The Boynes Care Centre

Updated 1 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Boynes Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection the service did not have a manager registered with the Care Quality Commission in post. This means the provider is solely legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service about their experiences of the care provided. We spoke with sixteen members of staff including the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. In addition, we spoke with the deputy manager of the service, the deputy manager from another service who was providing management support, the group quality and systems manager, three nurses, care staff, the administrator, domestic and maintenance staff.

We reviewed a range of records. These included three people’s care records and multiple medicine records. We looked at staff files in relation to their recruitment. In addition, we looked at a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with six family members to discuss their experience of the service provided to their loved one.

Updated 1 October 2021

About the service

The Boynes Care Centre is a nursing home providing nursing and personal care for up to 40 people living with dementia. At the time of the inspection 18 people were residing at the service.

The Boynes Care Centre consists of a two-storey building with two wings, Malvern and Cedars. The home consists of both a period and more modern purpose-built accommodation.

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

Risks to people were not always identified effectively to ensure people were not at risk of harm.

Medicines were not always managed safely to ensure people always received their medicines as prescribed. Audits in place were not effective in ensuring management practices were identifying shortfalls.

Omissions regarding fire safety monitoring and checks to protect people against the risk of fire were insufficient and had not fully identified and rectified concerns identified as part of the inspection.

Environmental checks to ensure the safety of people were not always undertaken in line with guidance and the provider’s own procedures or sufficient action was not always taken when risks were identified.

Care plans were in place and reviewed however these did not always fully identify people’s care needs and how these were to be met.

Improvement was needed in the recording of valuables when handed in for safekeeping.

Procedures were in place to prevent the spread of COVID-19. Staff were however at times seen not to wear a facemask to assist in reducing the risk of potential infection. Testing of people and staff members took place regarding the pandemic. Systems were in place for relatives and friend to visit and infection control measure where in place regarding these people.

Systems to monitor the quality of the service provided were not always effective in identifying risks to people. As a result, action had not always been taken in a timely way to reduce risks.

The provider had systems in place for the safe recruitment of staff. Staff were seen to engage with people in meaningful pastimes.

Staff were aware of their responsibilities regarding the reporting of abuse. People felt safe living at the home and liked the staff who provided their care and support.

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 August 2019).

At this inspection not enough improvement had been made in the safe domain previously rated as requires improvement.

Why we inspected

We received concerns in relation to staffing and communication. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

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 The Boynes Care Centre on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to medicine management, monitoring the safety of the environment, care documentation and governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.