Archived: Bagshot Park Care Centre

There was no registered manager in post. 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. The registered manager had resigned their post and the service had been supported by an interim manager. A new manager had recently started at the service and was in the process of submitting their application to register with the Care Quality Commission. Both the interim manager and new manager were present to support us with inspection.

At our last inspection in December 2015 we found breaches of the legal requirements with regard to the safe recruitment of staff and the management of care records. The provider wrote to us to inform us how they planned to take in relation to the above concerns. At this inspection we found that the required improvements had been made and the provider was meeting their legal responsibilities.

There were safe recruitment processes in place to ensure staff employed were suitable to work at the service. Staff were knowledgeable regarding their responsibilities of safeguarding people from the risk of abuse and were confident that any concerns raised would be correctly reported. There were sufficient staff deployed in the service to ensure people’s needs were met in a timely manner.

Risks to people’s safety and well-being were assessed and control measures implemented to keep people safe. Staff were knowledgeable about the support people required to manage risks safely. Medicines procedures were in place to ensure people received their medicines in line with prescribed guidelines.

Safety checks on the environment and equipment used were completed regularly. Where accidents or incidents occurred these were investigated to ensure any changes to the way people were supported were made and reduce the risk of reoccurrence. The provider had developed a business continuity plan which meant that people’s care would not be interrupted should an emergency occur.

People were supported by skilled staff who received induction and training to support them in their role. Clinical staff had access to supervision from a Nero-rehabilitation consultant to ensure that best practice guidance was followed and any concerns or changes in people’s health were identified quickly. People’s healthcare was supported by an in-house multi-disciplinary team which included nurses, physiotherapists and occupational therapists. In addition, people had access to external healthcare professionals and specialist advice.

People told us that the quality of food was good and a choice was always available. People were supported to maintain a healthy diet. Where people required support to eat this was provided in a dignified and unhurried way. Staff were knowledgeable about people’s individual dietary requirements and advice from professionals regarding nutrition was followed.

Staff were knowledgeable about protecting people’s rights and spent time with people ensuring they gained consent prior to delivering care. There was a strong emphasis throughout the service on maintaining and developing people’s independence and staff worked together to ensure people’s needs and abilities were continually assessed.

People were supported with kindness and compassion by staff who knew them well. There was a relaxed atmosphere throughout the service. Staff were aware of people’s individual communication needs and supported people to use a variety of communication aids to make their needs and preferences known. People’s privacy and dignity was respected and visitors to the service were made to feel welcome.

People’s care was provided in line with their needs and preferences. Prior to moving into the service people’s needs were assessed and care plans were developed using this information. Staff demonstrated a good understanding about how people preferred their support.

Complaints were taken seriously and responded to in a timely manner. People and their relatives told us they felt comfortable in raising concerns and felt listened to.

The provider had ensured that systems were in place to gain people’s views of the service and had taken action to resolve any issues raised. Regular audits were completed to monitor the quality of the service provided.

There is an in-house multidisciplinary team, which consists of two physiotherapists, speech and language therapist and two rehabilitation assistants. When required, staff have access to a locum occupational therapist and psychologist.

At the time of our inspection 12 people were living at Bagshot Park.

This inspection took place on 8 December 2015 and was unannounced.

The home had a registered manager. 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 and associated Regulations about how the service is run. The registered manager was present during part of our inspection.

Care plans contained information to guide staff on how someone wished to be cared for. Although we found records held for people were not always contemporaneous.

People were not offered individualised, meaningful activities and there was little going on at the service during our inspection.

Safe recruitment practices were not always followed, which meant the provider could not be assured they always employed staff who were suitable to work at the service.

Risks to people had been identified and accidents and incidents were recorded and appropriate action taken.

People received care from a sufficient number of staff. Staff maintained people’s health and ensured good access to healthcare professionals when needed. People received their medicines in a safe way as staff followed correct and appropriate procedures in administering medicines.

People were cared for by staff who cared about them. Staff demonstrated they were kind and respectful to people. Care was provided to people by staff who were suitably trained. People and relatives were happy with the care provided and they were made to feel welcome when they visited.

People were provided with a choice of meals each day and those who had dietary requirements received appropriate food.

Staff understood the legal requirements in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The correct processes were followed when people did not have the capacity to make a decision.

Staff received relevant support from their manager. This included regular supervisions and undertaking training specific to their role. Staff were able to evidence to us they knew the procedures to follow should they have any concerns about abuse or someone being harmed.

Quality assurance checks carried out by staff to help ensure the environment was a safe place for people to live and people received a good quality of care. People, relatives and staff were involved in the service as regular meetings were held and suggestions made were listened to.

Complaint procedures were available to people and should the service have to be evacuated there was a contingency plan in place which meant people’s care would be uninterrupted.

During the inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Review of the documentary evidence provided by the registered manager demonstrated that improvements had been made as required.

Where people were unable to make decisions regarding the care and support they needed, a mental capacity assessment had been carried out as required by the Mental Health Act 2005. Following this assessment, decisions had been made in consultation with the person or their representative and after taking clinical advice into account.

We saw evidence in documents provided to us by the service manager that care was planned and delivered in accordance with the wishes of the person using the service and that they had been involved in the planning of their care and had agreed to it. In the case of a person using the service being unable to make a decision, the manager had carried out an assessment of their mental capacity and had planned their care in consultation with the person's representative and general practitioner and psychiatrist.

Two people told us they were very happy with the care and support they received. They said they 'could not fault the nurses'. One person said, 'The staff, every one of them including the night staff are just wonderful. They will do anything for us.' People told us what they liked best about the service was the way the staff involved them in their care. One person said, 'All the staff discuss my care with me'.

We found people expressed their views and were involved in making decisions about their care, treatment and support. They experienced effective, safe and appropriate care and were provided with suitable equipment to maintain their safety. People had their medicines at the times they needed them from staff qualified and skilled to do so. People's comments or complaints were carefully considered and responded to. Suitable precautions were in place to protect people and staff from cross infection of health care associated infections.

The provider had not acted in accordance with legal requirements where people did not have the capacity to give their consent.