Buckingham Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People’s care plans reflected their physical, mental, emotional and social needs. This included any protected characteristics under the Equality Act 2010. Relatives told us they were actively involved in their family member's care planning. Where people were assessed as lacking capacity to make a particular decision, the provider followed best interest processes to protect people's rights. People had been referred to other health professionals as required such as the district nursing service. However, the newly appointed staff formed the majority of the staffing compliment and they needed guidance and support to ensure they followed the directions from health care professionals. The service used a system known locally as ‘right care’ for referring people to appropriate health care professionals. The registered manager told us the system was operated well and response times were good. The service had systems in place to monitor people’s individual wellbeing. However, the staffing situation at the service showed there was a risk people may not receive care and support that was evidence based and in line with good practice standards.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People had a comprehensive assessment of their needs, which included consideration of their clinical needs (including pain relief), mental health, physical health and wellbeing, and nutrition and hydration needs. People's needs were kept under review to ensure care plans met people's current needs.

Staff assessed people's needs using a range of assessment tools to ensure their needs were reflected and understood.

People were involved in the assessment of their needs. Their relatives and friends where appropriate were actively involved in developing their plan of care. A communication care plan was completed for each person. This helped to identify how to provide information to the person so it was accessible and tailored to meet their needs.

Hydration stations were available throughout the service. People's preferences and dietary needs were accommodated. In people's care records there was evidence of involvement from other health care professionals where required, and staff made referrals to ensure people’s health needs were met. Action was being taken by the management team to ensure newly appointed staff had guidance and support to ensure they followed directions from health care professionals.

We observed lunch being served on both floors. Some staff were providing additional guidance to staff to ensure people's needs were being met. There was a calm atmosphere and people were offered a choice of meals. We saw staff kindly engaging with people encouraging them to eat or offering drinks. People made positive comments about the quality of food provided.

Staff were aware of the people who needed a specialised diet and/or soft diet to ensure their needs were met. The management team told us staff made referrals to ensure people’s health needs were met. We saw this reflected in people's care plans.

The local authority were concerned about the quality of care and safety of people using the service due to staff competencies.

The management team told us the provider was finding it difficult to recruit staff to work at the service. This had led to a large number of staff vacancies. The provider had therefore used agency staff and had sponsored oversees workers.

The recruitment of overseas staff and the use of agency staff had created a training and development need. Staff handovers enabled information about people’s wellbeing and care needs to be shared. However, the skills mix of the staff team was not always meeting the needs of people using the service. Some staff were not aware of current good practice.

Most relatives raised concerns about the number of agency staff and overseas workers working at the service. They told us this impacted on the quality of care provided to their family member either due to a lack of skills and/or English language ability. They also told us some people did not respond well to these staff.

The registered manager told us they used the 'right care' system to refer people to appropriate health care professionals.

In people’s records we found evidence of involvement from other professionals such as doctors, optician, tissue viability nurses and speech and language practitioners.

People were supported to manage their health and wellbeing. The service promoted people’s wellbeing by providing daytime activities. Relatives told us they were kept fully informed about their family member's wellbeing.

People’s care was monitored to ensure they received the care and treatment they needed.

The provider had systems in place to ensure people's outcomes were met. The provider was taking action to ensure people consistently experienced positive outcomes by upskilling the staff team. Checks would be undertaken to make sure safe procedures had been adhered to.

Senior managers told us they would be working alongside staff to ensure there was effective monitoring of people’s care and treatment and their outcomes.

We checked whether the service was working within the principles of the MCA. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.

The management team understood the importance of ensuring that people fully understood what they were consenting to and the importance of obtaining consent before care was delivered.

People told us they felt consulted. People's capacity and ability to consent was taken into account, and they, or a person lawfully acting on their behalf, were involved in planning, managing and reviewing their care and treatment.