Buchanan Court

Buchanan Court is a nursing home providing personal and nursing care to 49 people aged 65 and over at the time of the inspection. The service can support up to 80 people. Care is provided over three floors. However, currently the second floor was unoccupied. Buchanan Court also provides six short term reablement beds for people to recover from an operation before they are discharged back to their own home.

People’s experience of using this service and what we found

People’s experience of the service was positive. They were protected from the risk of harm and abuse. There were effective systems and processes in place to minimise risks. Staff had been recruited safely.

People received person centred care. The service worked with a range of external professionals, so people received coordinated care.

People were protected from the risks associated with poor infection control because the service had processes in place to reduce the risk of infection and cross contamination.

There were governance structures and systems which were regularly reviewed. Quality assurance processes such as audits, unit rounds, accidents and incidents, were used to drive improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update) The last rating for this service was Good (published 12 November 2019).

Why we inspected

This was a planned focused inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Buchanan Court on our website at www.cqc.org.uk.

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.

Buchanan Court is a nursing home registered for a maximum of 80 people. It is managed by Care UK Community Partnership, a large social care provider in England. People using Buchanan Court may require nursing care, have dementia or require re-ablement. Re-ablement is a short and intensive service, which is offered to people who are frail or recovering from an illness or injury. The home is located close to shops and transport links. At the time of our visit, there were 36 people living in the home.

People’s experience of using this service

People and their representatives were satisfied with the care provided. People were safe in the home. Risks to people’s health and wellbeing had been assessed. There was detailed guidance for staff on how to minimise risks to people.

People were protected from abuse. Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to abuse.

People received their prescribed medicines. There were suitable arrangements for the safe administration of medicines.

There were sufficient staff to attend to people’s needs. Staff had been carefully recruited and essential pre-employment checks had been carried out.

The premises were well maintained, clean and tidy. The service had taken measures to prevent and control the spread of COVID -19 and other infections. There was a record of essential maintenance carried out. Fire safety arrangements were in place.

The service provided people with person-centred care and support that met their diverse and individual needs and preferences. People’s care needs had been carefully assessed prior to them coming to the home. Care staff were knowledgeable regarding people’s needs.

People could participate in a range of social and therapeutic activities. The service had ensured that people’s cultural and religious needs were noted and attended to.

There was a complaints procedure and people knew how to complain. Complaints recorded had been promptly responded to.

The service was well managed. Management monitored the quality of the services provided via regular audits and checks. The results of the last satisfaction survey indicated that people and their representatives were mostly satisfied with the care and services provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was Good (published 12 November 2019). At this inspection we found the provider remained as Good.

Why we inspected:

We undertook this focused inspection as we had concerns regarding the service and we wanted to check that people were well cared for. The inspection was prompted in part due to concerns received regarding safeguarding, the safety of people who used the service and the management of the home. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Buchanan Court on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

Buchanan Court is a nursing home registered for a maximum of 80 people. It is newly built and managed by Care UK Community Partnership, a large social care provider in England. People using Buchanan Court may require nursing care, live with dementia or require re-ablement. Re-ablement is a short and intensive service, which is offered to people who are frail or recovering from an illness or injury. The home is located close to shops and transport links. At the time of our visit, there were fifty-four people living in the home.

People’s experience of using this service

People told us they were satisfied with the care provided. They stated that staff treated them with respect and dignity and they felt safe in the home. We observed that staff interacted well with people and were caring and attentive towards them.

Risk assessments had been documented. Risks to people’s health and wellbeing had been assessed. There was guidance for staff on how to minimise risks to people.

Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to abuse.

People received their prescribed medicines. Staff had received medicines administration training and knew how to administer medicines safely.

Staff had been carefully recruited and essential pre-employment checks had been carried out. The home had adequate staffing levels and staff were able to attend to people’s needs. Staff had received training and had knowledge and skills to support people. There were arrangements for staff support, supervision and appraisals. However, a small number of staff felt unsupported. The registered manager told us that she was willing to speak with staff and her door was always open to them.

People were satisfied with their accommodation. The premises were clean and tidy. There was a record of essential maintenance carried out. Fire safety arrangements were in place.

Staff supported people to have a healthy and nutritious diet that was in line with their individual dietary needs and preferences.

The healthcare needs of people had been assessed. People could access the services of healthcare professionals when needed.

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 services supported this practice.

People’s care needs had been assessed prior to them coming to the home and staff were knowledgeable regarding these needs. The service provided people with person-centred care and support that met their individual needs and choices.

Staff supported people to participate in a range of social and therapeutic activities. The service arranged events to celebrate special cultural and religious days.

There was a complaints procedure and people knew how to complain. Complaints recorded had been promptly responded to.

The service was well managed. People said that management listened to them. Management monitored the quality of the services provided via regular audits and checks. The results of the previous satisfaction survey indicated that people were satisfied with the care and services provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was Requires Improvement (published 10 October 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

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.

Buchanan Court is a ‘care home’. People in care homes received 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.

Buchanan Court can accommodate up to 80 people in one adapted building. Buchannan Court is newly built and it is managed by Care UK Community Partnership a large social care provider in England. People using Buchanan Court may require nursing care, have dementia or require re-ablement. Re-ablement is a short and intensive service, which is offered to people with disabilities and those who are frail or recovering from an illness or injury. During both days of our inspection 31 people were using the service. Buchanan Court can carry out the regulated activities on four floors, however during the day of our inspections only two floors were in operation.

During our inspections no manager was registered with the CQC. However, a new manager had been appointed and commenced employment on the first day of our inspection. 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.

We found that medicines were not managed safely, for example medicines were not stored, documented and administered safely on occasions. We saw that the provider had a variety of quality assurance systems in place, however, we found that these were not always effective.

One positive feature we found during our inspection was the highly effective cross sector partnership work between Buchanan Court, NHS and Clinical Commissioning Groups to reduce the time people stayed in hospital and received treatment by the multi-disciplinary team (MDT) to return to their own home.

Staff had the appropriate skill and training to recognise and report poor practice and abuse. People who were at risk in relation to the treatment or care provided, had detailed guidance and assessments in place to minimise such risks. Most of the time sufficient staff were deployed to meet people’s needs. Appropriate recruitment procedures were followed to ensure people who used the service were protected from unsuitable staff. Staff followed appropriate infection control procedures and ensured the spreading of infections is minimised. Accidents and incidents had been documented, but we recommended that the service sought national guidance regarding analysing such events.

Not all staff had received regular supervisions, however we received reassurance that once the new manager had settled in into her new role she would commence regular staff supervisions again. People’s needs were assessed by suitably qualified and experienced staff to ensure their health and social care needs were met. A choice of healthy, nutritious and tasty meals was offered to people who used the service and people who required additional help with their dietary needs were appropriately supported. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People thought staff were understanding and respectful towards them. People using the service and their relatives spoke positively about the service and the care that the service provided. People said staff listened to them and involved people in decisions about their care. People told us staff respected their dignity and privacy when providing care. Staff were kind and showed compassion and understanding towards people they supported.

People's needs were assessed and a plan of care had been developed which included their choices and preferences. However, due to implementation of a new electronic care planning system we found some information missing and some information being duplicated. Guidance was in place for staff to follow to meet people's needs. Activity coordinators and champions offered a range of group and one to one activities to people which were meaningful and included people's hobbies and interests. Information was given to people about how to raise any concerns they may have. Any issue raised had been investigated and steps taken to resolve the situation to people's satisfaction.

People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys. A wide range of quality assurance monitoring systems were used to assess and monitor the quality of care provided.

We found one breach during this inspection. You can see what action we told the provider to take at the back of the full version of the report.