Archived: Across The Bay

Updated 26 September 2018

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.

Across the Bay provides personal care for 24 older people and is situated in Morecambe. The home is a four-storey building and a passenger lift is available to access all the floors. Communal facilities include two lounges on the ground floor and a dining room on the lower ground floor.

Before the inspection took place, we spoke with the Local Authority contracts teams, and Healthwatch. Healthwatch is a national independent champion for people who use healthcare services. We received no information of concern.

We looked at information the provider sent us in the Provider Information Return. This is 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 this information to help us plan our inspection visit.

As part of the inspection process prior to our visit we reviewed information held upon our database regarding the service. This included notifications submitted by the registered provider relating to incidents, accidents, health and safety and safeguarding concerns which affect the health and wellbeing of people. We used this information provided to inform our inspection plan.

This comprehensive inspection took place on 05, 07 and 17 September 2018. The first day was unannounced. The inspection was carried out by an adult social care inspector.

Throughout the inspection visits we gathered information from a number of sources. We spoke with eight people who lived at the home, three relatives and one visiting health professional to seek their views on how the service was managed.

We also spoke with the registered provider, the registered manager, the cook, the housekeeper and three members of staff who were responsible for providing care and support to people who lived at the home.

To gather information, we looked at a variety of records. This included care plan records relating to four people who lived at the home and recruitment records of three staff members. We also looked at other information related to the management of the service. This included health and safety certification, policies and procedures, accidents and incidents records and maintenance schedules.

As part of the inspection process we walked around the building to carry out a visual check. We did this to ensure the home was clean, hygienic and a safe place for people to live.

Following the inspection visit we made a referral to the local authority infection prevention and control team.

Updated 26 September 2018

This unannounced inspection took place on 05, 07 and17 September 2018.

Across the Bay is a four-storey building and has a passenger lift for people to access all the floors. Communal facilities include two lounges on the ground floor and a dining room on the lower ground floor.

Across the Bay 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. There were eighteen people residing at the home at the time of inspection.

We last carried out a comprehensive inspection at Across the Bay in February 2016. At the inspection in February 2016 we identified a breach to Regulation 18 of the Care Quality Commission (Registration) Regulations as the registered provider had not submitted all statutory notifications in a timely manner. We rated the key question as, 'requires improvement.' However, the service was rated good overall. Following the inspection visit, we asked the registered provider to complete an action plan to show us how they intended to make the required changes. The registered provider submitted an action plan and we used this inspection visit to ensure improvements had been made.

At this inspection visit carried out in September 2018, we found the registered provider had made the required improvements and was now meeting all the fundamental standards.

We found processes were in place to ensure medicines were stored and administered in line with good practice. However, processes were not consistently followed. We have made a recommendation about this.

We saw risk was addressed and managed. Risks assessments were in place to ensure staff were aware of risk to keep people safe from harm. Although risk assessments were in place, we found these did not always formally address all risk. We have made a recommendation about this.

People who lived at the home told us they felt safe and were aware of how to respond to any abusive practice. Staff could identify types of abuse and the associated responsibilities they had in reporting abuse. The registered manager understood the importance of raising awareness of safeguarding principles and ensured they were embedded in all aspects of practice.

People who lived at the home told us there were enough staff to meet their needs. Staff told us they were not rushed and had time to complete all tasks, as well as having time to talk to people. People and relatives told us staff responded in a timely manner when call bells were activated.

We reviewed infection prevention and control processes at the home. The registered provider employed a part time cleaner to carry out cleaning tasks. Although people told us they considered the home clean and tidy we identified some areas where improvements could be made. Following the inspection, we made a referral to the local authority infection prevention and control team so they could support the registered manager to consistently implement good practice guidelines.

People and relatives told us they considered the staff to be appropriately trained. Staff praised the training provided and the supportive nature of the management team.

All the people who lived at the home praised the quality of the food provided. They told us they were consulted with about the menu choices. We observed lunch being served and noted people were not rushed and were offered food according to their preferences and dietary needs.

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.

We saw evidence of multi-agency working to promote effective care. A health professional praised the skills and knowledge of staff who worked at the home. Relatives told us the home was good at meeting the needs of people. Two relatives told us they had seen a marked improvement in their relative’s health and well-being since they had moved into the home.

During the inspection we observed staff encouraging and supporting people to take part in activities. The registered manager told us they had made links with other community groups to increase and develop relationships for people who lived at the home.

People and relatives praised the caring and helpful nature of staff. From observations we saw staff were patient and respectful with people. We saw that person-centred care was considered and delivered to all people who lived at the home.

Records were comprehensive and person centred. Consent to care and treatment was routinely sought. When people lacked capacity to make their own decisions we saw good practice guidance was followed to ensure best interest decisions were made on behalf of people.

Staff who worked at the home described it as a good place to work. They praised the skills of the registered manager and said the home was well-led. People and their relatives told us they also considered the service to be well-led.

The registered provider liaised with health professionals when people required end of life care at the home to ensure people received care in line with good practice.

At the time of the inspection no one had any complaints about how the service was delivered. We were told by relatives the registered manager was approachable and would take time out to listen and act upon any concerns raised.

The registered manager had a good understanding of the need to promote autonomy and protect peoples Human Rights. The principles of the Human Rights Act were embedded throughout service delivery.

The registered manager was committed to ensuring the service was well-led. They understood the importance of networking with other similar groups and professionals to ensure good practice was shared and followed.

The management team implemented a range of assurance systems to monitor quality and effectiveness of the service provided. We saw audits were routinely carried out and action was taken when concerns were identified.