Background to this inspection
Updated
9 January 2020
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 two inspectors 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
De Baliol is a ‘care home’. People in care homes receive accommodation and nursing or 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.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We also contacted 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 all of this information to plan our inspection.
During the inspection
We spoke with five people and seven relatives about their experience of the care provided. We spoke with the registered manager, the deputy manager, a nurse, a senior care worker, three care workers, two activities coordinators, a member of the housekeeping team and the chef. We also phoned night staff and left our contact details should they want to provide any feedback about working at the home.
We looked at three people’s care plans, recruitment checks for one staff member, training and supervision records, medicines administration records and records relating to the management of the service.
We contacted various health and social care professionals for their feedback. We also spoke with the community matron for nursing homes and contacted a care manager and an infection control practitioner from the local NHS Trust.
After the inspection
We continued to seek clarification from the provider to validate evidence found. The registered manager sent us further information relating to people’s care and support to review.
Updated
9 January 2020
About the service
De Baliol provides nursing care and accommodation for up to 59 people. At the time of the inspection, 50 people were living at the home. Accommodation for people who were living with a more advanced dementia condition was on the first floor. Staff referred to this area as the ‘dementia care unit.’
People’s experience of using this service and what we found
People were complimentary about living at the home. We asked people how they would describe De Baliol for members of the public who were looking to choose somewhere to live for either themselves or a relative. One person told us, “I would tell them, I love it here, there are lots of people around. The staff are very nice and you can do what you like and have your freedom. I had a first home and this was my second home, by now I think of this as my first home and I love it.”
Systems were in place to safeguard people from abuse. People told us they felt safe. People were cared for by a consistent and stable staff team who knew people well.
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 and relatives spoke positively about the caring nature of staff. One relative told us, “Sometimes when I come in, I can see her through the window of the door and I see staff comforting her which is really nice to see. It makes me feel they do care about my relative.”
We observed that some staff were more confident and skilled when communicating with people who were living with dementia than others. Further dementia care training was planned.
People were supported to continue their hobbies both within and outside of the home. We spoke with the registered manager about further meaningful activities which staff could undertake with people in the ‘dementia care unit’ to help promote their engagement and wellbeing.
The home had a mini bus and people went out on trips to help ensure they remained involved in the local community where many of them had lived. Staff recognised the importance which animals, children and being outdoors had on people’s wellbeing. One relative told us, “There is a lovely big garden and when the weather is better you can go out into the garden. There is also a play area for visiting grandchildren which is nice.”
There was a cheerful atmosphere and positive culture at the home. Staff told us they felt valued and enjoyed working there.
A range of audits and checks were carried out to monitor the quality and safety of the service. The ‘dementia care unit’ was still relatively new and was developing. We discussed with the registered manager about ensuring their quality monitoring system included checking the experiences of people who had a dementia related condition. This was to make sure that best practice guidelines were followed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 May 2017).
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.