Buckingham Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The management team were clear about their roles and responsibilities and had an understanding of quality assurance. They had identified concerns about the staff compliment and put a plan in place to upskill the staff team. The registered manager and deputy manager would be working alongside staff to identify any concerns with the support from the regional manager. This would be a mixture of hours covering all 24 hours to gain insight of the whole staff team. The manager’s priority would be upskilling the staff team and providing staff with development plans. The registered manager actively sought peoples and their relative’s views by holding regular meetings and audits at the service. Most relatives felt the service was managed well and were kept fully informed. A few staff felt their concerns had not been acknowledged by the management team.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The culture at the service required improvement so people received person-centred care. The management team would be working alongside staff so they could identify concerns and to help shape the culture of the service and ensure staff had a good understanding of person-centred care.

The management team encouraged people and relatives to express views and concerns. They listened and acted on them to help shape the service and culture. However, a few relatives felt concerns were not always resolved effectively. A few staff spoken with felt their voice was not heard and the concerns they raised about the quality of care provided by agency staff and overseas workers had not been acknowledged by the management team.

The management team were aware of their roles and responsibilities and the lines of accountability.

A decision had been made prior to our visit that the regional manager would be providing five days a week support to enable the registered manager and deputy to work alongside staff and identify any concerns. This had been a response to recent concerns. There would be 7 days management cover by the registered manager and deputy. This would be a mixture of hours covering all 24 hours to gain insight of the whole staff team. The focus would be on reflective learning. The deputy had been completing night observations at the service since December 2023.

The provider's complaints process was displayed in the service. People and relatives felt confident they could raise concerns and they would be listened to. The management team were described as very approachable. One relative said, “I would talk to the manager first, then she would sort it out.” They also told us their views were actively sought. One relative said, “More than once a year [surveys], I also do a meal audit.” Most relatives felt the service was managed well and were kept fully informed. The provider's whistleblowing procedures were displayed in the service. This helped raise staff awareness on how to report any unsafe practice.

The registered manager told us they actively sought peoples and their relative’s views by holding regular meetings and audits at the service.

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. This had resulted in the diversity of the staff being dominated by agency and oversees workers. The language barrier made it difficult to understand, or be understood, by some staff. For example, staff were not always familiar with the local dialect used by people to express themselves.

A few staff did not feel they were treated fairly or their voice was heard. They felt concerns raised by staff about the care provided by oversees and agency workers had not been fully acknowledged by the management team. The quality of care provided by these staff was impacting on people and staff were compensating for their lack of skills.

There were planned and regular checks completed by the senior managers within the service to check the quality and safety of the service provided. The registered manager was aware of their responsibility to inform the CQC about notifiable incidents and circumstances in line with the Health and Social Care Act 2008. The management team had responded to recent concerns and put a plan in action to address the concerns.

The management team were clear about their roles and responsibilities.

Most of the relatives spoken with felt the service was well managed.

The provider acknowledged the service had received concerns from the local authority, relatives and staff. They had taken action to address these concerns.

The management team had a strong commitment to improving the service

The local authority shared concerns about the safety of people and the quality of care provided. Their concerns related to the staffing team, their competencies and poor team working. They also shared concerns about the reporting of safeguarding concerns and the follow up by the management team. The lack of appropriate management oversight to ensure the care logged on care software had actually been given. The district nursing team had also reported concerns to the local authority about pressure sores and the quality of care provided to people. At the time of our visit the service was in operational safeguarding and there was an embargo on admissions.

The management team understood their duty of candour, to be open and honest when things went wrong. They were committed to improving the service.

The management team told us they had responded to the concerns raised by the local authority, staff and relatives. They told us the senior management team would be working alongside staff and additional training would be provided to staff. This would include some scenario based training.