Bings Hall

We found the following examples of good practice.

The provider carries out testing for people living in the service and the staff as per government guidance. A designated area for testing had been set up. This was close to the reception however, away from residential or living areas.

A new conservatory had been built to expand the shared living area and provide extra space for social distancing.

Person specific risk assessments, were seen at the home. These risk assessments directed staff to care for people who had limited mental capacity, and supported those that could be affected by the impact of personal protective equipment, causing fear and anxiety.

All cleaning and laundry processes were clearly documented and monitored by the registered manager, to ensure compliance with the hygiene and safety measures in place at the home.

Staff members stated they felt safer at Bings Hall than anywhere else due to the infection control measures that had been introduced by the manager in March 2020.

Bings Hall is a residential care home, providing personal and nursing care for up to 17 older people. On the day of our inspection 15 people were living at the service. The service accommodates people across two floors, which has separate adapted facilities.

People’s experience of using this service:

People were safe living in the service. Risks had been identified and people were looked after safely.

Staff were kind and caring and supported people to be as independent as possible.

People had access to healthcare professionals when required and were supported to have enough to eat and drink to maintain their well-being.

Staff knew how to care for people, they were kind and compassionate. Staff used their skills and the resources and equipment provided so the risk of accidental harm or infections was reduced. Staff had developed effective skills to meet the complex needs of the people at the service.

People were supported to have their prescribed medicines safely to remain well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Positive partnerships had been developed with external health and social care professionals. People benefited from good multi-disciplinary working.

The registered manager had clear oversight of the service and worked alongside staff. Staff were respectful of the register manager and told us the registered manager was approachable and supportive.

Rating at last inspection:

In August 2018, we undertook a comprehensive inspection and looked at all key questions. There was a breach of the regulation around good governance. The service was rated as Requires improvement and the report was published on 2 November 2018.

The provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The overall rating for the service has changed from Requires improvement to Good.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor this service in line with our re-inspection schedule for those services rated as Good.

At the last inspection on 28 October 2015, the service was rated ‘Good’. At this inspection we found the service was now rated overall ‘Requires Improvement’. This is the first time the service has been rated ‘Requires Improvement’.

The inspection was completed on the 24 August 2018 and was unannounced. At the time of the inspection, there were 14 people living at Bings Hall.

The service had a registered manager in post and they were formally registered with us in June 2018. 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 were advised during the inspection by the registered manager that Bings Hall was newly registered with a new provider five days before our inspection. The shortfalls identified as part of this inspection relate to the previous registered provider and not the new owners of the service.

Improvements were required to the service’s governance arrangements to assess and monitor the quality of the service. The current arrangements had not identified the issues we found during our inspection. The registered provider lacked oversight as to what was happening within the service to make the required improvements. They also had not provided suitable support to the registered manager to ensure compliance with regulatory requirements and the fundamental standards.

Improvements were required to the recruitment practices to ensure these were robust. Not all staff had up-to-date manual handling training. Improvements were also required to ensure newly employed staff received a robust induction, formal supervision and an annual appraisal of their overall performance. Medication practices and procedures required strengthening to ensure these were in line with good practice procedures and guidance. Not all people’s care and support needs were recorded and detailed within a care plan. However, we did note there was no impact to demonstrate people’s care and support needs were not being met.

People were protected from abuse and they said they were safe and had no concerns about their safety and wellbeing. Policies and procedures were being followed by staff and the registered manager to safeguard people. Risks to people were identified and managed to prevent people from receiving unsafe care and support. Staffing levels and the deployment of staff was suitable to meet people’s needs. People were protected by the registered provider’s arrangements for the prevention and control of infection.

People’s healthcare needs were met and they had access to a range of services and professionals as required. The dining experience for people was positive and their nutritional and hydration needs were adequately met. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. Social activities were available for people to enjoy and experience. The service worked together with other organisations to ensure people received coordinated care and support. Suitable arrangements were in place to support people who required end of life and palliative care.

People confirmed they knew how to make a complaint or raise concerns. Records of compliments had been maintained to recognise the service’s achievements.

We have made some recommendations about medication practices and procedures, safe recruitment and the service’s care planning arrangements.

You can see what action we told the provider to take at the back of the full version of the report.

Care plans were in place and were comprehensive. Risk assessments had been cross referenced to care plans which ensured people's needs were met. We saw that people and their relatives had been involved in care planning.

The service was clean and well maintained. Staff had access to infection control training and they demonstrated a good technique in hand washing and the rationale for it.

There were enough suitably skilled and experienced staff to meet people's needs. We saw that people were attended to in a timely way and were unhurried when they needed assistance.

Records were up to date and fit for purpose.

We found that care planning was effectively managed so that care and treatment was provided according to people's wishes and needs. There was effective management of medication. We saw that there were regular quality checks including gaining the views of people living in the service.

Staff were trained appropriately and supervised regularly to maintain competence. Staff told us they had training to provide safe care including to people living with dementia.