Archived: Bernadette House

At the time of our inspection the home was without a registered manager. We spoke with the acting manager who told us they had submitted their application for registration to become a registered manager. We observed that they had arrangements in place to provide leadership and support in the interim period.

When we visited this service on 04 April 2014 we found that the service was not compliant because the provider had not ensured that accurate records were kept for people who used the service. We found this had a minor impact on people who used the service.

During this inspection we found that improvements had been made and the provider was now compliant.

We spoke with four care staff, the manager and the provider.

We saw there were systems in place to assess, record and monitor the care that people received.

We found that care records were accessible to staff and written in a format that was easy to follow.

We considered the findings of our inspection to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found-

Is the service caring?

We saw how members of staff treated people and observed care. We saw care was delivered well and in a respectful way. We saw that staff were kind and attentive and encouraged people to be independent. We saw that care workers showed patience and gave encouragement when they supported people.

We observed when staff supported people they did so at their own pace and reassured people if they were upset.

Is the service responsive?

We saw that people's individual physical, mental and social care and support needs were assessed and met. This also included people's individual choices and preferences as to how they liked to spend their day. During our visit people were offered activities, however we observed if they declined to take part their decision was acknowledged.

We observed staff obtained people's consent before they carried out any care. For example they asked people if they wanted an apron to wear to eat their lunch in.

Is the service safe?

Risk assessments regarding people's individual activities were carried out and measures were in place to minimise these risks.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards in place. We saw applications had needed to be submitted to assess whether two people were being deprived of their liberty. We observed these were not granted as on review it was not considered they were deprived of their liberty. Mental Capacity Act (2005) and Deprivation of Liberty Safeguards is law protecting people who are unable to make decisions for themselves.

Relevant staff had been trained to understand when an application should be made and how to submit one. This means that people will be safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk. We observed regular maintenance was carried out and health and safety checks were carried out according to legislation, for example legionella checks to ensure people were cared for in a safe environment.

We looked at staff rotas and saw they reflected what the deputy manager had told us regarding staffing numbers. When we spoke with staff they told us they thought there was usually sufficient staff to care for people safely.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

We found gaps in people's records regarding fluid intake. These gaps meant it was difficult to monitor what fluid people had taken and put people at risk of not receiving adequate fluids.

Is the service effective?

Our observations found that members of staff knew people's individual health and wellbeing needs. We saw that people responded well to the support they received from staff members.

We observed staff responded to people's needs and requests in a timely manner.

Is the service well led?

Staff said that they felt supported and trained to safely do their job. Training plans were in place to ensure staff had the appropriate skills to meet people's needs.

Quality assurance systems were in place and people were listened to. We observed it was unclear from records whether or not actions had been completed.

Staff told us they were clear about their roles and responsibilities.

At the time of our inspection the home was without a registered manager. We spoke with the provider about this and they told us they were in the process of completing the recruitment of a registered manager. We observed they had arrangements in place to provide leadership and support in the interim period.

We observed medicines being administered and looked at records and storage of medicines. We found medicines were administered appropriately and stored according to guidance.

To help us to understand people's experiences we used our Short Observational Framework for Inspection (SOFI) tool. The tool allows us to spend time observing and helps us to record how people spend their time. We carried out the tool for an hour. We

observed positive responses and contact with people.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities. We observed there was always a member of staff available to people within the lounge area and staff were present in other areas of the building in order to ensure people were supervised.

We heard staff offering people choices. We also saw staff reassuring people when they were distressed.

We saw from the care plans people received care which was appropriate to their needs.

We also looked at the cleanliness of the home and the systems which protect people from the risk of infections. We found the home was clean and had policies and training in place to support staff in the prevention of infections.

We observed procedures for the administration of medicines and found there were safe and appropriate policies and procedures in place.

People's personal records including medical records were accurate and fit for purpose.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We saw people were treated with dignity and respect and supported to make decisions about their care. The quality assurance systems in place enabled people to express their views about the services and care they received.

People said that the food was good. One person said when asked if they liked the food,"It's good."

People told us they could usually get help when they needed it.

Many of the people that used the service at Bernadette House had dementia and therefore not everyone was able to tell us about their experiences. To help us to understand the experiences people had we used our Short Observational Framework for Inspection (SOFI) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

We carried out the tool for an hour. We observed positive responses and interactions with people .

We heard a person asking for help and observed a member of staff respond to them, "What do you need help with?" When the person was unable to respond staff offered them a number of choices and we saw the person was able to say what they wanted.