18 August 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by two inspectors, one inspection manager, one pharmacist inspector and one Expert by Experience on day one. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Day two was carried out by one inspector.
Service and service type
Bamford Grange is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bamford Grange is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was no registered manager in post. However, a new manager had been appointed and was due to commence their employment.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service and three visitors about their experience of the care provided. We spoke with 16 members of staff including the area manager, regional support managers, deputy manager, nursing and care staff, activity co-ordinators, administrative staff and kitchen, laundry and maintenance staff. We reviewed a range of records. This included activity records and five people's care records. A variety of records relating to the management of the service, including policies and procedures were reviewed. After the inspection we reviewed additional information sent through to us.
18 August 2022
About the service
Bamford Grange Care Home is a care home providing personal and nursing care to up to 79 people. Bamford Grange Care Home provides care across separate five units over two floors. Units specialise in dementia care, general nursing and mental health. At the time of our inspection there were 54 people using the service and one unit was closed.
People’s experience of using this service and what we found
The home had a history of a change in home management and the last manager left their post before completing their registration with CQC. As a result, some areas of oversight of the service were affected. The home was being managed in the interim by two area support managers and the deputy manager. Staff and managers were helpful, supportive and transparent throughout the inspection.
Improvements had been made in the management of medicines. However, we have made a recommendation about additional checks to ensure paperwork is accurate and up to date in people’s medicines files. Staffing levels were appropriate on the day of our inspection and staff had been recruited safely. People’s individual risks had been assessed and plans were in place to reduce these risks. Environmental safety checks had been carried out. However, we have made a recommendation about the secure storage of potentially harmful substances.
Staff received a programme of induction and ongoing training. People were supported to access a wide range of health care professionals and people received timely care and treatment. People’s nutritional needs were assessed, and dietary requirements were met. However, we received mixed feedback about the food. 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.
People were supported by kind and caring staff. People were involved in decisions about their care and were treated with privacy, dignity and respect. One relative told us, “Staff are always kind and patient with him, they have a joke with him, and he loves this and interacts well with them. They always seem to ask him before they do anything, and they treat him with respect at all times.”
People’s communication needs were met. The home had new activity co-ordinators in post and people and staff were pleased they would be able to partake in the activity programmes. Visits were being fully facilitated and options were in place to continue visiting if a person needed to isolate.
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 requires improvement (published 27 April 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of one regulation. This service has now been rated requires improvement for the last four consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
The overall rating for the service has remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.
You can read the report from our last inspection, by selecting the 'all reports' link for Bamford Grange Nursing Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified a breach in relation to management oversight at this inspection. We have made two recommendations.
Please see the action we have told the provider to take at the end of this report.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.