Bay Court Nursing Home

Updated 21 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection was carried out on 3 and 8 January 2019. The first day of the inspection was unannounced; the inspection team consisted of one adult social care inspector and an expert by experience. An expert by experience is a person who has experience of using, or caring for someone using, this type of service. The second day of the inspection was announced and completed by one adult social care inspector.

We reviewed all information the Care Quality Commission (CQC) held about the service before the inspection. This included all contacts about the home, previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to tell us about by law. We also reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We met people who lived at the home throughout our visits and spoke with five people to gain their views about the service. We also spoke with five relatives to ask for their views. We spent time in communal areas observing staff interactions with people and the care and support delivered to them. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living with dementia.

We met fifteen staff which included the new manager, senior lead nurse, senior auditing nurse, two registered nurses, activity person, senior care staff, care staff, housekeeping staff, the cook, and the administrator. We also spoke with two of the directors of the service, a visiting social worker and hairdresser.

We looked at three people's care records and five people’s medicine records. We also checked four staff records, meeting minutes and various quality monitoring audits and the services policies and procedures. We sought feedback from and health and social care professionals who regularly visited the home and received a response from two of them.

Updated 21 February 2019

This comprehensive inspection of Bay Court Nursing Home took place on 3 and 8 January 2019. The inspection was unannounced. This meant that the provider and staff did not know we were coming. The second day of the inspection was announced.

Bay Court Nursing Home is registered to provide nursing and personal care for up to 29 people. Most people using the service have multiple health care needs. There were 29 people living at the home on the first day of our inspection.

Bay Court Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection. The home is a large detached house in the East Devon seaside town of Budleigh Salterton and is within walking distance of the town centre shops and services. The home is set over four floors with two passenger lifts providing level access to each floor. There is a large main communal lounge with a dining area where people could spend their time as they chose. People have access to a well-maintained garden.

At our last inspection in August 2016 we rated the service Good. At this inspection we found the service remained Good overall but the responsive domain has been rated as outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

The registered manager had deregistered with the Care Quality Commission (CQC) in November 2018. 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 and associated Regulations about how the service is run. The deputy manager who had worked at the service for three years had been appointed as the new manager. They had submitted their application to CQC to register as the registered manager and were awaiting an interview. The provider had appointed a senior auditing nurse to support them in their role alongside the senior lead nurse.

The service was well led by the new manager. They were very passionate about people being at the heart of the home. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. There were effective systems in place to monitor the quality of care provided.

There was an excellent understanding of the importance of seeing each person as an individual, with their own social and cultural diversity, values and beliefs. The provider and staff recognised the importance of social activities and understood meaningful activities formed an important part of people’s lives. Staff were very passionate about the activities at the home being meaningful and appropriate. They had established people’s hobbies and interests and supported them to revisit them. There were numerous examples of people doing meaningful activities. One person wanted to fundraise as part of their hopes and dreams in 2018. They had held a bake sale with cakes and a raffle for charity. Another person had previously worked with guide dogs. Staff had contacted the guide dogs for the blind and they had visited and have since regularly visited the home. This had a significant impact on this person who had opened up and was now very active at the home. Staff went above and beyond giving their own time to support people on these activities.

People remained safe at the service. People said they felt safe and cared for in the home. People were protected because staff knew how to recognise signs of potential abuse and how to report suspected abuse. People’s care needs were assessed before admission to the home and these were reviewed on a regular basis. Risk assessments were undertaken for all people to ensure their individual health needs were identified and met.

Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed.

Staff received a comprehensive induction and were knowledgeable. They had received training and developed skills and knowledge to meet people’s needs. Staff relationships with people were caring and supportive. They delivered care that was kind and compassionate.

There were adequate staffing levels to meet people’s needs. People received person centred care. Staff knew people well, understood their needs and cared for them as individuals. People were relaxed and comfortable with staff that supported them. Staff were discreet when supporting people with personal care, respected people’s choices and acted in accordance with the person’s wishes. People where possible and appropriate family members were involved in developing and reviewing their care plans.

Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. 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.

People were supported to eat and drink enough and maintain a balanced diet. People were positive about the food at the service. The manager and staff were committed to ensuring people experienced end of life care in an individualised and dignified way.

People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the management team. There had been no complaints received at the service since our last inspection. Where there were niggles or concerns action was taken to resolve them.

The premises and equipment were managed to keep people safe. The home was very clean throughout without any odours present and had a pleasant homely atmosphere.

Further information is in the detailed findings below.