Bascombe Court

Bascombe Court is a residential care home in Brixham. Accommodation is provided over three floors with lifts available for people who have mobility needs. The service can accommodate a maximum of 46 older people. Some people may be living with dementia. Nursing care was provided by the local community nursing teams.

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

People using the service benefitted from a kind, caring and committed staff team. People and their relatives told us they were treated with kindness, compassion and respect. We observed positive and caring interactions between staff and the people they supported. People were able to be independent as possible and were also provided with prompt, sensitive support when needed.

People were placed at the heart of the service and were as far as possible involved in decisions about their care and lifestyle. People and relatives told us they were listened to and care was personalised.

People’s care was delivered safely. The staff team was consistent, employed in sufficient numbers and had the skills, training and recruitment checks to help ensure people were cared for safely.

People’s risks were understood and managed well. People’s rights and independence were respected and promoted. Management and staff understood their role with regards to the Mental Capacity Act (2005). People’s consent was sought before care and support was provided. When people were unable to consent and make decisions for themselves appropriate processes were followed.

People’s needs in relation to their health, diet and overall well-being was understood and met consistently.

People lived in a home that was well-maintained, comfortable and designed to meet their needs. People were supported to occupy their time in a meaningful way and people who mattered to them were welcomed into the home.

People lived in a home that had a positive culture and was led by a passionate and committed management team. Staff felt valued in their role and were determined to achieve good outcomes for people. The provider, registered manager and staff had formed positive relationships with health and social care professionals and liaised with these services to help ensure people’s full range of care needs were met.

Quality assurance systems were effective in continuing to drive and sustain improvement across the service.

Rating at last inspection: At the last inspection the service was rated as Good (published January 2017)

Why we inspected: This was a planned comprehensive inspection based on the last inspection. The service remained Good.

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

Bascombe Court is a residential home in Brixham, Devon providing accommodation and care for up to forty six people. People living at the home are older people, some of whom were living with dementia or a physical disability. On the day of the inspection, forty one people were living at the home.

The home 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 and associated Regulations about how the service is run.

People told us they felt safe living at Bascombe Court and relatives echoed this opinion. People who lived at the home and their relatives were positive about the care they received and praised the staff and management. People and relatives told us staff were kind, attentive and caring. We saw staff were respectful in their interactions with people. Staff sought permission from people before any care or support was offered and personal care was carried out in the privacy of the person's room.

People were protected by the home’s systems for the safeguarding of people, and staff understood what they needed to do to keep people safe or report concerns. There were enough staff on duty to support people and the home followed a full recruitment procedure for staff.

Staff received appropriate training and support to be able to effectively offer safe care and treatment. Staff understood people's needs and preferences for the way they wished their care to be delivered. Care plans were personalised to each individual and contained sufficient detailed information to assist staff to provide care in a manner that was safe and respected people’s wishes. People's care plans included information about who was important to them, such as family and friends. Detailed records of the care and support people received were kept. Risks to people were being assessed and actions taken to minimise them where possible. This included the analysis of falls and accidents.

Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People had varied individual interests they took part in and were supported to be involved in activities in the home. The home had a variety of activities on offer which ensured that people had choices and could be stimulated and motivated to take part throughout ther day if they wanted.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and staff received training to ensure that medicines administration was managed safely.

People were supported to eat and drink sufficient amounts to meet their needs. People had access to healthcare professionals when they needed them, so their healthcare needs were met.

The provider and registered manager had ensured that there were effective systems for governance, quality assurance and ensuring safe care for people. They demonstrated good leadership, and there was a clear ethos and philosophy of care, which was understood and put into practice by the staff.

Systems for quality assurance included seeking the views of people living at the home and their relatives about what could be improved and what was working well for them. This was done through questionnaires and regular meetings. Information for people was displayed in the home and included leaflets about people's rights and standards people should expect.

People lived in a safe environment. Rooms were decorated to individual taste and people could choose what items to keep there.

Records were well maintained, and notifications had been sent to CQC or other agencies as required by law.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

At the time of our visit there were 26 people living at the home. We spoke with five of the people who lived there, four staff, two health and social care professionals, one visitor, the Registered Manager and the provider. There were five care staff, two domestics, a cook and a general assistant on duty. The Registered Manager was registered to manage two homes. On the day of our inspection they were at the other home, but came to Bascombe Court to support the inspection.

Is the service safe?

We found care and treatment had been planned and delivered in a way that was intended to ensure people's safety and welfare. For example, we saw a comprehensive assessment of people's needs and a range of risk assessments had been completed. These included assessments for moving and handling, pressure areas and diet and nutrition. We saw that where people had been assessed as being at risk from pressure sores, suitable equipment had been provided to minimise the risk.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards aim to ensure that people are protected from the risk of inappropriate restraint in any form. The Registered Manager told us that no-one was subject to a current DoLS authorisation by a Local Authority. However, they were aware of recent changes in the legislation and were checking to see if applications for authorisation were needed.

When we asked people if they felt safe at the home they told us they did. One person told us 'Oh yes!' and another said 'Can always go and talk to people if I'm worried'.

Staff told us they had never seen any incident of abuse at the home. We saw no incidents during our inspection that gave us cause for concern. The two health and social care professionals that we spoke with also told us they had never seen anything that worried them during their visits.

Is the service effective?

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. For example, we saw that where people had been assessed as needing help with personal care, there was evidence in the daily records that this help had been given. We saw information recorded in one person's care plan about how staff were to manage the person's distress. The provider may wish to note that daily records for this person showed that not all staff were following the care plan. This meant that staff were not always responding to the person in a consistent manner and their distress could be increased.

We spoke with four care staff who told us they felt supported to ensure they were effective in their role. One told us 'If something is not right I go straight to the manager and she gets things sorted'.

Is the service caring?

People living at the home spoke highly of the care received. One person told us 'The staff are all very nice and helpful' and another said 'Staff are very good, can't fault them at all'.

We discussed people's care needs with staff and they told us about people's needs and how they liked their care to be delivered. Staff we spoke with were able to tell us what they did to support people and knew what to do for them if they needed any additional support. For example, one staff member told us about how a person needed prompting with eating as they sometimes forgot that they needed to eat. Another staff member told us about how one person needed more help with their personal care as they had got frailer.

People told us that there were activities and entertainments on offer and they could choose to attend or not. One person told us they enjoyed going out on the bus trips. On the day of our inspection we saw people enjoying an arts and crafts session.

People living at the home were very complimentary about the staff at the home. People told us 'Staff are wonderful, really wonderful', 'For me it is the ideal place' and 'This is my home'.

Is the service responsive?

Information about visits from and to health care professionals had been recorded in individual care plans, showing clear evidence that people were supported to maintain access to specialist medical services. We spoke with one social care professional who told us they were very happy with the way the home had provided information to them during their visits. We also spoke with a visiting Community Nurse who told us the staff always called them in appropriately and followed any directions given to them.

People told us that regular meetings were held with the Registered Manager. People said they were able to raise any concerns, or make suggestions. We saw minutes of a meeting where people had complained about the quality of sausages being provided. We saw that at the next meeting people praised the quality of sausages now being provided. This showed us that the provider acted on people's requests.

Is the service well-led?

Staff told us and records confirmed that they received regular supervision and appraisals. Regular supervision ensured staff had the opportunity to discuss their work and learning and development in a measured, monitored and supported way.

We saw that the Registered Manager had identified, assessed and managed risks relating to the health, welfare and safety of people who used the service and others who may be at risk. For example, we saw that an infection control audit had been completed in July 2014.

We saw a copy of a system of monthly audits completed by the Registered Manager. These audits included a visual check of moving and handling equipment such as handling belts and hoists. We saw that the last audit had been completed in July 2014. We saw that medications were audited monthly, the last audit being undertaken in July 2014.

We found that people's consent had been obtained for care and treatment provided to them by the service.

People who live at the home told us they were well looked after and were happy. One person told us "This is our home, if we weren't happy living here we wouldn't be doing so'. A family member told us 'We were lucky to find this place; we'd looked at about 20 other homes and this is the best we found'.

People had been protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. The service had an effective, robust recruitment procedure in place. One person told us 'We have a marvellous lot of carers; nothing is too much trouble for them'.

People told us that they felt safe and knew what to do if they had concerns. One person told us that they would feel comfortable making a complaint "but I've never felt the need". People told us that they would not hesitate to report any issues to any member of care staff or management team.

One person said they 'couldn't think of any place better to be' and how they had a 'good fun relationship' with the staff. Another person said 'I enjoy it here. I have all the comfort and pleasures. It couldn't be nicer.' A relative described the home as a 'life saver'. They said that their relative had settled in very well and 'looked upon it as home'. They also said that the home was 'lovely and clean' and 'bright and airy'. They commented on the benefits of 'stimulation' and said the food was 'excellent'.

All the people and relatives we spoke with described the staff as kind. One person described the staff as 'very kind, very helpful in every way'. Another said 'I can't criticise or grumble. I've always been looked after very well.'

All the staff we spoke with were positive about the support they received. One carer said 'I love it' when asked about their experience of working at the home and described the manager as 'very approachable'.

The home had an effective quality assurance system.