Butts Croft House

Updated 17 May 2022

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

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 was carried out by two inspectors and an Expert by Experience who contacted relatives by telephone. 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

Butts Croft House is a care home. People in care homes receive accommodation and nursing or personal care. 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. Registered managers 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 first day of our inspection was unannounced. We told the provider we would return for a second day to complete our inspection.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection and any recurrent themes of concerns. We sought feedback from the local authority and commissioners who work with the service. We also contacted Healthwatch and an independent advocacy service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. This information helps support our inspections.

The provider had not been asked to complete a new Provider Information Return (PIR) since our last inspection visit. This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. We took this into account during our inspection.

We used all this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three people who lived at the home and eight relatives about their experiences of the care provided. We spoke with the provider, the registered manager, the operations manager, four members of care staff, a housekeeper, the chef and a kitchen assistant. We also spoke with a healthcare professional who regularly visited the home.

We reviewed four people's care records, three people's medicines records and three people’s daily records. We looked at a sample of records relating to the management of the service including health and safety checks, accident and incident records, policies and procedures and a sample of completed audits and checks. We checked two staff recruitment files.

Updated 17 May 2022

About the service

Butts Croft House provides care and accommodation for up to 35 people. Whilst the majority of people who live at the home are older people living with dementia, the service also offers care and support to young people living with dementia. The home provides some temporary beds for people who have come from hospital for further care or assessment before going back to their own home. At the time of our visit there were 27 people living in the home.

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

Following our last inspection, the provider had restructured to build more resilience into the management team and to ensure audit processes identified and addressed areas of improvement to ensure the quality and safety of the service. The provider had also re-introduced regular inspection visits by an external management consultant.

New systems introduced had brought about improvements in the management of medicines, infection control and the administrative practices of the home. However, the new quality assurance systems needed to be fully implemented and embedded to drive improvement and maintain standards in other areas of the home, such as risk management and care planning.

Staffing levels kept people safe and staff understood their responsibility to report any concerns about people or poor practice by other staff. Staff received the training needed to provide effective support and the provider encouraged staff to take further training to meet their specific responsibilities.

Staff understood people’s individual nutritional needs and snacks and drinks were readily available to encourage people to eat and drink. Where people were unwell or lost weight, medical advice was routinely sought and followed.

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 but improvements needed to be made to evidence people's mental capacity to consent to their care had always been assessed effectively.

Staff promoted a homely environment and relatives spoke of a friendly and welcoming atmosphere in the home. People's privacy and dignity was maintained, and staff treated people with respect. Improvements were being made to ensure people had opportunities for engagement in different activities in the home and there were plans to extend the activities further.

The provider and management team were responsive to the feedback provided during our inspection and were open about the further improvements that were still to be made.

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 11 November 2021) and there were breaches of regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulation, but further improvements were still required. This service has been rated requires improvement for the last seven consecutive inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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 COVID-19 and other infection outbreaks effectively.

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.