Archived: Blyth House

Blythe House is a nursing home that provides personal and nursing care support for up to 16 people in one adapted building. At the time of our inspection there were 15 people living at the service.

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

People were safeguarded against the risk of abuse and harm. Safeguarding procedures were in place and the registered manager and staff had a clear understanding of these procedures and how to respond to concerns appropriately. There were systems in place that ensured the handling and responding to complaints was managed appropriately. There were systems in place that enabled good oversight of the management of the service and to monitor the quality of care that people received.

Appropriate recruitment checks took place before staff started work and there were enough staff to meet people's needs safely. Medicines were managed safely. The provider and staff followed current government guidance in relation to infection prevention and control.

People's care and support needs were assessed before they started using the service and care plans were in place to ensure staff could support them safely. Staff received training relevant to people's care needs. People received appropriate care and support from staff to maintain a healthy balanced diet.

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 6 November 2020).

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this unannounced 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, Responsive 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 changed from requires improvement to good. This is based on the findings at this inspection.

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.

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

Follow up

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

We found the following examples of good practice.

The provider had adapted a conservatory to include a windowed partition and intercom, allowing family and friends to visit without entering the main building. Visits were supervised by the Activity Coordinator who ensured that visiting protocols were followed. People were supported to see their visitors in the garden in good weather, or to speak to their families on the phone or via video call. The provider had introduced virtual consultations to reduce the need for external visitors to the home.

The provider had arrangements in place to test both people and staff for COVID-19, in line with the current guidelines on testing.

The provider had clear protocols for people who were infected with Covid-19, and for people who had been admitted to the home from hospital or the community. Staff were adhering to PPE and social distancing guidance. The provider had a designated area for donning and doffing PPE.

Staff who were more vulnerable to Covid-19 were supported and risk assessed to ensure staff and people remained safe.

Blythe House is a nursing home that provides personal and nursing care support for up to 16 people in one adapted building. At the time of the inspection 16 older people were living at the service.

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

People were not always safeguarded against the risk of abuse and harm as safeguarding concerns were not acted on and reported immediately as required and in line with best practice. The provider failed to report and respond appropriately where possible harm, abuse or incidents had occurred. Systems and processes were not operated effectively to investigate evidence of such harm and abuse and to effectively prevent abuse from occurring. The provider failed to establish and ensure an effective and accessible system for identifying, receiving, handling and responding to complaints from people and their relatives acting on their behalf.

The provider failed to ensure safe management oversight, to seek and act on safeguarding concerns and feedback given and to monitor and improve the quality and safety of the service. The registered manager at the time of the concerns failed to act on their responsibilities under the duty of candour and to take responsibility when things went wrong.

People’s relatives told us they thought their family members were safe and looked after, however explained that it was difficult to be fully confident due to the limitations on visiting their loved ones during the Covid 19 pandemic.

At this inspection we found three breaches of regulations.

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 was Good report published (04 March 2019).

Why we inspected

We received concerns in relation to a safeguarding incident. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from ‘Good’ to ‘Requires Improvement’. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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

People’s experience of using this service:

¿ The home had safeguarding policies and procedures in place and staff had a clear understanding of these procedures.

¿ Appropriate recruitment checks took place before staff started work and there was enough staff available to meet people’s care and support needs.

¿ Risks to people had been assessed and reviewed regularly to ensure people’s needs were safely met.

¿ People were receiving their medicines as prescribed by health care professionals.

¿ There were procedures in place to reduce the risk of the spread of infections.

¿ Assessments of people’s care and support needs were carried out before they moved into the home.

¿ Staff received training and support relevant to people’s needs.

¿ 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 support this practice.

¿ People were supported to maintain a balanced diet.

¿ Staff treated people in a caring and respectful manner.

¿ People were consulted about their care and support needs.

¿ People were supported to participate in activities that met their needs.

¿ End of life care and support was provided to people and their family members when required.

¿ People knew how to make a complaint if they were unhappy with the service.

¿ There were effective systems in place to assess and monitor the quality of the service.

¿ The home worked in partnership with health and social care providers to plan and deliver an effective service.

¿ The provider took people and their relatives views into account through satisfaction surveys and meetings. Feedback from the surveys and meetings was used to improve on the service.

¿ Management support was always available for staff when they needed it.

Rating at last inspection: Good (Report published on 7 September 2016).

Why we inspected: This was a planned inspection based on the last inspection rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

The home had a registered manager in post. 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 and associated Regulations about how the service is run.

People using the service said they felt safe and staff treated them well. Appropriate recruitment checks took place before staff started work. There were enough staff on duty and deployed throughout the home to meet people’s care and support needs. Safeguarding adult’s procedures were in place and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People’s medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed an induction when they started work and they were up to date with the provider’s mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to ensure that people were receiving the food and fluids as recorded in their care plans. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people’s privacy was respected. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. The home had been awarded an accreditation by the Gold Standards Framework for the high standard of care provided to people in the final years of their lives.

Care plans and risk assessments provided guidance for staff on how to support people with their needs. There was a range of appropriate activities available for people to enjoy. People and their relatives knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

Staff said they enjoyed working at the home and received good support from the registered manager. The provider sought the views of people using the service, relatives and staff through meetings and surveys. The registered manager used the feedback from the meetings and surveys to make improvements at the home.

People told us they were always treated in a respectful manner, and the staff knew them well and understood how to attend to their needs. Everyone we spoke with said that the staff explained what they were doing and involved them in decisions about their care. People said they were given choices about meals and activities and they felt safe and well cared for.

The staff understood how to keep people safe and the home was clean and well maintained. One person said: 'there are never any unwanted smells and the home is clean and bright'.

The provider ensured that safe recruitment practices were adhered to in order to keep people safe. People understood their rights to make complaints or raise concerns and there were processes in place to manage these appropriately.