This inspection took place on 17 November 2015 and was unannounced. We last inspected this service on 18 and 19 March 2015 where we identified breaches relating to:
Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to staff failing to carry out person centred care.
Regulation 11 HSCA 2008 (Regulated Activities) Regulations 2014 which related to obtaining and acting in accordance with the consent of service users in relation to the care and treatment provided for them in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards.
Regulation 18 HSCA 2008 (Regulated Activities) Regulations 2014, which related to the arrangements in place to ensure that staff were appropriately trained and supervised to deliver safe care and support to people.
This inspection took place on 17 November 2015 and was unannounced. This meant the staff and provider did not know we would be visiting. This inspection was a re-rating inspection carried out to provide a new rating for the service under the Care Act 2014 and to see if the registered provider and registered manager had made the improvements we required during our last inspection on 18 and 19 March 2015.
The provider sent us an action plan telling us about the actions to be taken and that the improvements would be completed by June 2015.
During this inspection we found the provider was no longer in breach of regulations and had made significant improvement to the service and the care people received.
Boroughbridge Manor and Lodge Care Home is a residential care home for older people, some of whom are living with dementia. The home can accommodate up to 76 people over three floors and is located in the town of Boroughbridge. The registered provider is Boroughbridge Manor Limited. There were 64 people living at the home.
The service had a registered manager in place. They had been in post since February 2015 and registered with the Care Quality Commission since 6 August 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe. Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures to support them in their role.
Risk assessments were completed so that risks to people could be minimised whilst still supporting people to remain independent. The service had systems in place for recording and analysing incidents and accidents so that action could be taken to reduce risk to people’s safety.
Medication was managed safely and people received their prescribed medication on time. Staff had information about how to support people with their medicines.
Staff recruitment practices helped ensure that people were protected from unsafe care. There were enough qualified and skilled staff at the service. Staff had received relevant training which was targeted and focussed on improving outcomes for people who used the service. This helped to ensure that the staff team had a good balance of skills, knowledge and experience to meet the needs of people who used the service.
Staff had received further guidance and training with regard to current good practice for supporting people living with dementia. They were able to speak more confidently about the issues and how this had impacted on their practice and improved the well-being for people they cared for.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions.
People had their nutritional needs met. People were offered a varied diet and were provided with sufficient drinks and snacks. People who required special diets were catered for.
People’s needs were regularly assessed, monitored and reviewed to make sure the care met people’s individual needs. Care plans we looked at were person centred, descriptive, and contained specific information about how staff should support people. People had good access to health care services and the service was committed to working in partnership with healthcare professionals.
People told us that they were well cared for and happy with the support they received. We found staff approached people in a caring manner and people’s privacy and dignity was respected.
People looked well cared for and appeared at ease with staff. The home had a relaxed and comfortable atmosphere.
People were involved in activities they liked and were linked to previous life experience, interests and hobbies. Visitors were made welcome to the home and people were supported to maintain relationships with their friends and relatives.
The provider completed a range of audits in order to monitor and improve service delivery. Where improvements were needed or lessons learnt, action was taken.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance systems in place. This helped to ensure that people received a good quality service. They told us the manager was supportive and promoted positive team working.