Archived: Bushbury Court Nursing Home

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well lead?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with two relatives of people using the service, three staff supporting them and looking at two people's care records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Relatives of people who used the service told us they felt their relatives were safe. Safeguarding procedures were in place and generally staff understood their role in safeguarding the people they supported.

The provider had a policy and procedure in place to gain the consent of people who used the service. The processes used to gain consent for people was not always clearly recorded.

Staff knew about risk management plans and we saw that they supported people in line with those plans. The registered manager ensured that staff rotas were planned in advance to maintain the staffing numbers required to provide care in a safe way. The staff had the training and support required to ensure that people's needs were met. Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints and checks made on the service. This reduces the risk to people and helps the service to continually improve.

Is the service effective?

People's health and care needs were assessed with them where people could express themselves and with family members where people were unable to tell staff themselves. Relatives told us they were involved in the care planning and reviews of care. We saw that care plans were regularly updated.

Visitors confirmed that they could visit when they wanted to and spend time alone in privacy if they wished.

Is the service caring?

People were supported by staff that were generally kind and caring. We saw that care staff gave people encouragement and were patient with them. One relative told us, 'I visit my relative every day and the staff are marvellous'.

People's preferences, interests and diverse needs had been recorded and care and support was usually provided in accordance with people's wishes.

Is the service responsive?

People had the opportunity to engage in a range of different activities each day. However, there were limited opportunities for people to take trips out into the community. One relative told us, 'I would like to see my relative get out more'.

Relatives were aware of the home's complaints procedure and knew how to raise concerns. One relative told us, 'If you raise something with them they will get back to you'.

The home had regular meetings with relatives which were recorded. The meetings took on board comments made to improve the service and acted on suggestions.

Is the service well led?

The service had a quality assurance system. Records seen by us indicated that shortfalls in the service were addressed promptly.

Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure that people received a good quality of care. Staff told us the home was well organised and they felt supported by their manager.

We used a number of different methods to help us understand the experiences of people who lived at the home, because people had complex needs which meant they were not able to tell us their experiences. We spoke with the relatives of two people to gather their views.

Relatives were involved in the care planning and delivery as people had complex care needs. Records showed that consent was obtained before care and treatment was delivered.

We found that staff were aware of people's health condition and how to deliver appropriate care. We observed positive interactions between staff and people. One relative said, 'The care is great here, we have had no problems.'

Systems were in place to ensure people had appropriate coordinated care when their care was transferred to and from the home.

We found that selection and recruitment processes were consistent. Relatives were complimentary about staff. One relative told us, 'The staff are really good and friendly.'

Complaints and comments were taken seriously. Records showed that feedback from people and their relatives were taken seriously.

People's care records and records related to the management of the home were stored appropriately and fit for purpose.

We found that improvements were made in the way staff involved people in their care and reassured people when needed.

We found that people's care was delivered in a timely manner. Measures had been put in place to monitor people's health and take appropriate action.

Arrangements were in place to safeguard people from unlawful or excessive use of restraint. We found that staff knowledge and understanding of how people should be protected, had improved.

Staff had received different training, and this was ongoing. We found that interactions between staff and people were positive and frequent. One staff member said, 'We actually work together as a team now and we all feel involved.'

Systems were in place to monitor the quality of the service provided to people. We found improvements had been made across the outcome areas that the provider was previously non-compliant with. One staff member said, 'Things have changed a lot, for the better.'

We found that relatives were involved in making care and treatment decisions. One relative said, "They show me and my daughter the care plan so we get to see it." However, we found that staff did not always involve people when supporting them and there were limited opportunities for people's independence to be promoted.

We found that people's care plans were not always updated to reflect accurate information. We saw that staff did not always deliver care that was planned in people's records. This meant that people did not receive care that met their needs.

We found that arrangements were not always in place to ensure that people were safeguarded from abuse. We saw that some people were being physically restrained inappropriately.

We found that there was insufficient number of staff to care take of people's needs. One staff said, 'We have a staff shortage, we do what we can.'

We found that many concerns highlighted during this inspection visit were raised at a previous inspection. This meant that improvements had not been made to ensure better outcomes for people at the home.