New Bassett House Care Home

New Bassett House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home has one floor with four wings containing bedrooms and bathrooms with communal spaces around the home, including a tea room for people and visitors to enjoy. There was a well-maintained garden with secure areas. The service was registered to provide accommodation for up to 40 people. At the time of our inspection 35 people were using the service.

New Bassett House had a registered manager. 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.

We last inspected the home 25 & 27 January 2017. The home was rated as 'requires improvement' and we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff training was not up-to-date, and equipment used for the safe moving and handling of people had not been checked or serviced in a timely manner and in accordance with current health and safety recommendations.

Following the last inspection 25 & 27 January 2017 we asked the provider to complete an action plan to show what they would do and by when, to improve the key questions of safe and effective from requires improvement to good. We found the provider had acted to ensure equipment had been serviced and maintained. Some staff refresher training record was still required however, measures were in place to address this. This meant the provider was no longer in breach of the regulations.

The registered manager felt well supported by the provider. The management team carried out a range of audits to check the support and care people received to continually monitor and improve the quality of the service. However, the provider had not consistently monitored and analysed information relating to falls occurring within the home and care plan audits had not always been completed.

The monitoring of staff training had improved however, some staff still required refresher training and this was being addressed by the registered manager and the providers’ training department. Risks to people were assessed and plans implemented for staff to follow to reduce the risk. Although some assessments had not been updated, staff were still knowledgeable about people and the support they required.

Staff were knowledgeable about their role and put their learning into practice. People were supported to attend health care appointments to maintain their health and well-being and received support with food and drinks that took account of their preferences and dietary needs. People’s health needs were regularly monitored and they were referred to external healthcare professionals when a need was identified.

There were sufficient staff to meet people’s needs and provide support when required. Medicines were stored, managed, and administered safely and people received their medicines on time.

People were supported to have choice and control about their care and the registered manager and staff team ensured people were cared for in an environment where they were supported to live their lives as they wished. People were encouraged and supported to pursue interests and hobbies, as well as maintaining relationships important to them.

The staff demonstrated they had a good understanding of the visions and values of the home which were to ensure people’s independence was supported and they were well cared for. People told us they were encouraged and supported to maintain their independence. People were treated with respect and family members and friends were encouraged to visit as often as they wished.

Staff were caring, kind and supportive and ensured people’s privacy and dignity needs were met. The management team and staff had a good understanding of people’s individual needs and preferences.

People told us they felt safe at New Bassett House. The registered manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. Staff had a good understanding of risks associated with people’s care needs and how to support them.

People and relatives knew how to make a formal complaint and told us they felt comfortable raising any concerns they had with the staff. The provider had systems in place to monitor formal and informal complaints so they could identify areas where improvements could be made.

Staff felt the management team were supportive and promoted an open culture within the home. Staff could discuss their own development and best practice during one to one supervision and team meetings.

People were encouraged to share their views about the quality of service provided through regular meetings and quality surveys.

This inspection took place on 25 and 31 January 2017; the first day was unannounced. The service was last inspected on 10 February 2015 and was rated as good overall, with requires improvement in the key area of safe.

At our last inspection in February 2015, we found people were not protected from the risk of unsafe care or treatment. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 We also found systems and processes put in place to protect people from abuse had not been operated effectively. This was a breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the inspection the provider sent us their action plan to tell us about the improvements they were going to make to rectify the breaches. At this inspection we found improvements had been made.

New Bassett House Care Home is situated in Shirebrook and provides accommodation and personal care for up to 40 older people. At the time of our inspection, 36 people were living at the service. The service provides care and support for people, with a range of medical and age related conditions, including mobility issues, diabetes and dementia.

There was a registered manager in post. 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.

Staff training was not always up-to-date. Equipment used for the safe moving and transferring of people had not been checked or serviced in a timely manner and in accordance with current health and safety recommendations.

The provider had recruitment procedures in place and employed new staff once appropriate checks had been completed. New staff participated in a thorough induction program which included a period of shadowing an experienced staff member. There were enough staff available to support and respond to people’s needs in a timely manner. Staff participated in supervision

People’s agreement and consent for care was obtained. The provider followed the key principles of the Mental Capacity Act 2005 (MCA) and met the legal requirements the Deprivation of Liberty Safeguards (DOLS).

New staff received an induction and training in a range of skills the provider felt necessary to meet the needs of people at the service.

Staff were kind, caring and compassionate; people were supported and encouraged to remain as independent as possible. Staff knew people and their needs well; they were aware of the importance of treating people with dignity and respect.

Staff worked in conjunction with health care professionals to ensure people received appropriate healthcare and treatment in a timely manner. People were provided with food and drinks to meet choice, preference and any special dietary requirements.

People knew how to raise concerns and complaints; information was available should anyone feel it necessary to raise a concern or complaint. People had the opportunity to voice their thoughts about the service and meetings were held with people. The registered manager understood their role and responsibilities and was supported by the staff team. Audits were conducted to ensure the service met people’s needs. Systems were in place to check on the quality and safety of services provided.

At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Is the service safe?

Detailed assessments had taken place and care has been planned and delivered in a way that maintained each person's privacy, dignity and independence. However we found that no assessments of mental capacity had been undertaken.

Medicines were managed safely and effectively.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents. This meant that the service could identify the risks to people and had an adequate system of service improvement.

Staff were supported to undertake training relative to the needs of the people they cared for.

Procedures for dealing with emergencies were in place and staff were able to describe these to us. This meant that staff understood what to do in an emergency.

Is the service effective?

Staff had access to up to date information to help them meet people's needs. However, we found that body maps had not been completed when it was noted that people had problems with the integrity of their skin. We also found that the daily records had not followed through with an update on the progress of any skin problems. This meant that staff might not be able to track whether people's skin conditions had improved or not.

A visiting professional told us that staff always followed up any concerns and kept them up to date with people's conditions.

Is the service caring?

We observed staff speaking with people in a respectful manner and people appeared relaxed and comfortable in their surroundings. Staff spoke to people quietly and with respect. There was a happy cheerful atmosphere.

When speaking with staff it was clear that they cared for the people they supported.

People told us that they liked living at the home and that the staff were kind.

Is the service responsive?

The people we spoke with knew how to make a complaint if they were unhappy. We reviewed the records of complaints and found that they had been investigated and responded to in a timely manner.

People's relatives had completed satisfaction surveys. These survey results had been collated and where shortfalls or concerns were raised these were taken on board and dealt with.

Meetings had been held for people using the service and where issues had been raised that needed improvement, action had been taken. The improvements that had taken place were reported on at the next meeting.

Is the service well-led?

A registered manager was in place.

The service had a quality assurance system in place. Records showed that incidents identified had been investigated and the causes of the issues identified, however, we found that emerging trends had not been monitored.

The service worked well with other agencies and services to make sure people received effective care.

We spoke with two people who live at the care home. They told us that: 'The staff are very helpful, I only have to ask and they help me.' Another person said: 'I've got a very nice room, and I've got everything I need. The staff are all lovely'

We carried out a Short Observational Framework for Inspection (a SOFI) during this inspection visit. This involved us sitting in the dining room and observing for three quarters of an hour over the lunch period. This enabled us to see how the staff spoke with people who live at the home, and how they offered help and support. Our observations showed that people were treated with respect, and that staff had good relationships with the people who live at the care home.

At our last inspection visit on 6 March 2013 we identified concerns in two outcome areas ' Care and welfare and Infection control. We found at this inspection visit those concerns had been addressed and the issues had been dealt with.

We looked at nine outcomes from the Health & Social Care Act (2008). We found the staff to be friendly and approachable and our observations showed staff to be caring and focussed on the people who live at New Bassett House.

The people we spoke with said that their privacy and dignity was respected and they were helped to express their views. One person told us, 'I do as I please. I'm quite independent.' Staff respected people's personal preferences and people thought that their needs were met. However, we found that people's needs were not always assessed promptly at the time of their admission. Care plans were worded so as to provide staff with a clear guide to meeting people's needs.

People told us that the premises were kept clean. However, there was a lack of systems in place to reduce the risk and spread of infection.

People felt that, generally, there were enough staff to meet their needs. They were asked for their views and comments that they made were acted on. The manager was monitoring a number of aspects of the quality of service provided.