The Byars Nursing Home

Updated 9 August 2019

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 was completed by one inspector, an assistant 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

The Byars Nursing Home is a care home. People in care homes receive accommodation and nursing or personal care. 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.

What we did before the inspection

We reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse and accidents; and we sought feedback from the local authority and professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection, we spoke with five people who used the service and eight relatives to ask about their experience of the care provided. In addition, we received feedback from two health professionals and a further three relatives following our inspection.

We spoke with twelve members of staff including the nominated individual, registered manager, clinical leads, senior carer workers, care workers, maintenance manager, housekeepers activity coordinators, and the catering manager. We reviewed a range of records. This included two people's care records and multiple medication records. We also looked at staff files in relation to recruitment and supervision records along with records relating to the management of the home. We also reviewed a variety of policies and procedures developed and implemented by the provider.

Updated 9 August 2019

About the service

The Byars Nursing Home is owned and managed by Beckedge Limited. It is situated in the village of Caythorpe in Nottinghamshire and offers accommodation for up to 30 older people. At the time of our inspection 28 people lived at the service.

People’s experience of using this service

The service clearly demonstrated how it continued and consistently met the characteristics of providing excellent care. People were at the heart of the service and staff were clearly committed and compassionate, striving to provide excellent care at all times. The registered manager had developed innovative ways of involving people in how the service developed and was a part of the local community. There was an open, transparent and person-centred culture that was driven by a motivated and committed staff team. They constantly looked for ways to improve the service and ensured people received the outstanding care they deserved. This motivation resulted in a whole team who were totally supportive and committed to providing high quality, individualised care. The staff team told us they were truly valued and respected. Staff were highly skilled, motivated and knowledgeable. They were also very well trained and supported and encouraged to progress and develop.

There was a homely welcoming atmosphere at the service and we observed very positive and caring relationships between people using the service and the staff who cared for them. Staff worked hard to promote people's right to make their own decisions about their care where possible and respected the choices they made. 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 received excellent opportunities to participate in a variety of social and recreational activities and opportunities. These included activities important to people and supported interests and hobbies. The service had many animals that lived at The Byars Nursing Home and people enjoyed their company and got great comfort and joy from their presence. People received opportunities to participate in their local community. The registered manager had developed positive links with organisations and encouraged and welcomed their contribution and involvement in the development of the service.

People received excellent end of life care where they were fully supported in how they received care and support at the end of their life. Care was delivered in partnership with people and their families and people were always asked for their consent to their care. Effective, personalised steps were taken to ensure people who lacked capacity to make decisions received care that was in their best interest and met their needs.

People consistently told us they felt safe and staff, and the provider used creative and innovative methods to ensure that risks to their health and safety were reduced. We found that sufficient staff were deployed to safely meet people’s needs. Staff had received comprehensive training to ensure they had detailed knowledge to protect people from the risk of avoidable harm or abuse, whilst enabling them to live fulfilled unrestricted lives. People were protected from the risk of an acquired health infection, as the service employed dedicated cleaning staff to ensure the environment was clean. There were appropriate infection control and prevention policies and procedures in place, which were regularly reviewed to ensure effectiveness, to monitor and reduce the risk.

The service was exceptionally well-led. The registered manager demonstrated how their open and listening management style and robust quality assurance systems had sustained continual development and improvement at the service. They had demonstrated ways of working that ultimately improved the outcomes for people living at The Byars Nursing Home. They were clear about their expectations relating to how the service should be provided and led by example.

Rating at last inspection

At the last inspection we rated the service as Outstanding for four domains and Outstanding overall. At this inspection, we found the service had improved to Outstanding in all domains.

Why we inspected

This was a planned inspection to assess if the service was meeting the requirements of the Health and Social care Act 2014.

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.

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