Bowercroft Care Limited

We found the following examples of good practice.

The service supported people to maintain safe contact with friends and family. This included staff supporting people to use the telephone and internet. Visits were facilitated using the garden, ‘drive through’ and conservatory with a protective screen.

Plans were in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment that were readily available at stations throughout the service.

The provider had measures in place to prevent visitors from catching and spreading infections. Visitors were asked screening questions; temperature checks were performed, and facilities were provided to wash hands on arrival. Lateral flow tests were carried out to check the COVID status of visitors and visits were staggered to minimise contact and enable cleaning between visits.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19. The building was clean and free from clutter and there were enhanced cleaning practices.

Staff ensured people’s welfare had been maintained by facilitating socially distanced activities, such as quizzes and reminiscing discussions. People self-isolating received one to one support with activities.

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

People's experience of using this service:

People told us they enjoyed living at the service and felt safe. One person said, “It’s a happy home, all the staff are lovely and caring. You’ve only got to ask and they will do anything for me.” We observed kind natured interactions between people and staff. Staff knew people well and protected people’s dignity whilst maintaining their privacy.

People’s safety had been promoted and potential risks posed to people had been mitigated. Equipment used within the service had been regularly serviced to ensure they were in good working order. The registered manager and staff understood their responsibilities about safeguarding and had been appropriately trained.

There were enough appropriately trained staff on duty to meet people’s needs. Staff were recruited safely to ensure their suitability to work with people. Staff received support and guidance in their role by the registered manager.

Accidents and incidents were recorded, and risk assessments were in place for the event of an emergency. Arrangements were in place for the safe administration of medicines.

People were involved in planning their care and support. Care plans were person-centred and promoted people’s independence. Care records were regularly reviewed and updated when necessary. People’s needs were assessed before they moved into the service.

People were supported to maintain their nutrition and hydration with a variety of choices. People could access appropriate health care services when required.

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 involved in planning and reviewing their care and support.

Systems were in place to monitor and improve the quality and safety of the service. People’s feedback about the service was actively sought and acted on. The provider had a continuous development plan in place to enhance and improve people’s experiences.

Rating at last inspection: At the last inspection the service was rated Good (published 22 August 2016)

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Bowercroft Care Limited is a care home providing accommodation and care for up to 18 older people who may be living with dementia. At the time of the inspection 15 people lived at the service.

We last inspected the service on the 23 and 25 June 2015, when we made recommendations for improvement in relation to administration of medicines, updating policies and procedures, quality assurance auditing and enhancing the environment for people living with dementia. At this inspection we found that the provider had taken action and improvements had been made.

There was a registered manager employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Management understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

The registered manager and staff had received training about the Mental Capacity Act 2005 and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care.

People said they felt safe and relatives told us that they knew their relatives were safe. People were protected against the risk of abuse. Staff had had training and recognised the signs of abuse or neglect and what to look out for. Management and staff understood their role and responsibilities to report any concerns and were confident in doing so. Staff told us they knew what to do if they needed to whistle blow, and there was a whistleblowing policy available.

People had varied needs, and some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy by showing warmth to the provider, registered manager and staff who were supporting them. Staff were attentive and interacted with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Gaps in applicants employment history had been followed up and DBS checks had been updated as appropriate. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments were being updated and were individual for each person. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice, such as doctors, speech and language therapist (SALT) and dieticians.

People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the home cooked food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.

People were given individual support to take part in their preferred hobbies and interests, and a range of activities were being provided by the activities co-ordinator and staff.

Medicines were stored, administered and disposed of safely. There were policies and a procedure in place for the safe administration of medicines. People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.

People were aware of the complaints procedure and they knew who to talk to if they were worried or concerned about anything. Relatives said that they knew who to complain to if they had any concerns and provided positive feedback on the service as a whole. The registered manager said there had been no formal complaints made since the last inspection in June 2015.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; and daily contact with the provider and staff. The provider had suggested to relatives to leave a review on an on line website and many had done so.

The providers and registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The providers and registered manager understood the requirements of their registration with the CQC.

The provider had put into place signage on bedroom doors and pictorial signage on bathroom and toilet doors to aid and support independence of people living with dementia.