Archived: Bishop's Court

Updated 5 November 2015

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.

This inspection took place on 28 May 2015 and was unannounced. The inspection team consisted of a lead adult social care (ASC) inspector, a bank inspector and 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. The expert-by-experience who took part in this inspection had experience of nursing and dementia care.

This comprehensive inspection was conducted following receipt of information of concern. Because of this we had not asked the provider to complete a Provider Information Return (PIR), which is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However during the inspection the manager told us about how they planned to take the service forward.

We reviewed the information we had on the service including concerns that had been raised with us in relation to staffing levels at night and the support for some individuals who were living at the service. We also reviewed information from the Local Authority and notifications sent to us by the provider. Following the inspection we asked the provider to send us further information which they did so in a timely manner.

We spoke with several people living in the home although due to the nature of their dementia they were not always able to communicate effectively with us in response to our discussions with them.

We spoke with five visiting relatives’ two healthcare professionals, 14 members of staff including carers, nurses and ancillary staff. We looked at audits, six care files, staff recruitment files and documentation relating to staff training and supervision and other records relevant to the running of the service

We carried out pathway tracking to establish if what was stated in the provider’s policies was put into practice and if the care provided to people using the service was as it had been planned. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

We observed and chatted to people living in the home, staff and visitors throughout the inspection and looked at the general environment.

Updated 5 November 2015

This unannounced, comprehensive inspection took place on 28 May 2015 and was conducted following receipt of information of concern. The service was registered to provide accommodation for 41 people, there were 23 people living in Bishops Court at the time.

The service is located in a single storey building and provides nursing and personal care, predominantly for people living with dementia. It is situated in the Sefton Park area of Liverpool and is close to local amenities, such as shops and local transport links to Liverpool city centre. There is a large car park at the front of Bishop's Court and the building has gardens which are fully accessible to people using the service and their visitors.

The home was registered to provide accommodation and care to people who may have nursing needs and a registered manager was employed.

A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the manager had been away from the service since 23 April 2015. A senior manager from the organisation had been managing the service since 24 April 2015 but has not submitted an application to the CQC to become the registered manager. People spoke positively about her saying she was ’’really approachable.’’

We found that there was little signage around the service to identify different areas such as toilets and dining rooms. In order to support people living with dementia we have made a recommendation in relation to this.

We found that there were sufficient numbers of staff on duty in the daytime but some staff had expressed concerns about staffing levels at night.

Medicines overall were managed safely but some improvements were required. This was because for some people there was not sufficient information recorded around the administration and review of medicines to be given when required (PRN) and a care plan was not always in place to support this. We also saw that discontinued medications were not always supported by a signature from a nurse or G.P. The service provided information at a later date to show that they had sufficient safeguards to ensure that discontinued medication was verified by an appropriate professional.

People living in Bishops Court, staff, relatives and professionals that we spoke with were all positive about the service provided. The people living at the home and relatives told us they felt safe.

We saw there were effective recruitment procedures in place and staff performance issues were addressed appropriately.

The staff in the home knew the people they were supporting and the care they needed. The staff were trained and competent to provide the support required by the individuals.

There was a calm, relaxed atmosphere within the home and we observed good interaction between people living at Bishops Court, staff and visitors.

The care plans that we reviewed showed that preadmission assessments had been conducted and consent forms to care plans had been completed and signed by either the people using the service or their representatives. This showed that people using the service and their representatives had been involved in their care planning. There was adequate information available in the care plans to ensure people using the service to be supported in an individualised way that met their needs.

There was a complaints policy available, and there was evidence that complaints were dealt with effectively.