Archived: Bethel Care Homes

Bethel Care Home is a residential care service providing personal care and accommodation for up to three people living with a learning disability. At the time of our inspection two people were using the service.

The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People’s experience of using this service:

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons.

The service was not always clean and the systems in place did not ensure the premises was safe for people living there. We identified a breach of regulation in relation to safe care and treatment. Staff understood how to manage people’s risks and keep people safe from harm. The service worked well as a team to ensure people received safe and responsive care and support in a timely manner and the service demonstrated a culture of continuous learning and improvement to ensure the best quality support was provided.

Staff were provided with adequate training, supervision and appraisal to provide effective, care and support. People were encouraged to keep healthy and well. 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. The service had not been adapted in all places to meet the needs of people living there; a recommendation was made to review this and ensure people felt safe and comfortable moving around the home.

People were treated with dignity and respect and were supported to be as independent as possible.

The service provided a wide range of activities for people living at the service. We found that not all information about the home was made accessible to people living there; we recommended the service review best practice guidelines and ensure information could be understood by all. Staff had not received end of life training and people were not supported to discuss this.

The quality assurance systems in place did not identify the shortfalls we found during our inspection. We identified a breach of regulation in relation to good governance. People, staff and other professionals spoke positively about the registered manager and the service.

Rating at last inspection:

At the last inspection the service was rated Good (published 28 November 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Enforcement:

We identified two breaches of regulation in relation to safe care and treatment and good governance. Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At our previous inspection in July 2015, there were breaches to legal requirement in relation to short falls in the leadership and quality assurance systems in place. They had failed to pick up inadequate training, appraisal and maintenance of the service. Policies were not always up to date. People’s records were not always accurate and they were not always lawfully deprived of their liberty. Staff awareness and training of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) was limited and out of date. During this inspection we found that improvements had been made.

Bethel Care Home provides accommodation and support with personal care for up to three people with a learning disability. On the first day of our visit the two people using the service were out. We observed interactions between a staff member and one person on the second visit.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe. Staff understood their responsibilities and how to recognise and report abuse.

There were appropriate risk assessments in place to manage any risks within and outside the service. Staff could explain the actions they would take to mitigate any identified risk.

Premises had been refurbished and looked clean. Appropriate health and safety checks, weekly fire drills took place to ensure the environment was safe.

Medicines were managed safely by staff who had received appropriate training. We checked medicine administration records and found no discrepancies.

There were appropriate recruitment checks in place to ensure only suitable staff were employed.

Although staff were supported by regular supervision and appraisal, we found that training could be further improved in areas such as autism awareness and understanding of the MCA. We recommend the provider seeks advice on appropriate training. In addition the signage in within the service was not in a pictorial format and could not be easily understood by one of the people.

People were supported to access health care services in order to maintain their health. We saw evidence of input from the GP and that referrals were made appropriately.

Care plans were individual and more specific to people’s needs. They were reviewed when people’s needs changed.

We observed that people were treated with dignity and respect. People’s diversity was respected and they were supported to eat a diet that met their cultural needs and preferences. People were enabled to attend their preferred places of worship and to maintain relationships with people who were close to them.

There was a complaints procedure displayed at the entrance in a pictorial format that was understood by people who used the service.

People told us they went out when they wanted. Activities were based on people’s interests and included regular outings.

Staff had attended mental capacity training but were not always fully aware of how it applied in their daily practice. The registered manager had taken appropriate steps to ensure a person’s best interest’s assessment took place in order to lawfully deprive them of their liberty for their own safety.

People thought the service was run well by an approachable management team. Staff and people were involved in how the service was run.