Background to this inspection
Updated
3 October 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
Our inspection was carried out by three inspectors, an assistant inspector, a specialist nurse advisor and two experts 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. The experts by experience had experience of caring for older people and people who were living with dementia or a mental illness.
Service and service type
Bakers Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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.
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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 15 people who used the service and five relatives about their experience of the care provided. We also spoke with a visiting GP and a visiting nurse from the clinical commissioning group (CCG). We spoke with 14 members of staff including the registered manager, three nurses, five carers, the chef, head of housekeeping, two domestic staff and a wellbeing co-ordinator with responsibility for activities.
We reviewed a range of records. This included six people’s care records including risk assessments. We looked at eight staff files, in relation to recruitment and supervision. A variety of records relating to the management of the service including staff training and quality assurance were reviewed.
After the inspection
The registered manager sent us documentation we requested including training data.
Updated
3 October 2020
About the service
Bakers Court Care Home is a nursing home providing personal and nursing care to up to 78 people aged 65 and over in one building across three floors. At the time of the inspection, 71 people were using the service.
People’s experience of using this service
The provider had increased the numbers of staff on duty, but staff were not deployed effectively to meet people’s needs. People did not receive a good dining experience. Care plans did not always include the level of detail needed to provide people with person-centred and safe care. The provider’s quality assurance systems did not address the issues we found at this inspection.
People had risk assessments to minimise the risks of harm or abuse they may face. However, risk management plans were not always reviewed and updated when people's needs changed. Staff knew what action to take if they suspected somebody was being harmed or abused. Medicines were managed safely. People were protected from the risks associated with the spread of infection.
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.
People’s care needs were assessed before they began to use the service. Staff were supported to carry out their role with training, supervision and appraisals. People were supported to maintain their health. Staff understood their responsibilities under the Mental Capacity Act (2005).
Staff were knowledgeable about people’s individual needs and they knew how to provide a personalised care service, although people’s personal preferences were not always well documented. People’s communication needs were met. The provider had a system in place to handle complaints. People who were at the end of their life had their wishes for their last days documented.
People and their relatives gave mixed feedback about the leadership of the service. Staff spoke positively about the management of the service. The provider held regular meetings for people using the service, their relatives and staff. The provider sought feedback from people using the service and relatives to identify areas for improvement. The provider worked in partnership with other agencies.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 January 2019) and there were breaches of regulation. The provider completed an action plan after the inspection to show what they would do and by when to improve.
At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received about the quality of care of people using the service. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.