Bowbridge Court

Updated 10 December 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.

This was a focused inspection to review the Key Questions of Safe and Well-led only. Our report is only based on the findings in those areas at this inspection. The ratings from the previous comprehensive inspection for the Effective, Caring and Responsive key questions were not looked at on this occasion. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

Inspection team

The inspection was carried out by three inspectors and an assistant inspector. An Expert by Experience supported the inspection by seeking feedback from relatives over the telephone. 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

Bowbridge Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Bowbridge Court does not provide nursing 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 was an announced inspection. We announced the inspection the day we visited to discuss the safety of people, staff and inspectors with reference to the COVID-19 pandemic.

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 about the service. 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

During the inspection we spoke with eight people who used the service and 10 relatives. We spoke with eight staff. We spoke with the registered manager and the provider’s regional director. We looked at a range of records including five people’s care records and how medicines were managed for people. We also looked at staff training, and the provider’s quality auditing system. During the inspection visit we asked the registered manager and regional director to provide additional evidence about how the service was managed, which they did. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We spoke with staff and relatives after the inspection visit to get feedback from them about the quality of the service. We continued to seek clarification from the provider to validate evidence found and reviewed the evidence they sent us.

Updated 10 December 2020

About the service

Bowbridge Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Bowbridge Court does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bowbridge Court accommodates up to 54 people in one purpose-built building, which is split across three floors. One of the floor specialises in providing care to people living with dementia. On the day of our inspection 45 people were living at the service.

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

Staff were not consistently using personal protective equipment (PPE) effectively. The registered manager took action to address this. The service was kept clean, which minimised the risk of people acquiring an infection. We were assured that the provider was preventing visitors from catching and spreading infections and were assured that people were admitted safely to the service. Staff were not always deployed effectively to meet people’s needs.

People and relatives said they felt the service was safe. The registered manager and provider took appropriate action to ensure people were protected from the risk of abuse. People’s needs were assessed, and risks associated with their health conditions documented. Staff knew about risks associated with people’s health conditions and understood how to provide care which kept people safe. Risks associated with the service environment were assessed and mitigated.

People received their prescribed medicines safely. The system for managing medicines ensured people were given the right dose at the right time. Accidents and incidents were reviewed and monitored to identify trends and to prevent reoccurrences. The provider had improved their processes for analysing incidents to determine how to improve the quality of care.

The service was well-led. People and their relatives spoke positively about the way the service was run. The provider and management team undertook audits of all aspects of the service to review the quality of care, and identify areas where improvements were needed. This included a range of regular checks on all aspects of people’s care, and the building environment. Staff we spoke with clearly understood their roles and responsibilities in providing people with safe and good quality care.

People, relatives and staff were encouraged to give regular feedback on the quality of the service. Staff worked with other health and social care professionals to ensure people received the care and support they needed.

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 2 May 2019) and there were breaches of regulations 12, 13 and 17 of the Health and Social Care Act Regulations 2014. Following the last inspection, we retained conditions already imposed on the provider’s registration. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, infection prevention and control, staffing levels and how risk is managed for people’s behaviours. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-led sections of this full report.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bowbridge Court 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.