Buckingham House

Buckingham House is a nursing home providing personal and nursing care for up to 60 people. At the time of inspection there were 46 people using the service.

People’s experience of using this service and what we found

People did not receive safe care and treatment. Risks and care needs were not always identified and actions to lessen risks not taken.

People did not always have their clinical needs met effectively. Instruction from health professionals was not always followed leaving people at risk of further health complications.

The environment was not always safely maintained and risks to people’s safety not always identified or rectified.

People did not always receive care that was personalised to their individual needs.

Infection control was not effectively managed.

There was no clear management governance or oversight of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 April 2019).

Why we inspected

The inspection was prompted in part due to concerns received about how people’s needs were being managed. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Buckingham House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding people from abuse, person centred care, management of risks, safe premises and management and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Buckingham House is a nursing home that was providing personal and nursing care to 28 people aged between 18 and over at the time of the inspection.

People’s experience of using this service:

¿ People were supported by staff who knew how to recognise potential abuse and who they should report any concerns to. People’s care considered their risks and reduced the risk of harm and where required, had access to equipment to support them. There were enough staff on duty to meet people’s social and care needs.

¿ People had a choice of food and were supported to maintain a healthy diet in line with their needs and preferences. Staff were trained to meet people’s needs and acted promptly to refer people to healthcare professionals when required.

¿ People enjoyed positive and caring relationships with the staff team and were treated with kindness and respect. People’s independence was promoted by staff who encouraged them.

¿ People’s needs and routines were known and supported by staff who ensured these were met and respected. People and relatives knew how to complain if needed, and were confident any comments or concerns were listened and acted on.

¿ People and staff were happy with the way the service was led and managed and the provider worked well with external professionals to ensure people’s needs were met.

¿ Service management and leadership was consistent and areas for improvements were identified and acted on. The registered manager assured people’s views and experiences were gathered and any improvements were made.

¿ We found the service met the characteristics of a “Good” rating; More information is available in the full report

Rating at last inspection: Good (Published September 2016)

Why we inspected: This was a planned inspection based on previous rating.

Follow up: There will be ongoing monitoring and routine inspections of the location.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Buckingham House offers residential and nursing care for up to 30 older and younger people with support needs for including people with dementia. There were 29 people living at the home at the time of our inspection.

People had their own rooms and the use of a number of communal areas, including a dining area, lounges and garden areas.

A registered manager was in post at the time of our inspection. 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. The registered manager oversaw five locations on the Moundsley Village site, and was supported by a unit manager at Buckingham House. The unit manager at Buckingham House was in the process of applying to become the registered manager for Buckingham House.

Caring relationships had been built between people and staff. Staff knew the needs and preferences of the people they cared for and people were given reassurance and encouragement when they needed it. Where people needed support from staff in order to make their own day to day decisions this was provided by staff. People's rights to privacy, dignity and independence were taken into account by staff in the way they cared for them.

Risks to people's safety were understood by staff who took action to promote people’s safety and wellbeing. Staff adapted the way they supported people to stay as safe as possible as people’s needs changed. Staff knew what actions to take if they had any concerns for people's safety or wellbeing. There was enough staff available to support people so their care needs would be met and for people to have opportunities to do things which interested them. People received the care they needed to take their medicines and were supported to obtain pain relief when they needed.

Staff worked to promote people’s rights and protected their freedom. People were supported by staff who had developed the skills and knowledge needed to provide care for people. Where people needed assistance to have enough to eat and drink to remain well this was provided by staff. People saw their GPs when needed and staff were supported through advice from specialist health professionals.

People benefited from living in a home where staff supported them to do things they enjoyed and to keep in touch with people who were important to them. People were confident staff would take action if complaints were raised and guidance on how to do this was available.

Staff were supported to know what was expected of them through discussions with their managers. People and staff made suggestions for improving the care provided and their suggestions were acted upon. Regular checks were undertaken on the quality of the care by the registered manager, unit manager and provider and actions were taken to develop the home further.