Byfield Court

Updated 30 December 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 two inspectors.

Service and service type

Byfield Court is a ‘care home’. People in care homes receive accommodation and 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had about the service since the last inspection. We sought feedback from the local authority who work with 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. This information helps our inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and three relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, deputy manager and care workers.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 30 December 2021

About the service

Byfield Court is a residential care home providing personal care and accommodation to 11 people who live with autism and/or have a learning disability.

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

People’s individual health needs, such as constipation, had not been risk assessed or guidance put in place for staff to follow. Following the inspection, the registered manager put guidance in place and shared this with staff.

Care plan audits were not always effective when identifying risks to people’s health. The registered manager only took action to address these concerns when they were brought to their attention.

Medicines had been managed safely. People had guidance in place if they had ‘as required’ medicines. The service had a stable staffing team that knew people well. The home was clean and tidy and followed the current COVID-19 guidance including testing and vaccinations.

People were given choice regarding the care and support they received. People were supported to eat and drink a balanced diet. The service was adapted to meet the needs of people living there. People were treated with respect and dignity. Staff knew people well and supported people to maintain their independence.

People received person centred care. Staff supported people to take part in activities. Information was accessible for people in a format which suited them.

The registered manager had developed a positive culture within the service. Relatives and staff spoke highly of the management team.

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 his practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• The home was registered to support a maximum of 11 people. This is larger than the current best practise guidance. However, they were able to reduce the impact to people by the way the building was used. One person had their own room on the top floor and the other rooms were spaced out across another two floors.

Right care:

• Staff encouraged people to make their own choices and maintain their independence. Staff encouraged people to carry out daily house chore such as mopping the floor with support. Staff also supported people to make choices using picture cards or in a format that best suited them. People received care and support that suited to their needs.

Right culture:

• Staff understood how to keep people safe. Staff understood people’s communication preferences. For example a poster was on display in easy read format, informing people how to complain if they weren’t happy with the service. The registered manager had developed a positive culture within the service.

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

Rating at last inspection

The last rating for the service under the previous provider was Good, published on 31 May 2019.

Why we inspected

This was a planned inspection due to length of time not being inspected while with a new provider. The service had been under the new provider since September 2020.

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.

We found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the service not identifying and mitigating people’s individual health risks at this inspection.

Please see the action we have told the provider to take at the end of this 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.