Archived: Batley Hall Nursing and Residential Home

Updated 28 August 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an assistant inspector as well as an Expert by Experience. 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

Batley Hall Nursing and Residential Home 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.

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 Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 14 people who used the service and five relatives about their experience of the care provided. We spoke with 13 members of staff including the home manager, compliance and quality inspector, human resources manager and a further 10 members of staff.

We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 28 August 2019

About the service

Batley Hall Nursing and Residential Home is registered to provide nursing and residential care for up to 51 older people, some of whom live with dementia. On the day of our inspection, 31 people were living in the home.

At the time of our inspection the home was being managed by a peripatetic manager who had been at the home for three weeks. We refer to them in this report as the ‘home manager’. A new home manager had been appointed and was set to start in September 2019.

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

We found poor examples of team working. Our conversations with staff and care records we looked at showed staff were not always supporting each other to provide a good service. Staff supervisions had been infrequent and a process to commence appraisals had recently started.

We saw minimal recording in response to complaints and concerns. Records did not show how complaints had been investigated and there were no written responses.

We saw incidents where staff did not have the skills to positively respond to behaviour which may challenge others. The registered provider had not given staff training in end of life care. The home manager told us they were addressing both these areas.

Staffing levels were reduced on an afternoon and we observed some people demonstrating behaviour which may challenge others when no staff were present. High levels of agency usage were deployed at the time of inspection. Safe recruitment procedures were being followed.

Improvements had been made to the safe management of medicines at this inspection. Systems to receive, store, administer and dispose of medicines were safe.

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.

People and relatives were happy with the service they received and consistently said the care and support they received from staff was good. Staff knew how to respect people’s privacy and dignity.

Electronic care records were used to show people’s needs, preferences and wishes. There was sufficient, person-centred information for staff to follow, although key information was not always easy to find.

Risks to people were assessed and handovers identified people most at risk and the associated reasons. Systems relating to fire management were up-to-date.

People told us they enjoyed the food and their dietary needs were being met. We observed people had a positive mealtime experience. Care records showed people received access to healthcare when this was required.

We have made a recommendation for the registered provider to review staffing levels and deployment of staff during the afternoon and evening periods.

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 July 2018) and there were multiple 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, enough improvement had not been made as the provider was still in breach of one regulation. The regulations were now being met in two areas where breaches were previously found. However, two new breaches of regulation were found at this inspection. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to good governance as management oversight was not evident over key aspects of the service. This demonstrated that systems to assess, monitor and improve the service were not sufficiently robust

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.