Archived: Bournedale House

Updated 30 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on the 12 July 2016 and was carried out by one inspector and a member of the CQC staff team who works in the Equality, Diversity and Human Rights Department. They joined this inspection team to learn more about the work of the Care Quality Commission.

We looked at information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care. We refer to these as notifications. We reviewed the information from notifications to help us plan the areas we wanted to focus our inspection on. We contacted the local authorities who commission services from the provider for their views of the service.

We met all 11 people living at the home. Some people living at the home were unable to communicate verbally due to their health conditions. We spent time in communal areas observing how care was delivered and we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, senior carer, two care assistants and the cook. We spoke with two health professionals and the relatives of two people using this service. We looked at records including parts of four care plans and medication administration records. We looked at the staff file of the most recent member of staff to join the home. We sampled records from training plans, incident and accident reports and quality assurance records to see how the provider monitored the quality of the service.

Updated 30 September 2016

This unannounced inspection took place on the 12 July 2016. The service was last inspected in May 2015, when we identified it was not meeting two regulations. At that time people could not be confident that risks they faced relating to their condition would be well managed or risk assessed.

Bournedale House provides accommodation for a maximum of 11 older adults who may be living with dementia. There were 11 people living at the home at the time of the inspection. Ten people were unable to verbally tell us about the care they received. We tried to determine their experience of the service by using our observation tool, and a variety of non-verbal communication methods.

The service has a registered manager who was present throughout the 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.

People told us they felt safe living at the service. Staff we spoke with were aware of how to recognise possible signs of abuse and the need to report any concerns.

There were not always enough staff available in the places people needed them to meet people's requests for support in a timely manner. The absence of staff to support and supervise people had resulted in people experiencing falls.

People could be confident that their medicines would be given safely.

The staff had been provided with training about the Mental Capacity Act (2005) but could not always explain how they put this into practice when supporting the people living at the service. Staff had received basic training to ensure they were aware about safe care and some of the people’s individual needs.

People could be confident that changes in their health would be identified. People did not always receive the support they required to maintain their nutritional and hydration needs.

Individual staff did not consistently treat people with dignity and respect, and systems and processes within the home did not promote good practice in this area.

Relatives gave us positive feedback about the care provided. Everyone told us that staff were kind and caring and knew people well. The majority of staff that we spoke with were enthusiastic about their role and could describe how people preferred to be supported.

There were very limited opportunities for people to join in with activities they liked, and which reduced the risk of them becoming socially isolated. Staff practice and the systems within the home did not promote people being seen as individuals. We have made a recommendation about increasing the focus on people using the service.

The service had ensured people maintained relationships with those who were important to them.

People living at the home and their relatives were aware of how to raise concerns and were confident that any concerns raised would be dealt with in a timely manner.

People, relatives and the staff were happy with how the service was managed. The registered manager had successfully improved some aspects of the service since our last inspection although this had not been entirely effective, and further work was still needed to ensure improvements to quality and safety continued and were maintained. We have made a recommendation about the ongoing leadership and development of this service.