Byron House Care Home

Updated 14 January 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of an inspector, specialist advisor in nursing 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

Byron House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Byron House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We also looked at the provider’s last inspection report. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service. Some people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We further received feedback from 6 relatives. We requested feedback from 3 healthcare professionals. We looked at 5 people's care records and 6 medicine administration records (MAR). We spoke with the chief executive officer, head of quality, registered manager and 11 members of staff including nurses, carers, the chef, domestic staff, maintenance person, activities coordinator and students. We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, 5 staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 14 January 2023

About the service

Byron House is a residential care home providing personal and nursing care to up to 28 people in an adapted building. The service supported older people across 3 floors, some of who were living with dementia. At the time of our inspection there were 25 people using the service.

People’s experience of using this service and what we found

People received care from highly skilled staff who had received training based on people’s needs. The provider’s value-based recruitment and induction strategy focused on key attributes of empathy, kindness and strong teamwork skills rather than the individual’s experience. People were involved with the staff induction process.

There was strong emphasis on staff development and the provider had invested in specific training based on people’s needs. Staff had completed high quality training that ensured they were confident and competent at delivering person centred care. All training was delivered in practice which allowed better understanding of the content. Staff were encouraged and supported to develop their skills and follow a streamlined career progression path within the service.

The provider ensured their practices were in line with the current good practice, guidance and legislation. There was a focus on continuous development, for example, they took part in research which resulted in changes in care to both people living at the service and for the wider general public. People experienced a positive dining experience. People’s feedback was sought and used to always improve nutrition and hydration.

There was a warm, welcoming atmosphere promoted by caring, compassionate staff. All staff despite their roles, were trained to care. For example, domestic and maintenance staff knew people well and were trained to support people with care needs. People enjoyed worthwhile relationships with staff, who valued and respected them. There was a strong commitment to providing personalised care that appreciated people for who they were and recognised the value of their life experiences. Relatives were considered partners in care and their involvement was key to providing person centred care. Relatives were extremely impressed by the positive outcomes people had achieved through the support and encouragement provided at the service.

The provider's vision and values put people at the heart of the service. These were centred around provision of a high-quality service to people whilst allowing people to live their lives the way they chose. People benefitted from exceptional care delivered by a dedicated staff team who were committed to the vision and values of the service. Staff excelled in managing people’s complex needs, including distressed behaviours by using effective distraction techniques that had a positive impact on people’s well-being. We saw many examples where staff successfully enhanced people’s quality of life.

People living at Byron House were supported to lead purposeful lives, engaging with their families and the local community. Whilst adjustments had been made due to the restrictions of the Covid-19 pandemic, measures had remained in place to ensure meaningful relationships and people's overall health and wellbeing was maintained. People had excellent opportunities and access to a variety of activities to prevent social isolation.

Arrangements for social activities met people's individual needs and followed best practice guidance so people could live as full a life as possible. The service had gone the extra mile to find out what people had done in the past and evaluated whether it could accommodate activities and made them happen. People received exceptional personalised care and support specific to their needs, preferences and routines. The service took a key role in the local community and was actively involved in building further links with the local community. Contact with other community resources and support networks was encouraged and sustained.

The provider and registered manager provided exceptional leadership and had developed a dedicated staff team who were committed to providing outstanding care. Staff were motivated by, and proud of the service. They loved being part of dedicated team and vowed to provide excellent care. The registered manager was fully dedicated to providing high quality care that achieved the best possible outcomes for people. Without exception, feedback about the registered manager and the management team was exceedingly positive in relation to their exceptional leadership skills and caring, empathetic approach to everyone. The registered manager and provider constantly looked for ways to improve the service and had effective systems in place to monitor the quality of the service.

Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place which incorporated their values. Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.

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 were supported to maintain good health and to meet their nutritional needs.

Rating at last inspection and update

The last rating for the service under the previous provider was good, published on 5 December 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk