Bowfell House

Updated 27 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 team consisted of one inspector 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

Bowfell House 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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. Inspection activity started on 28 July and ended on 17 August 2021. We visited the service on 28 July and returned on 5 August 2021 to speak with the registered manager and other staff.

What we did before the inspection

We reviewed information we had received about the service since it was first registered. 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 used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and six relatives about their experience of the care provided. We spoke with members of the management team including the registered manager, the nominated individual and the quality assurance manager. We also spoke with five care workers, domestic, activities, catering and maintenance staff. We observed interactions between people and the staff.

We reviewed a range of records. To help us assess how people’s care needs were being met we reviewed five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed, including policies and procedures and systems for monitoring the quality of the home.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We arranged for the provision of electronic documents and evidence to support our findings on site. We spoke with a professional who visits the service. We received two statements from senior members of staff whom we were not able to speak with during the inspection.

Updated 27 October 2021

About the service

Bowfell House is a residential care home providing personal and nursing care for up to 40 people aged 65 and over. At the time of this inspection the service was supporting 40 people.

In October 2019 the provider closed two older homes and people moved to Bowfell House, a purpose-built residential care home serving a close-knit community. The new home has 40 en-suite bedrooms over two floors, quiet lounges, a library, hairdressing salon and a balcony area to the first floor. A landscaped garden area is purposefully designed and planted with flowers and shrubs that appeal to the senses.

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

People were at the heart of the service; receiving outstanding care that was personalised to them, taking account of their individual needs and wishes. Without exception people, relatives and professionals were full of praise about Bowfell House and the whole staff team. Bowfell House was exceptionally well led and this was consistently echoed by people and staff we spoke with. There was dynamic and effective leadership within the service. The family-run service was well- organised with an open and transparent culture at the fore. Morale in the service was extremely high; with staff proud to work at Bowfell House and remarkably motivated and enthusiastic about delivering high quality care.

Distinctive leadership at location and provider level had achieved a service that was outstandingly effective, caring and responsive. The registered manager led by example and was passionate and committed to ensuring people received tailored care to meet their diverse needs. The registered manager and nominated individual were visible and hands on in the home, supported by a strong management and staff team. Along with other senior team members they effectively demonstrated how the robust quality assurance systems in place contributed to continual development and improvement at the new home.

There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result, the quality of the service had continued to grow and develop. Both the registered manager and nominated individual demonstrated an open leadership style, working in partnership with other stakeholders to drive continuous improvement within the service. Strong links previously established with the local community prior to the COVID-19 pandemic were being re-established at the time of this inspection. Relationships with family members had flourished due to the time and effort spent by management in communicating and keeping people fully informed. Feedback about the service from people and those close to them was remarkably consistent and exceptionally positive, whilst feedback from other professionals indicated collaborative and highly effective working relationships were established.

All staff demonstrated extremely compassionate, attentive and caring approaches in their interactions with people. They consistently promoted and encouraged people's independence and treated them with the utmost dignity and respect. People and their relatives were extremely complimentary about the approach of the staff and the management team. People and relatives shared numerous examples of how compassionate and dedicated staff repeatedly went the extra mile to ensure they were satisfied with all aspects of their care and achieved positive outcomes. This had not wavered during the COVID-19 pandemic. Everybody we spoke with said they would highly recommend the service.

People were encouraged and supported to pursue hobbies and interests and participate in a wide range of meaningful activities to enable them to live as full a life as possible. The service had fully reviewed meal-time routines, recognising they were a social highlight of the day for many. People enjoyed an extremely positive meal-time experience and were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services.

The service continued to provide a safe service to people. Effective systems were in place intended to minimise the risks to people, including from abuse, falls and with their medicines. Safely recruited staff fully understood their roles and responsibilities in keeping people safe and were well trained in meeting people's needs.

Staff understood the importance of obtaining consent when providing care. Ensuring people received care and support tailored to meet their individual needs to enhance their quality of life was integral to the ethos of the home. Staff demonstrated an enhanced understanding about people's choices, views and preferences and acted on what they said.

The design and layout of the building was hazard free, clean and in a good state of repair with equipment maintained. People's individual needs including those living with dementia were met by the design and decoration of the home. Consideration had been given to providing points of interest and stimulation along with more tranquil areas in the building. The result was a safe and homely environment that local people could identify with.

People and those close to them were fully involved in the delivery and design of the service. They contributed towards plans of care, which were regularly reviewed and adapted to meet changing needs and were involved in the planning of menus and specially themed dining events. People knew how to complain and share their experiences. Their views and opinions were actively sought, valued and listened to. Concerns and complaints were thoroughly investigated, responded to and used to improve the quality of the service.

Monthly newsletters were produced to promote everyone' s involvement in the service which included ongoing communication about the large variety of activities on offer and updated national guidance for the COVID-19 pandemic. There was a distinctive focus on creating a service for the community that welcomed and embraced diversity and promoted equality. The service was dedicated to ensuring continuous quality improvement to make a real difference for ‘Bowfellians’, people living at Bowfell House, their friends and family members.

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.

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

Rating at last inspection

This service was registered with us on 13/10/2019 and this is the first inspection.

Why we inspected

This was a planned inspection to rate the service.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bowfell House on our website at www.cqc.org.uk.