Bulwell

We found the following examples of good practice.

On arrival, there was a central area for staff and visitors to apply personal protective equipment (PPE) accessed from the garden, prior to entering the home. Visitors had no contact with other residents and minimal contact with care home staff because they were asked to enter the home through a back door. The visits were taking place in people’s bedrooms or a spare, spacious room.

People and staff were assessed twice daily for the development of a high temperature. There was a prominent signage for staff and people to remind them of frequent hand washing and sanitising.

Staff were allocated to work in one of the three areas which minimised movement across the homes. Staff had ample supplies of PPE and we observed them using it correctly, as per the government’s guidance. Staff were encouraged to take breaks in a staff room one at a time to ensure social distancing. Staff were taking Lateral Flow Test to screen for COVID- 19 before every shift.

The home was clean. Team leaders and the management team performed regular checks on cleaning and staff compliance with PPE. The management team performed infection control audits and had made improvements following issues they had identified.

The service specialises in caring for young adults and people with learning disabilities, mental health issues, physical disabilities and autism spectrum disorders.

We found the following examples of good practice.

¿ There was clear signage that the home was currently closed for visitors. On arrival, there was a central area for staff and visitors to apply personal protective equipment (PPE) accessed from the garden, prior to entering the home.

¿ Staff entered the building they were working in via different garden entrances after applying PPE, each entrance had masks, hand sanitiser and a bin outside.

¿ Staff were allocated to work in one of the three areas which minimised movement across the homes. When agency staff were required, they also stayed in one area and were block booked to minimise the risk of cross infection.

¿ While visiting was restricted people kept in touch with families using social media, photographs and scrap books.

¿ People were given information about COVID-19, the restrictions and PPE in place, in a format they could understand and staff used social stories to help with explanations.

¿ In preparation for the home reopening to visitors, the management team had converted a bedroom into a visiting room with outside access. Visitors were booked in advanced, expected to sign in and have a temperature and COVID-19 test performed before they entered the building.

¿ The service had a number of areas for people to spend time relaxing and doing activities. Staff had moved furniture around to encourage people to socially distance. However, not all people were able to understand the need for social distancing, so people (and staff supporting them) were cohorted to the homes they lived in to minimise the spread of infection.

¿ The home was clean. Team leaders and the management team performed regular checks on cleaning and staff compliance with PPE. The management team performed infection control audits and had made improvements following issues they had identified.

¿ Staff had up to date training in infection control procedures and policies and the management team had set up regular staff meetings to reassure staff and discuss concerns.

¿ The staff had covered shifts when colleagues were self-isolating so people were not upset by frequent changes.

Wycar Leys Bulwell is a care home for a maximum number of 22 people with learning disabilities. It consists of three buildings which are known as The Cottage, Homestead and Middleton House. There were a total of 19 people accommodated during our inspection.

There was a registered manager in place at the time of this 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 received safe and effective care from staff. The staff team was a mix of established staff and more recently recruited staff, all had a good understanding of the various types of harm and their roles and responsibilities in reporting any safeguarding concerns.

Risks to people’s individual needs and their home environment had been assessed. Staff had information available about how to meet people’s needs, including action required to reduce and manage known risks. When incidents occurred these were recorded and details updated in people’s care plans.

There had been a recent reduction in core staffing numbers and the service used agency staff to maintain sufficient staffing across the service. There were sufficient numbers of staff to meet people’s care needs. Staff were recruited safely. Staff received regular training and supervision and were able to reflect on the care and support they delivered and identified further training requirements.

People receiving support had their rights protected under the Mental Capacity Act 2005. The staff were knowledgeable about the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and applications for DoLS had been made appropriately. Staff gained consent from people whenever they could and, where people lacked mental capacity, we saw that arrangements were in place for staff to act in their best interests.

People received appropriate support with their medicines. Staff had received training in supporting people with their medicines and staff had their competency assessed.

People were supported to eat and drink sufficient amounts to meet their nutritional needs. External health professionals were involved in the person’s care when required.

Care plans were being updated and these reflected people’s individual needs and personal wishes. Where possible people and their representatives were involved in the development of their care plans.

The service encouraged feedback from people or their representatives about the service they received. A complaints process was in place. People were able to express themselves when they were not happy about something. A formal complaints procedure was in place and people’s representatives felt able to make a complaint and felt confident that the management would respond appropriately.

People’s representatives told us they were happy with most aspects of the service provided and spoke positively of staff and registered manager. People received care and support from kind, caring and compassionate staff, who respected their privacy and dignity at all times.

The people, their representatives and the staff team had confidence in the registered manager and the way the service was run. The staff team did not feel supported by the larger organisation.

Systems had been recently introduced to monitor and improve the quality of the service provided but this needed to be sustained. The vision and values of the staff team were caring and person-centred to make sure people were at the heart of the service.