Background to this inspection
Updated
17 September 2019
The inspection
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Bethany is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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. The registered manager was handing over to a new manager who had been promoted from within the home and was going through the process of registering. In this report we have referred to them as the home manager.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We reviewed information we held about the provider and the provider’s website in order to plan our inspection.
During the inspection
We spoke with ten people who used the service and three relatives about their experience of the care provided. We spoke with ten members of staff including the nominated individual, home manager, members of care staff and one of the kitchen team. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the GP who supports residents living in the home.
We reviewed a range of records. This included three people’s care records and medication records and four staff files in relation to recruitment and staff supervision. We looked at a variety of records relating to the management of the service, including policies and procedures.
We observed lunch time in the dining room and made observations around the home in communal spaces to see how staff interacted with people.
After the inspection
After the inspection we continued to liaise with the registered manager who provided us with further evidence to review. We received feedback from 11 people’s relatives to tell us their experience of the home. We also received feedback from the trainer who is contracted by the provider to deliver training for staff and from the local Clinical Commissioning Group (CCG).
Updated
17 September 2019
About the service
Bethany is a purpose-built care home for up to 37 people. There are en suite bedrooms across three floors, shared living spaces and dining areas.
Each floor of the building is adapted to provide care for people with different levels of needs with one floor dedicated to providing care to people living with dementia. At the time of the inspection there were 31 people living in the home.
There is also a café, chapel and purpose-built bungalows on the site which are privately leased.
People’s experience of using this service and what we found
Bethany provided high-quality, person-centred care and support to people living there. The service had good measures in place to ensure people were safe. People’s risks were assessed and there were detailed support plans and measures in place to manage their risks. Medicines were managed safely and the home was clean and well maintained.
Care provided was in line with good practice and national guidelines. People were supported to achieve good outcomes and have a good quality of life. There were very positive relationships with other agencies and professionals to ensure people received joined-up, effective care. 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, their relatives and other professionals consistently told us of the outstanding, caring, patient and kind way in which staff supported people. People’s views and preferences were at the centre of their care and people were supported to have a voice in all aspects of their care decisions. The service was exceptionally respectful of people’s dignity and privacy and mindful of their emotional wellbeing.
People were supported in a way which met their needs, which reflected their individual choices and preferences, and which promoted their independence. People had access to a range of activities in the home and in their community, which reflected their cultural and spiritual needs, as well as their interests and preferences.
There was consistent, exceptionally strong leadership in the organisation and the home which drove a culture of continuous improvement and compassionate, person-centred care. People’s relatives and other professionals consistently reflected on their confidence in the leadership and management in the home and that people were at the heart of the service.
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 22 October 2016). At this inspection we found the service had improved to outstanding.
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.