Bethany House Care Home

Bethany House is a registered care home with nursing, providing accommodation for up to 15 people living with complex health needs and physical disabilities. At the time of the inspection the service was full. The accommodation is arranged over two floors with large communal areas. The service has a hydrotherapy pool which has been out of use due to COVID-19. Plans are in place to re-open this in the future.

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

People told us they were happy living at Bethany House and felt safe there. However, some relatives had concerns about the safety of the people living in the service as they felt they were being supported by people who did not know their loved ones well enough. The manager was working towards more detailed guidance for staff to ensure they had the knowledge required to manage risk and meet peoples’ needs.

There were inconsistencies in the level of detail about peoples’ medicines which meant we were not assured that medicines were always managed in a safe way. The manager had made some improvement in these areas recently, but more improvement was needed.

There was not always enough staff with the right experience, skills and knowledge to meet peoples’ needs in the right way. Some staff and relatives shared this concern. The manager had recently increased the number of staff on each shift to address this concern and was actively recruiting for the service. Staff had been recruited safely to ensure they were suitable to work with people.

The service did not have a registered manager. The previous registered manager left in December 2020. The operations manager was providing interim leadership, either in the service or remotely, and the service was being supported by the operations director. Staff were positive about the manager and found them to be open, honest and approachable. The provider had quality assurance systems in place and there was a commitment to continual improvement.

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 good (published 30 January 2020). Following this inspection, the rating has deteriorated to requires improvement.

Why we inspected

We received concerns in relation to staffing levels and skills, the management of medicines and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bethany House on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Bethany House is a residential care home with nursing that provides accommodation and personal care for 15 people living complex health needs. At the time of the inspection the service was full.

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

People told us that they were happy living at Bethany house and felt safe there. They and relatives of those less able to communicate their needs spoke positively about the support and kindness shown by staff towards people. People and relatives thought that staff had a good understanding of people’s individual support needs and respected their preferences for how they wanted their support to be delivered.

The atmosphere in the home was quiet and relaxed. There were good easy-going relationships and communication between people and staff. Staff were observed interacting well and spontaneously with those people that required more support to engage and make their wishes known. Risks were managed well and took account of people’s ability to experience positive risk taking.

There were enough staff available to support people’s needs. A safe system of recruitment helped ensure all required suitability checks on new staff were carried out. Staff were provided with a broad range of training to inform their knowledge and understanding of people’s complex needs. Staff ensured people received their medicines regularly and safely.

Relatives told us that staff kept them informed about their family members health and wellbeing. Staff monitored people’s health, helped them access appointments and sought advice from health professionals as needed. Peoples care plans were personalised to reflect their specific support needs and individual preferences, and they and relatives were consulted and involved in reviewing these. Care plans were kept updated to reflect changes. People told us they enjoyed their meals and relatives spoke positively about the good quality of meals provided that catered for people’s specific dietary needs.

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.

Staff showed people kindness, compassion, respect and upheld people’s rights to privacy and dignified care. People and relatives felt able to raise concerns if they had them to the registered manager and staff and felt confident these were acted upon.

Opportunities for stimulation and activity were provided and this was responsive to people’s individual abilities and preferences. The hydrotherapy pool was important for people’s exercise and stimulation. Staff understood how people liked to communicate their needs and how they best received information about the service or their own care and support.

A system was in place to protect the confidentiality of people and staff. Staff felt valued by the registered manager and able to contribute ideas and suggestions and be listened to. Monitoring and audit systems were in place to routinely check service quality. People, relatives and professionals were surveyed for their views about the service and their feedback was used to inform future service development.

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 (Report published 29 June 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.