We carried out a review of the data available to us about Bayford House Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bayford House Care Home, you can give feedback on this service.
Bayford House Care Home is registered to provide personal and nursing care for up to 59 people with a range of needs including complex health and care needs. At the time of inspection, the service was supporting 51 people. The home is set across two units, Bayford House and Newdale Court. The home is set in its own gardens which people could access. There was a range of communal areas that people and their relatives could use.
People’s experience of using this service and what we found
People were supported by staff who understood the action to take should they have any concerns about people's safety. The risks associated with people's care had been identified and plans put in place to minimise these. There were enough suitably recruited staff available to keep people safe and staffing levels were reviewed and changed to reflect changes in people's needs. People were protected from infection by staff that kept the premises clean and used appropriate protective equipment when needed.
Care plans described people's needs and preferences and guided staff about people's needs and how to meet them. People had enough to eat and drink and had choices in what they ate and drank. Staff accommodated any specific dietary requirements or preferences. People received care and treatment from competent and skilled staff who had the relevant knowledge to meet people's needs.
The provider had a system to ensure all staff had regular training to keep them up to date with best practice. Training courses and training events were relevant to the needs of the people living at the service and staff ensured they put learning into practice. People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible. The policies and systems in the service promoted this practice.
People told us care and nursing staff were kind, caring and compassionate. Staff were attentive to people's needs and knew how to promote their wellbeing. When people were anxious, care staff took time to reassure them and promote their wellbeing. People were treated with dignity and respect.
People received care that was responsive to their needs. People had been involved in reviewing their care to ensure it continued to meet their needs. People participated in activities of their choosing. People and relatives felt able to raise any concerns and could be assured these would be investigated.
The registered manager and staff team all had a very good understanding of their roles and were empowered to make suggestions to keep improving the care. The registered manager and provider had clear and robust systems to assess, monitor and improve the quality of care people received. Systems were designed to continuously improve the service and drive positive changes. People said the registered manager and staff were approachable, listened and responded to them and acted on feedback they shared with them.
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 Good (published 29 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The home manager had applied to the Care Quality Commission to become the 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.
At the last inspection the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated Good:
People continued to receive safe care. Staff were knowledgeable about how to keep people safe from harm. Risks to people's safety were assessed and plans were in place to manage and reduce risks. Staff were recruited safely using robust procedures. There were sufficient numbers of staff to keep people safe and meet their needs. Medicines were managed safely by staff who had received appropriate training and had their skills monitored. Staff were aware of and had practised emergency procedures.
People continued to receive effective care. Staff were trained and competent to carry out their roles effectively. They were supported in their job roles through one to one meetings, appraisals and team meetings. People were supported to eat a choice of freshly prepared meals. They were supported with special diets if required and when necessary their dietary intake was monitored. Frequent snacks and drinks were available. People were supported to maintain their health and wellbeing. Advice was sought from healthcare professionals when necessary.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.
The service remained caring. Staff were kind, considerate and compassionate in the way they delivered support to people. They encouraged people to be as independent as they possibly could be. People’s privacy and dignity were maintained. Staff addressed people in the way they liked. They spoke respectfully to and about people. People's relatives and visitors were welcomed into the home whenever they wished to visit.
The service had made improvements and was now responsive. Activities were designed to take people’s individual interests into account. The range of activities had been widened and included more opportunities for trips out and community involvement. One to one sessions were now a regular feature for people who were at risk of being isolated. People received person centred care. This focussed on their individual needs and recognised their preferred routines. People and their relatives were comfortable to raise concerns and speak with the staff team or home manager if they wished.
The service remained well-led. There was good leadership in place and the staff team worked well together. There were systems in place to assess, monitor and analyse the service in order to make improvements. Links were maintained with the local community to provide support to people living at Bayford House Care Home.
Further information is in the detailed findings below.
This inspection took place on the 12 and 13 February 2015 and was unannounced. Bayford House Nursing Centre is set within six acres of landscaped gardens on the fringes of Newbury. The home is registered to provide personal care and nursing for up to 63 people and is divided into two areas. The main building provides accommodation and nursing care, whereas the adjoining building, Newdale Court, provides residential care only. Accommodation is provided over two floors; all of the rooms on Newdale and most of the rooms within the main building have en-suite facilities. There are spacious communal areas throughout the home.
On the day of our visit 28 people were using the services on the nursing wing and 15 people were using the services provided at Newdale Court.
There is 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.
People’s care plans detailed how the person wanted their needs to be met. Risk assessments identified risks associated with personal and specific health related issues. They helped to promote people’s independence whilst minimising the risk identified. People told us that sometimes they feel isolated as staff were busy and did not always have time to “stop for a chat”. Comments included: “I don’t think they have time for chatting, but they are nice”. The manager told us that this was an area that they planned to improve. We have made a recommendation that the provider seek guidance from a reputable source, about promoting activities and contact for people who use the service.
People told us they felt safe and secure. They said they would approach staff if they were worried about their safety or about the services provided and felt they would be listened to. The recruitment and selection process helped to ensure people were supported by staff of good character and there was a sufficient amount of qualified staff to meet people’s needs safely. Staff knew how to report any concerns they had about the care and welfare of people to protect them from abuse. Learning from incidents and investigations took place. The manager had kept a track of incidents and accidents which were analysed monthly to identify any patterns. Appropriate changes were implemented to promote people’s safety.
The service had taken necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLs provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm.
Staff were supported to receive the training and development they needed to care for and support people’s individual needs. The manager made reference to the In-Reach Team (partnership working with West Berkshire Health and Social Care Professionals) and stated: "I think support has been enormous delivering training and assessing resident’s needs, they have been very approachable. What has been particularly good about this was having another professional’s view coupled with the training they had delivered to staff.”
People told us they were happy living in the home and that staff were attentive, kind and respected the decisions they made. Comments from people included: “as you know things in life don’t stay the same, I’m not worried about anything and I get all the support I need. I’m very happy”. People’s families also told us that they were involved in the decisions made about there relatives care and were kept informed. Comments from people’s families included: “I visit most days, the reason (name) is here is to be closer to home. I don’t think we could possibly find a better place”.
People received good quality care. We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care.
As part of this inspection we spoke with ten people and four visitors. We spoke with eleven staff; three of these were agency staff and two were registered nurses. We also spoke with the registered manager, deputy manager, the home's area manager and training manager.
We looked at nine people's records, they included, care plans; risk assessments and records kept in people's rooms that were used to monitor their care. We also reviewed records relating to the management of the home that included audits and provider reviews used to measure the quality of the services.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we viewed.
Is the service safe?
People told us they felt safe and secure. They said they would approach staff if they were worried about their safety or worried about the services provided and felt they would be listened to.
The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were able to describe the circumstances when an application should be made and knew how to submit one.
People's care plans detailed how the person wanted their needs to be met. Risk assessments identified risks associated with personal and specific health related issues, and recorded guidance for staff to minimise those risks. The provider had identified that improvements were needed to ensure people's care plans were person centred and had taken action to make this happen.
Staff knew how to report any concerns they had about the care and welfare of people and to protect people from abuse. Staff had not received health and safety refresher training and had not received support and guidance from management to ensure the health and welfare needs of people were continually met.
Is the service effective?
Comments from people we spoke with included: 'We have residents meetings. I have no concerns or complaints'. People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
People's individual interests were identified and used to enhance people's lifestyle. One-to-one activities were provided for people who remained in their room due to ill health or choice. However, due to staff vacancies and or delegation of staff, recreational activities provided on the nursing wing were limited in comparison to the residential unit Newdale Court.
Comments from people who lived on Newdale Court included: 'They are nice people here. There are not many afternoons when I have nothing to do'. Comments from people who lived on the nursing wing, who were able to speak with us included: 'I find it very lonely as I stay in my room all the time' and 'there are not as many activities as there used to be'.
Is the service caring?
We saw that care staff interacted positively with people who used the service and were sensitive to people's needs. Staff were observed to approach people in a respectful and appropriate manner. People we spoke with told us staff were considerate and kind. Comments included: 'The staff are very nice, there is not one I don't like'. 'Everybody is kind and helpful'. 'My dignity and privacy is respected and I feel safe here'.
Is the service responsive?
People told us that staff responded to their needs. However, we saw that some people waited longer for assistance from staff on the nursing wing at lunch time. People told us that they have a call bell should they require assistance. Comments from people included: 'Lovely Staff. Don't wait long for attention. They are very responsive'.
The home asked people about their views of the services provided and had taken action to improve. People knew how to make a complaint if they were unhappy. They told us that the new manager and staff were approachable. The home had taken complaints seriously and investigated complaints within the timescale of their complaints policy.
Is the service well-led?
The service had a robust quality assurance system. Records seen by us showed that identified shortfalls were addressed. However we told the provider that although actions had been identified, in some instances, we noted that action had not been taken within the timescale set by the provider. We also told the provider that staff do not feel they have the support from the senior managers necessary to support them to meet the needs of the people who were using the services. They told us this had resulted in low staff morale. Although the home had a stable group of staff who had worked in the home for a number of years there were staff vacancies and these were being filled by agency staff. The home had a new registered manager who registered with the commission in June 2014. The home had policies and procedures but some staff told us these could not always be located. Staff were fully aware of the homes whistle blowing policy, referred to by the home as the Speak UP policy to protect people who were using the services.
People were treated with respect and dignity. They were called by their preferred name and offered choices. There were a range of activities for people to get involved in. We spoke with the activities coordinator who was very enthusiastic and had a very positive influence on the residents.
People were offered a choice of food and drink. The provider had taken steps to ensure variety and incorporate people's likes and dislikes. People's weights and risk of malnutrition and dehydration were monitored so that action was taken swiftly when necessary. One person said 'the food has very much improved. You get a choice from the menu but you can still change your mind'.
Staff told us that they felt supported and that communication within the team was very good. They confirmed that they had regular supervision meetings which fed into an appraisal.
The provider had an effective means to monitor and assess the quality of the service.