, some further improvements were still required related to the safe domain.

Bentley Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bentley Manor accommodates up to 80 people across three separate units, each of which have separate adapted facilities. Two of the units specialises in providing care to people living with dementia. At the time of the inspection there were 74 people living at the home.

The majority of people were very positive and complementary about the care and support they received at Bentley Manor. Improvements had been made to demonstrate that risks to people were assessed and action taken to mitigate these risks. We specifically looked at people at risk of falling and found that appropriate action had been taken. In some instances we saw that records had not been updated to reflect the action taken.

Overall, we found that there were sufficient staff to meet the needs of people. However, at certain times levels were affected by unexpected staff absences such as sickness. The registered manager confirmed that action would be taken to ensure all staff understood the systems for managing staff absences, especially at short notice.

Where necessary safeguarding concerns had been identified and reported to the local authority and CQC had also been notified. Staff understood when and how to report safeguarding concerns. Staff were recruited following safer recruitment processes. We found that medicines were managed safely.

Staff were knowledgeable about the Mental Capacity Act 2005 (MCA) and understood it’s principles. We saw that staff sought consent from people before providing support. Staff were trained to carry out their duties as required. Staff received supervision to support them with their development, however there were occasional gaps and variations in the frequency of these. The management team told us that they would focus on this.

People were supported to meet their nutritional needs. Overall people told us they were happy with the food on offer, however a few comments suggested that the food was sometimes cold and people would appreciate more fruit and vegetable choices. Any nutritional risks were monitored and action was taken in response.

A range of health professionals were involved in people's care. The registered manager had developed several clinical pathways because of learning from a recent incident at the service.

People told us that they were treated in a kind and caring manner. We saw that staff respected people’s dignity and privacy. We saw some good examples of care being provided in a way which met individuals’ needs. The service considered people’s diverse needs well

People’s care plans reflected their physical, mental, emotional and social needs. They included information about people’s histories, likes, dislikes and preferences. Activities were available to people, but these had recently reduced due to staff changes. The management team planned to get these back on track. The staff had trained in Namaste care, which provides specific support to people living with dementia.

There was a complaints procedure in place and people told us that they felt able t

Inspection areas

Safe

Requires improvement

Updated 16 October 2018

The service was not consistently safe.

Overall there were sufficient staff, but this was affected at times by staff absences.

Medicines were managed safely.

Risk assessments were in place and action was taken to mitigate risks. Some records had not always been updated.

Where necessary safeguarding concerns had been identified and reported to the local authority

Effective

Good

Updated 16 October 2018

The service was effective.

Staff spoken with were knowledgeable about the MCA and understood it�s principles.

People's nutritional needs were met.

A range of health professionals were involved in people's care. The registered manager had developed several clinical pathways.

Staff were well trained and supported in their roles.

The environment had been well adapted to meet the needs of the people living there.

Caring

Good

Updated 16 October 2018

The service was caring.

Staff were kind and caring in their approach.

People were involved in the planning and decisions around their care.

People told us their privacy and dignity was respected by the staff.

Importance was placed on ensuring that the service met people's diverse needs.

Responsive

Good

Updated 16 October 2018

The service was responsive.

People's needs were met in a way that took account of their personal preferences.

Care plans were in place and had been reviewed on a regular basis.

Some activities and entertainment took place, however these had recently reduced due to staff changes. This was being addressed.

There was a complaints procedure in place and people felt able to raise any concerns about the service.

Well-led

Good

Updated 16 October 2018

The service was well-led.

There was a registered manager in post, who was supported by a deputy manager.

People and staff were positive about the management of the service.

People's views on the quality of the service were sought.

There were arrangements in place to regularly assess and monitor the quality of the service.