Bethany House

Updated 12 January 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.

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 was carried out by one inspector and an Expert by Experience who made calls to people using the service and their relatives. 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

Bethany 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. Bethany House is a care home without 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 not a registered manager in post. A new manager had been appointed but was not yet working at the service at the time of our inspection.

Notice of inspection

This inspection was unannounced on both days.

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 5 people who use the service and 3 relatives above their experience of the care they received. We spoke to 8 staff members including the head of service, a registered manager supporting Bethany house from a sister service, senior support workers and support workers. We reviewed 3 care records, 3 medication administration records, policies and quality checks the providers carried out and meeting minutes.

Updated 12 January 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Bethany House is a residential care home providing personal and nursing care to 6 people at the time of the inspection. The service can support up to 8 people.

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

Right Support

More work was needed around identifying and supporting people to achieve their aspirations and goals. The provider had recognised this and was working towards this as part of the ongoing work with the care records.

The service had not been regularly maintained and updated over the years. As a result of this, as well as a recent fire in the service, a large amount of renovation and repair was required. This work was all taking place at once. The level of building work undertaken impacted people living at the service and this hadn’t been taken into consideration or effectively communication to people or staff.

Staff enabled people to access specialist health and social care support both in the community and in the service.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Staff supported people to play an active role in maintaining their own health and wellbeing wherever possible.

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.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People’s care, treatment and support plans reflected their range of needs, however, more work was needed around promoting their wellbeing and enjoyment of life.

Right Culture

Staff knew and understood people well and were responsive, supporting their right to live life of their choosing.

Staff recruitment was on-going, but most contract staff had worked at the service a long time which supported people to receive consistent care from staff who knew them well.

There was evidence of people being involved in their care plans and feedback sought around any issues. However, more work was needed to evaluate the quality of support provided to people, involving the person, their families and other professionals as appropriate. More work was needed to enable people and those important to them to work with staff to develop 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 and update

The last rating for this service was requires improvement (published 25 August 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection some improvements had been made but we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 28 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, the environment and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, the environment and governance at this inspection.

We have made a recommendation around how the provider involves and consults with people using the service. We have also made a recommendation around reviewing people’s capacity and access to advocacy services.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.