A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? 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. If you want to see the evidence that supports our summary please read the full report.
At the time of our visit there were 26 people living at the home. We spoke with five of the people who lived there, four staff, two health and social care professionals, one visitor, the Registered Manager and the provider. There were five care staff, two domestics, a cook and a general assistant on duty. The Registered Manager was registered to manage two homes. On the day of our inspection they were at the other home, but came to Bascombe Court to support the inspection.
Is the service safe?
We found care and treatment had been planned and delivered in a way that was intended to ensure people's safety and welfare. For example, we saw a comprehensive assessment of people's needs and a range of risk assessments had been completed. These included assessments for moving and handling, pressure areas and diet and nutrition. We saw that where people had been assessed as being at risk from pressure sores, suitable equipment had been provided to minimise the risk.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards aim to ensure that people are protected from the risk of inappropriate restraint in any form. The Registered Manager told us that no-one was subject to a current DoLS authorisation by a Local Authority. However, they were aware of recent changes in the legislation and were checking to see if applications for authorisation were needed.
When we asked people if they felt safe at the home they told us they did. One person told us 'Oh yes!' and another said 'Can always go and talk to people if I'm worried'.
Staff told us they had never seen any incident of abuse at the home. We saw no incidents during our inspection that gave us cause for concern. The two health and social care professionals that we spoke with also told us they had never seen anything that worried them during their visits.
Is the service effective?
We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. For example, we saw that where people had been assessed as needing help with personal care, there was evidence in the daily records that this help had been given. We saw information recorded in one person's care plan about how staff were to manage the person's distress. The provider may wish to note that daily records for this person showed that not all staff were following the care plan. This meant that staff were not always responding to the person in a consistent manner and their distress could be increased.
We spoke with four care staff who told us they felt supported to ensure they were effective in their role. One told us 'If something is not right I go straight to the manager and she gets things sorted'.
Is the service caring?
People living at the home spoke highly of the care received. One person told us 'The staff are all very nice and helpful' and another said 'Staff are very good, can't fault them at all'.
We discussed people's care needs with staff and they told us about people's needs and how they liked their care to be delivered. Staff we spoke with were able to tell us what they did to support people and knew what to do for them if they needed any additional support. For example, one staff member told us about how a person needed prompting with eating as they sometimes forgot that they needed to eat. Another staff member told us about how one person needed more help with their personal care as they had got frailer.
People told us that there were activities and entertainments on offer and they could choose to attend or not. One person told us they enjoyed going out on the bus trips. On the day of our inspection we saw people enjoying an arts and crafts session.
People living at the home were very complimentary about the staff at the home. People told us 'Staff are wonderful, really wonderful', 'For me it is the ideal place' and 'This is my home'.
Is the service responsive?
Information about visits from and to health care professionals had been recorded in individual care plans, showing clear evidence that people were supported to maintain access to specialist medical services. We spoke with one social care professional who told us they were very happy with the way the home had provided information to them during their visits. We also spoke with a visiting Community Nurse who told us the staff always called them in appropriately and followed any directions given to them.
People told us that regular meetings were held with the Registered Manager. People said they were able to raise any concerns, or make suggestions. We saw minutes of a meeting where people had complained about the quality of sausages being provided. We saw that at the next meeting people praised the quality of sausages now being provided. This showed us that the provider acted on people's requests.
Is the service well-led?
Staff told us and records confirmed that they received regular supervision and appraisals. Regular supervision ensured staff had the opportunity to discuss their work and learning and development in a measured, monitored and supported way.
We saw that the Registered Manager had identified, assessed and managed risks relating to the health, welfare and safety of people who used the service and others who may be at risk. For example, we saw that an infection control audit had been completed in July 2014.
We saw a copy of a system of monthly audits completed by the Registered Manager. These audits included a visual check of moving and handling equipment such as handling belts and hoists. We saw that the last audit had been completed in July 2014. We saw that medications were audited monthly, the last audit being undertaken in July 2014.