Background to this inspection
Updated
10 April 2020
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.
Inspection team
The inspection team consisted of an inspector, a specialist advisor who was a nurse and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service
Service and service type
Bucklesham Grange is a ‘nursing 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.
The home did not have a manager registered with the Care Quality Commission. A manager had been appointed and at the time of the inspection had been in post four months. They were in the process of registering with CQC. In the absence of a registered manager, the provider was 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 and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also sought feedback from the local authority safeguarding and quality assurance teams. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who lived in the home and with eight relatives. We also spoke with the manager, the deputy manager, the provider’s nominated individual and regional manager, two nurses, three senior care staff, four care staff, two agency care staff, two staff from the lifestyle team, two domestics and two visiting healthcare professionals.
We looked at the care records for seven people and several medicine records. We reviewed two staff recruitment files, staff training records and a range of quality monitoring records which related to the day to day running of the service.
After the inspection
We continued to seek clarification from the manager to validate evidence found. We received electronic feedback from three relatives and four members of staff about their experiences of Bucklesham Grange.
Updated
10 April 2020
About the service
Bucklesham Grange provides accommodation and nursing care for up to 57 people, some living with dementia. The home is purpose built and arranged over two floors and at the time of the inspection there were 52 people living in the home.
People’s experience of using this service and what we found
We have made a recommendation regarding the staffing arrangements in the home. Staff were not adequately deployed during busy times and there were instances where people were left unattended in communal areas in the home. The senior management team confirmed they would undertake an immediate review of their staffing arrangements.
People’s medicines were administered as prescribed. The home was clean, and staff had received training around infection prevention and control. However, some feedback received described inconsistencies in staff practice in this area. Accidents and incidents were recorded and reviewed to mitigate further occurrence.
There had been several personnel changes and staff turn-over since the last inspection. This included the previously registered manager now working at another of the provider’s services. This had affected consistency in the home despite the provider’s interim management arrangements. Feedback received cited inconsistencies with communication, staffing arrangements and a lack of leadership and direction in the home. However, the majority of feedback we received was positive and complimentary about the new manager and the improvements they were making in the home.
At the time of the inspection the manager had been in post four months and we were encouraged by the actions they were taking to develop the home. Staff morale was good, staff enjoyed their job and felt supported by the manager. The provider’s nominated individual acknowledged the home had been through many changes but assured us they would fully support the new manager to address the inconsistencies we had found.
Risks relating to people’s individual care needs had been identified and planned for. Assessments and plans to mitigate environmental risks were also in place. Staff understood their responsibilities in relation to keeping people safe and had received training in safeguarding.
People were treated with kindness and compassion. People’s care records provided guidance to staff on how to meet their specific needs. People and the majority of their relatives described positive relationships with the staff and management team. Provisions were in place to ensure people received visits from relatives and maintained their interests. Complaints were responded to appropriately.
Staff knew people’s care needs well and offered reassurance to people in times of unease. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. There was a welcoming atmosphere in the home.
Assessments of people’s needs were carried out prior to them moving into the home. There were safe recruitment practices in place for new staff. New staff attended an induction and completed training relevant to their role. Staff supported people to maintain a healthy nutritional intake. People had access to healthcare services and referrals were made when their needs changed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The rating at the last inspection was outstanding (published 13 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bucklesham Grange on our website at www.cqc.org.uk.
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.