Archived: Bentley Court Care Home

We spoke with five people, three representatives of people who used the service, five members of staff, the acting deputy care manager and a senior manager. We looked at nine people's care records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We spoke with representatives of people living at the service who told us they felt people were safe living there. They told us staff reacted to people's needs and ensured their safety and welfare.

We observed staff assisting people to mobilise and noted that on several occasions staff lifted people by their under arm area. This is an unsafe and prohibited lifting technique which can cause injury. We spoke to staff who told us that they were aware this technique was not permitted due to their training.

We found from records that one person had been administered a controlled drug. We saw that this medicine had not been used in the way it should be to assure the drug was safe and effective. This meant that this person was not protected from the risks associated with controlled drugs. We also found issues with the recording of medicines.

We have asked the provider to tell us what they are going to do to meet the regulations in relation to ensuring that arrangements for medicines are safe.

Staff told us that one person was subject to a Deprivation of Liberty Safeguard (DoLS). DoLS is a legal framework that may need to be applied to people in care settings who lack capacity and may need to be deprived of their liberty in their own best interests to protect them from harm and/or injury. We found that this DoLS had recently expired but saw that the service was in liaison with the local authority regarding its extension. We saw that records relating to the reasons for the DoLS, and what it covered, were available in care records for staff to access.

Is the service effective?

We saw that people and their representatives were involved in the review of their care plans. Representatives we spoke with confirmed they were involved in these discussions. We found that most care records were updated to show people's changing needs.

Staff told us they received regular supervision meetings and could raise issues of training with managers. Staff told us they were being provided with specific training courses which they had requested as part of discussions with management. This meant that the management listened to and developed the skills of staff.

Is the service caring?

We observed staff interacting positively with people and responding to their wishes. People were complimentary about staff. One representative of a person living at the home called staff, 'Brilliant'.

Representatives of people living at the home said that staff reacted quickly when people became ill. They told us staff would make appointments with appropriate healthcare professionals and contacted them to let them know what was happening. This was confirmed in records. This assured people's health and welfare was promoted.

We found one instance where a person had a specific cultural requirement which was correctly detailed in their care records. We found two occasions where this requirement was not supported by staff in the way outlined in records. This meant that this person's cultural needs were not met by staff.

We have asked the provider to tell us what they are going to do to meet the regulations in relation to meeting people's care needs.

Is the service responsive?

We found that staff responded to people's choices and respected these. People we spoke with told us staff listened to them. Staff were able to accurately describe people's likes and dislikes and their changing needs. One person told us, 'Plenty of choice with food and drink'. They said they could have a 'lie in' in bed if they wished and staff did not force people to get up at a certain time.

Representatives told us they found the management team responsive to them and that they listened. One representative told us, 'Always talk to X [the acting manager]' and 'Any problems I talk to them'.

Is the service well-led?

Since the registered manager had left, the service was led by an acting care manager and acting deputy manager. The new management team were being supported by the provider's senior management and a member of senior management was present during our inspection.

We saw that a number of audits were carried out in order to assess the quality of the care and safety at the service. We also found that the senior management team were carrying out audits and feeding back actions from these to assist the service's management team. Dependency calculations were undertaken to evaluate the staffing levels required to meet the needs of people.

You can see what action we told the provider to take at the back of the full version of the report.

We found improvement in the way people's dignity was maintained. People's values and diversity were promoted. One person told us, 'I have no complaints'. However, we did see some instances where people's dignity was compromised.

Although we found some improvement in the care provided to people, we saw that some people did not always have access to call alarms to summon assistance. One person told us, 'The care is very up and down'.

We found that medication amounts were accurately recorded and medications were appropriately stored. However, we found that some people's care records did not detail what would indicate that they needed 'as required' prescribed pain relief.

We found that, although the service did have systems in place in order to identify issues affecting care, these systems were not always effective in ensuring standards of care for everyone.

Care records did not always fully explain what support people required to meet their needs. Lack of detail in some people's records meant that there was a risk their needs would not be met.

We found that people were not always given day to day choices. People's values and diversity were respected and promoted.

The care people received was not always reflected in their care plans. We found that some people were not assisted to move in a safe way.

We saw that the home had an appropriate medication policy and procedures in place. We found that people received the correct medication, although some improvements in records were required to support this. One person told us, 'I do get my right medication'.

We found that people were supported by adequate numbers of staff who had the appropriate skills and training. One person told us, 'Staff are marvellous'.

The service had a clear complaints procedure. The home advertised the complaints procedure so people knew how to make a complaint.

We found that people were supported in making day to day decisions about the care they received. People's values and diversity were respected and promoted.

The care people received was reflected in their care plans, although some plans were not up to date and did not always show people's decisions to refuse some aspects of care. One person we spoke with told us staff, 'Look after me well'.

Arrangements were in place to ensure that people were protected from harm. People said they felt safe living at the service and were treated well. Some staff were unclear about how they could report concerns to outside agencies.

We found that staff were recruited in a safe way and correct checks were carried out to ensure their suitability to care for people. Staff told us that they went through a robust recruitment process.

The service had a clear complaints procedure which was accessible to people. One person told us, 'I would complain if I wanted to'.