Bodnant House

Updated 9 January 2021

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.

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.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice for the inspection because we wanted to be sure the provider had an Infection Control procedure and Covid 19 risk assessment in place . We did this so we could adhere to their policies and follow government guidelines in relation to social distancing.

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 other professionals who worked with the service. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

On the day of our inspection we spoke with the provider, the acting manager and the deputy manager. We reviewed a range of records. These included two peoples care records and risk assessments, two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance checks and safeguarding information were also examined during the inspection.

Updated 9 January 2021

About the service

Bodnant House is a residential care home registered to provide accommodation and personal care for adults who may be living with a learning disability, autistic spectrum disorders, mental health needs, and sensory impairments. The care home accommodates up to nine people in one adapted building. At the time of the inspection there were six people living at Bodnant House.

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

We expect health and social care providers to guarantee people living with autism and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People received care that was person-centred and promoted their dignity, privacy and human Rights. People had choice and control about their lifestyles and the support they needed. The values and attitudes of the management and the staff provided a person-centred culture and achieved good outcomes for people.

Systems in place to safeguard people from potential harm had been reviewed and enhanced to ensure people were protected. All staff had completed training about safeguarding and whistle blowing to support people to stay safe.

There were risk management plans in place to keep people safe and we found these had been improved to provide more detail and were reviewed regularly or when people’s needs changed.

The manager had implemented a dependency tool to ensure staffing numbers were sufficient to meet people's needs. We found there were sufficient numbers of staff to meet people's needs safely. The staff rota showed when people needed one to one care and who was going to support them.

The provider had made improvements to the recruitment practices and records showed that all the necessary staff recruitment checks had been followed when new staff had been employed. This was to ensure that staff employed to work at the service were suitable to support vulnerable people.

The systems in place to manage medicines safely had been improved to ensure people received their medicines as prescribed. All staff who were required to administer medicines had their competencies checked and weekly audits of medicines had been completed so any areas of concern were identified and actioned swiftly.

Systems were in place to control and prevent the spread of infection. Staff completed training in relation to the control of infection which included personal protective equipment (PPE), hand hygiene and COVID-19. We observed staff using personal protective clothing and equipment safely.

Improvements had been made to the systems in place to ensure lessons were learned and improvements made when things went wrong. Records showed that lessons learned were discussed during staff meetings every month and during staff supervision. Staff were able to reflect on incidents and learn from them when they did not achieve the desired outcome.

The systems in place to maintain effective oversight of the quality and safety of the service had been reviewed and improved to ensure they were effective. Monthly and weekly quality checks were completed by the manager and the provider also undertook unannounced spot checks at the service.

Records management had improved, and we found systems in place to be organised with detailed records that were fully completed and reviewed on a regular basis.

Accidents and incidents were recorded, and the manager and provider had implemented more effective processes to analyse these to identify any areas that may need improvement.

The provider had improved their systems to ensure they notified the Care Quality Commission of incidents that affect the health, safety and welfare of people who used the service.

The provider and manager had enhanced the way they involved and engaged with people. We saw that meetings with people using the service and staff were held monthly and follow up action had been taken when necessary.

The provider and manager had improved how they worked in partnership with key organisations. We found they had worked closely with the local authority, safeguarding teams and clinical commissioning groups to make significant improvements at 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 Inadequate (published 22/09/2020) 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 we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 22 September 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced inspection of this service on 13 July 2020. Multiple breaches of legal requirements were found. Already stated above.

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 and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. 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 COVIS-19 and other infection outbreaks effectively.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.