We carried out a review of the data available to us about Buttercup House Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Buttercup House Care Home, you can give feedback on this service.
We found the following examples of good practice.
• The provider had acted to make sure people could have visitors safely. There had been a temporary marquee in the garden during the summer, window visits for people who could not leave the building, and video conferences for families who could not visit physically. The provider planned to use an outbuilding in the garden for visits during the winter with suitable use of PPE, distancing and cleaning protocols in place.
• The provider had anticipated guidance and acted proactively to keep people safe. For instance, they had started a strict home lock down before this was included in government guidance. This had reduced the risk of COVID-19 entering the home.
• The provider had acted to make sure new standards of hygiene and cleanliness could be maintained. They had sourced new cleaning products, and developed and updated staff guidance and audit checklists to meet the new standards.
• The staff team had responded positively to new infection prevention and control procedures. The provider had kept the home free of COVID-19 at the time of our visit.
Further information is in the detailed findings below.
Buttercup House is a residential care home. It provides personal care and accommodation for up to 20 older people. There were 20 people living at the service at the time of inspection, some of whom were living with dementia.
People’s experience of using this service:
People and relatives were very happy with the quality of care at Buttercup House.
Staff were motivated to ensure that people had meaningful occupation and remained active in their everyday lives. The provider had developed links with local community resources to organise activities and events which people could participate in.
Staff treated people with dignity and respect. They understood people’s needs and were patient in their approach. People received individualised care and followed daily routines which they were comfortable and familiar with. People were supported responsively and with compassion when receiving care at the end of their life.
The provider had made adaptions to the home to make it suitable for people living with dementia. The environment was safe, whilst remaining homely and welcoming.
There was a positive atmosphere at the home. Staff were motivated in their role and the registered manager was approachable and in tune with people’s needs. There were enough staff in place, who received appropriate training and support in their role.
People and relatives felt comfortable raising issues with the provider. There were appropriate systems in place to gain people’s feedback and respond to complaints.
The provider and directors visited the home regularly and were motivated in making improvements to the home. There were systems in place to monitor the quality and safety of the service.
There were safe systems in place to manage people’s medicines and other risks associated with their health. People had appropriate access to healthcare services and external stakeholders were consulted when required. People were protected from the risks of suffering abuse or coming to avoidable harm.
People were involved in developing their care plans and relatives fed back positively about the collaborative relationship they had with the provider. 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.
Rating at last inspection:
The service was rated good at our last inspection (report published 27 April 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the time of the inspection the home was undergoing extensive building work and refurbishment to better accommodate the people living at the home.
Buttercup House Care Home did not have a registered manager, however the manager had commenced the process to register with the Commission. 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.
People and their families told us they felt the home was safe. Staff and the manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.
The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.
People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.
There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.
Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.
People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.
Staff developed caring and positive relationships with people and were sensitive to their individual choices, treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.
People received person centred care from staff who knew each person well, about their life and what mattered to them. The people living at the home experienced a level of care and support that promoted their health and wellbeing and aimed to enhanced their quality of life.
People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs.
There was an opportunity for families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through quality assurance questionnaires. They were also supported to raise complaints should they wish to.
People’s families told us they felt the home was well-led and were positive about the manager and provider who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.
There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.
This inspection took place on 26 August and 01 September 2015. This visit was unannounced. At our last inspection on 04 September 2013 we found the provider was meeting the required standards of care.
Buttercup House is a care home which provides accommodation and care for 20 older persons, most of whom were living with dementia. The home was converted from two semi-detached homes into one larger home. There were bedrooms situated on both floors with a communal lounge, dining room and a conservatory. People could access the upstairs rooms by use of stairs and a stair lift. At the time of our inspection there were 17 people living in the home.
The home did not have a registered manager, although a new manager had been appointed and we were aware that they had applied to CQC to become the 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 2008 and associated Regulations about how the service is run.
A previous registered manager had left the service at the end of 2014. An acting manager had been appointed who left before completing their application to become the registered manager. New staff had been difficult to recruit but the provider managed to engage permanent staff from an agency until all vacancies were filled.
Some people told us they did not always feel safe and that on one occasion care was not carried out as they would prefer. Staff had received training in identifying and reporting abuse and knew who they would contact regarding safeguarding concerns.
Risks associated with the delivery of care had not been assessed although there were risk assessments for nutrition and infection control. This meant reasonable steps had not been taken to mitigate or minimise risks which placed people at risk of harm.
People, their relatives and staff told us that staff were always busy. The provider had assessed the level of staff required to deliver the identified needs of people. However, people were not engaged in regular activities during the day and staff did not have sufficient time to spend with people as other people required their support.
People’s needs were assessed before they came to live in the home and these assessments were regularly updated. Care plans were based on the needs identified within the assessment. Some of these had not been reviewed regularly which meant that some of the care plans were not reflecting the current needs of people. The care planning system used was being replaced to reflect a more personalised approach to care needs. A review was occurring of all care plans to update them where required.
Meals were both nutritious and healthy and people were able to choose what they wanted to eat. People’s weights were monitored regularly and food supplements were given in consultation with health care professionals. People were supported to maintain good health and were supported to attend health appointments or by GP visits to the home.
People had built good relationships with staff although they were concerned about the change of manager within the last year. This had meant they were not too sure who they could talk to about concerns they had. Their views were heard by the provider and action taken based on what they had told the provider. A quality assurance system was inplace to seek people, their relatives and staff’s view of the quality of the home.
Care plans and records contained personal information about people’s likes and dislikes. They also contained details of their life history and important events in their lives. People could talk about their care needs with staff and the manager. Systems were available for people to write about their concerns if they did not want to speak to staff. People did not feel involved in their care plans and were unaware of changes made to them.
The home was in the process of change, concerning management and the culture they wished to engage, in order to meet the needs of people. People and relatives were unaware of changes and requested they should be informed of them. Management systems were in place to effectively monitor the quality of the service and actions were taken for improvements when these had been identified.
We saw in people's records their needs were assessed and a care plan was written which was relevant to their needs. Risk assessments were in place to ensure the safety and welfare of people. We saw people were treated with dignity and respect and observed staff engaging people in conversations when working with them.
We found the building to be clean and hygienic. We looked in people's rooms and saw they had been cleaned and bed linen had been changed. The cleaning records were up to date and the maintenance of the building was carried out quickly and efficiently. The provider had made noticeable improvements to the decor in some areas since our inspection in April this year.
On our previous inspection we had found the service to be non compliant in three areas. These areas were:- requirements relating to workers, supporting workers and complaints. The provider had prepared an action plan to assist them to meet compliance. We found the provider and manager had completed the work necessary and were now compliant in these areas.
We also spoke with the manager, two staff, two relatives and a general practitioner. One of the relatives said "The staff are nice but there have been a lot of changes recently". The staff we spoke with were both new in post. One told us "There are some good staff here and the service is well run." The GP told us "Staff are supportive and always aware of problems."
There had been several changes of staff over the last six months and new staff had been appointed. The provider and manager had identified some areas of care they needed to improve and were keen to improve the service for people who used it.
We looked at care plans and found they were effective and staff were following them. We saw people receiving care in line with their needs and they were treated with dignity and respect. The service had effective systems in place for the administration of medicines.
We saw staff had received training but the service was not supporting them with their professional development. The service did not have effective recruitment and complaints processes.