19 January 2023
During an inspection looking at part of the service
Bowerfield Court is a nursing home providing accommodation for people who require nursing or personal care and treatment of disease, disorder or injury for up to 40 people. At the time of the inspection 35 people were using the service. The nursing home accommodates people across two floors in one building, with shared communal living and dining areas and outside space, and single person bedrooms with ensuite facilities.
People’s experience of using this service and what we found
People felt there was not always enough staff to support them when they needed assistance, although they told us generally staff were kind and caring and worked hard. Records did not easily allow oversight to ensure safe recruitment processes had been completed, or that staff had received all the relevant training needed for their role.
The new management team were working hard to address any shortfalls identified within the home. There were suitable audits which were identifying issues and required actions. However, this had not yet been embedded and there were still areas of shortfall regarding care plans and record keeping. People and staff spoke very positively about the new management team and felt that improvements were being made.
Medicines were mostly managed safely. However, some records necessary for the safe and responsive administration of medicines were not in place and we have made a recommendation about this.
The care home was clean and tidy and there were appropriate checks of equipment and throughout the building. There were systems in place to ensure staff knew people’s current needs and the new manager had oversight that these were being appropriately managed such as wound management.
People were mostly supported to have 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. However, records did not always reflect how people were involved in developing and reviewing aspects of their care, or that information about a person’s capacity and any restrictions was accurate and up to date.
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 05 May 2022). The service remains rated requires improvement. This service has been rated requires improvement for 2 consecutive inspections.
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 improvements had been made in some areas and the provider was no longer in breach of regulation 12. However, at this inspection we found the provider remained in breach of regulations 17 and regulation 18.
At our last inspection we recommended that the provider review their process for recruitment and regulatory requirements to ensure they are following suitably robust processes. At this inspection we found the processes in place did not allow for easy oversight and further work was needed in this area.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 08 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, good governance and staffing at the service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bowerfield Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified ongoing breaches in relation to staffing and the overall governance of the service. We have made a recommendation in relation to medicine administration records.
Please see the action we have told the provider to take at the end of this report.
Follow up
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.