Bymead House

Updated 23 September 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 4 inspectors over 2 days. There were only 2 inspectors on site at any time. An Expert by Experience contacted relatives to obtain feedback by phone following the inspection. 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

Bymead House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bymead House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

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 and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 2 relatives during our inspection and contacted 23 more relatives by telephone following the inspection, 9 of whom gave us detailed feedback. We spoke with 11 staff members in person including the nominated individual, registered manager, clinical leads, housekeepers, registered nurses, chef, care practitioners, senior care assistants and care assistants. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received emailed feedback from 24 staff members following the inspection. We requested feedback from 7 health and social care professionals and received feedback from 5 of them. We reviewed 8 care records and multiple medicines records. Records relating to the day-to-day management of the service were also reviewed.

Updated 23 September 2023

About the service

Bymead House is a residential care home providing personal and nursing care to up to 30 people. The service provides support to older people and people who have a physical disability. At the time of our inspection there were 28 people using the service.

Bymead House is an extended premises occupying a large plot with accessible grounds. There is a passenger lift and accessible bathrooms to enable access throughout the service.

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

We have made recommendations about medicines, staff supervision, and storage of confidential information. Throughout the inspection we mentioned any areas of concern found and all were immediately improved, if not completely addressed, a detailed action plan was devised.

There was mixed feedback about meal provision, people and their relatives were involved in giving regular feedback about meals.

We made a recommendation about data storage as we were not assured information in an office had been properly secured. We looked into numerous concerns that had been raised about the service and while able to corroborate some, for others we were not able to find evidence to prove or disprove them.

Not all staff had participated in 1-to-1 staff supervision, and supervisions were not seen as effective. We have made a recommendation to review best practice guidance and update procedures accordingly.

Medicines were safely administered, and audits ensured oversight of the process. There were some improvements required around risk assessments and storage, we have made a recommendation about this.

Accidents and incidents were recorded, and actions taken both to minimise future occurrences and to ascertain any patterns that could inform risk management.

Staff completed training in safeguarding and both people and their relatives felt the service was safe. Staff were safely recruited and, before commencing in post, induction and mandatory training was completed. The premises were very clean and use of PPE and visiting was in line with current guidance.

Peoples’ needs were assessed before being admitted to the service and a procedure of clinical review of assessments prior to admission was in place to ensure only those who’s needs could be met were admitted.

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 this practice.

We received mostly positive feedback about the service and the management team, and the provider was developing new quality assurance questionnaires to issue to people, staff, and relatives so they could benchmark people’s opinions of 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 this service under a previous legal entity was good (published 8 June 2018). The service remains rated good.

Why we inspected

The inspection was prompted in part due to concerns received. A decision was made for us to inspect and examine those risks. We were not able to corroborate most of the concerns raised with us.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Recommendations

We have made recommendations in 3 areas following our inspection. We have asked the provider to review data storage, staff supervision and medicines administration, and make improvements as needed.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.