Archived: Bathurst Lodge Residential Care

Bathurst Lodge is a care home operated by Holmleigh Care Homes Limited. The service provides support, personal care and accommodation for up to six people. It provides care to adults living with a learning disability, autism and behaviours that may challenge. Six people were living at the home at the time of our inspection.

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

Since our last inspection the service had made changes to the management team at Bathurst Lodge. The management team had ensured there was effective oversight and governance of the service. The quality of care provided and staff interactions were closely monitored to ensure a caring ethos was evident and maintained. The managers of the service worked alongside staff to ensure that any issues were managed and priorities in relation to the quality of support were identified and acted upon promptly.

People's independence was respected and promoted. The support provided to people focused on them having opportunities to personally develop and maintain relationships. People received a consistent level of care from a team of care workers. There were enough staff employed to meet people's needs.

Staff communicated with people effectively to ascertain and respect their wishes. Safe recruitment practices were followed to protect people from unsuitable staff.

People received personal care that was person-centred and individualised. People's communication needs were identified, recorded and highlighted in care plans. People had access to documents in large fonts and pictures and symbols were used to support people to understand the information presented to them..

People were supported to access health services when needed. People's care plans provided staff with information about people's preferences and ways in which staff could support people emotionally and effectively when attending their healthcare visits.

Staff at the home supported people with the activities they enjoyed. Staff were responsive to people and their social health needs and people were encouraged to be as independent as possible.

People were protected from abuse and harassment and received appropriate support to take their medicines safely as and when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Rating at last inspection

The last rating for this service was Good (published 10 January 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.

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

Bathurst Lodge is a large detached house in a residential area of Gloucester. The service is registered to provide personal care for up to six people with learning and mental health difficulties. On the day of our visit, there were six people at the home.

There was a registered manager for the service. 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 staffs skill and approach in responding to behaviours that challenge in a caring way was variable .Some staff did not convey a patient caring manner when they supported those people. The remaining staff did convey that they were caring towards people and were patient in approach.

People spoke positively about the staff and the support given by them with their particular needs. People were treated in a polite way and staff spent plenty of time with people. There were positive and warm interactions between them. People approached staff when they wanted to talk with them .

Care plans were informative and set out for staff what actions were needed to support people with their range of care needs. Staff were aware of what was written in each person’s care records. They knew how to provide care that was flexible to each individual and met their needs. Care plans were reviewed and updated regularly. This was done so that they were up to date and reflected the current needs of people.

There were recruitment and training processes in place that helped to ensure that staff were properly checked and were knowledgeable to be able to support people effectively.

The staff told us they could address any concerns or raise any issues informally with senior staff and the registered manager. The staff had received formal supervision meetings and areas for improvement were properly addressed with them.

There were enough staff deployed at any time to meet people needs. Feedback from people and others involved in their care was positive. There were quality checking systems in place to monitor the service so that people received care that was personalised to their needs.

Staff spoke positively of the management of the service. They said that the registered manager and the deputy manager provided strong and supportive leadership. Staff said they saw them or the deputy manager every day. They also said they were always available and helped them whenever they needed support and guidance.

Feedback about the home from people and others involved in their care was positive. Regular reviews were undertaken to see where improvements were needed and the service could be further developed. There were systems in place to monitor the service to ensure people always received care that was personalised to their needs.

Staff spoke positively of the management structure of the organisation they worked for. They said that the senior managers and the registered manager provided strong and supportive leadership. The staff team told us they were particularly well supported by the registered manager, who spoke positively about their role. Staff said they saw them every day and they were always there and helped them whenever they needed support and guidance.

At the time of the inspection the service had 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 were at risk of cross contamination when using the home’s bathrooms as they had not been adequately maintained. This meant the bathrooms could not be effectively cleaned to prevent the spread of infections. You can see what action we told the provider to take at the back of the full version of the report.

Risk assessments and guidance were in place to direct staff when people were at risk of harm or abuse. However, there was inconsistent recorded monitoring of when staff had intervened or administered medicines if people became agitated. Staff worked with people to ensure their safety, however records were not in place to reflect the assessment and impact of environmental restrictions on people within the home such as locked doors.

Staff were knowledgeable about reporting any concerns or allegation of abuse. Staff had sought advice and support from other health care services when people’s health and emotional needs had changed. People’s care records reflected their health and well-being needs. The home catered for people’s dietary needs and preferences. They were encouraged to take part in the planning and cooking of meals. Staff had been trained to support people who required additional support with their nutritional intake.

Staff were kind and caring. They encouraged people to become independent and express their own decisions. Staff had sought the opinions of significant others such as their family and doctors when people could not make important decisions for themselves.

Adequate recruitment and training processes were in place to ensure that staff were suitably checked and knowledgeable to support people. Staff told us they could address any concerns or issues informally with senior staff and the registered manager; however they had not received formal supervision meetings. Any shortfalls in staff conduct were immediately addressed. There were sufficient staff to meet people needs.

The home valued people’s feedback and involvement in running the home. Their concerns and problems were immediately addressed. Quality assurance checks were in place to ensure people received a good service and remained safe in their own home.

We looked at the care files of three people who used the service. These files were comprehensive and up to date. The care plans and risk assessments were person centred and individual to each person and reflected their needs. People's care had been reviewed on a regular basis.

The provider had a medication policy in place that was up to date and fit for purpose. Staff had been training to administer medicines and had their competencies checked every six months. The deputy manager told us that staffing had recently been increased to match the needs of the people who used the service. We were also told that with the current staffing levels, all people's needs were able to be met. The provider's quality manager told us that the home had not received a complaint since 2010. We noted however, that an effective complaints system was in place should the need arise.

We were able to speak to one person who used the service. They told us 'I really enjoy living here, I like to help out around the home and there is lots to keep me occupied'. We also saw the satisfaction surveys and all the results showed positive results.

Three relatives said that they would recommend the home and rated it as excellent in their satisfaction surveys.