Lower Bowshaw View Nursing Home

Updated 19 January 2024

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.

Inspection team

The inspection was carried out by 2 inspectors and 1 regulatory coordinator.

Service and service type

Lower Bowshaw View Nursing Home 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. Lower Bowshaw View Nursing Home 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.

Inspection activity started on 14 November 2023 and ended on 28 November 2023. We visited the location’s service on 14 November 2023, 16 November 2023 and 27 November 2023.

What we did before the inspection

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.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We requested feedback from 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 this information to plan our inspection.

During the inspection

We spoke to 5 people using the service, 5 relatives, 3 visiting professions and 16 members of staff including the registered manager, nurses, support staff and domestic staff. We spoke to the local authority's commissioning team and the Integrated Care Boards quality team for feedback

We reviewed a selection of people's care records and medication records. We looked a selection of staff files in relation to recruitment, training and support staff received. We reviewed a variety of records relating to the management of the service, including incident records, audits, policies and procedures.

Updated 19 January 2024

About the service

Lower Bowshaw View Nursing Home is a care home providing personal and nursing care for to up to 40 people in one adapted building over two floors. At the time of our inspection there were 36 people using the service.

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

Building maintenance was not always completed within a timely manner, putting people’s health and safety at risk. Staff were recruited safely, however there were issues the number of staff deployed to deliver safe and timely care, especially at busy times. During the inspection we were informed that additional staff were to be deployed at busy times. Some furnishings within the home required updating and the provider was in the process of addressing this.

Not all staff training was up to date or robust, and there were insufficient processes in place to monitor staff capabilities. The registered manager was undertaking work to improve staff induction, training, and quality assurance at the time of the inspection, this work will take time to embed.

The registered manager had undertaken work to improve people's care plans, however during the inspection we found that some records had not been reviewed regularly and that some monitoring information was missing, this meant that we could not check if people had received the right care.

The majority of people and their relatives told us that they were happy with the care they received, and that staff were kind and caring. Staff told us they felt supported and that improvements in training were taking place in the service. The management team within the service expressed a strong desire to work towards improvements and had started work in this area.

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.

Rating at last inspection and update

The last rating for this service was good (published 18 June 2021).

Why we inspected

The inspection was prompted in part due to concerns received about the provider making sufficient timely improvements to the environment of the home and staff training. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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 full report.

Since the inspection the provider has taken some steps to improve the service, for example some outstanding health and safety actions have now been completed and additional staff training has been booked.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lower Bowshaw View Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to governance, staffing and equipment and premises.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 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