Bucklesham Grange is a residential care home with nursing that provides accommodation and personal care for up to 57 people, some living with dementia. There were 54 people living in the service when we inspected on 7 June 2017. This was an unannounced inspection. At our last inspection 9 February 2015 we rated the service good. At this inspection we found that the service had continued to develop and improve and was outstanding in Caring and Well Led. People received exceptional care that was personalised to them, taking account of their individual needs and wishes. They were at the heart of the service and told us how compassionate and dedicated staff went the extra mile to ensure they were extremely satisfied with all aspects of their care.
A registered manager was in post at the time of our inspection. 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 2008 and associated Regulations about how the service is run. They were supported by a general manager with a clinical governance background who had day to day oversight of the service working closely with the managers from the different areas of the service such as administration, lifestyle, maintenance and hospitality.
Bucklesham Grange was exceptionally well led. There was visible and effective leadership within the service. The service was effectively organised and well run with an open and transparent culture. The registered manager was supported by a dynamic management team that demonstrated a holistic approach and had clear oversight of how the service was meeting people’s physical, emotional and social needs. They were able to effectively demonstrate how their robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example. Morale in the service was extremely high, at all levels within the service. Staff were proud to work at Bucklesham Grange and were remarkably motivated and passionate about delivering high quality care.
Staff were extremely compassionate, attentive and caring in their interactions with people. Staff understood the importance of obtaining consent when providing care. 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 supported this practice.
Ensuring people received care tailored to meet their needs which enhanced their quality of life was fundamental to the running of the service. An enabling and supportive culture focused on meeting the individual needs of people had been established and was reflected in people’s care records. Staff respected people’s privacy and dignity and promoted their independence. They demonstrated an enhanced understanding about people’s choices, views and preferences and acted on what they said.
The service provided outstanding end of life care. Effective systems and processes including working in partnership with the local hospice were in place to ensure people experienced a comfortable, dignified death in line with their wishes.
People and or their representatives, where appropriate, were actively involved in making decisions about their care arrangements. This led to people experiencing an excellent service which was distinctive to their individual needs
People were encouraged to maintain relationships that mattered to them such as family, community and other social links. They were supported to pursue their hobbies and to participate in activities of their choice. This protected people from the risks of social isolation and loneliness.
Staff were highly motivated, enjoyed their jobs and understood their roles and responsibilities. They were proud of where they worked, were extremely passionate and committed to delivering a high standard of care. They shared positive experiences about the way the service was managed, how they were supported and encouraged to professionally develop.
There were sufficient numbers of staff, who had been recruited safely, and who had the skills and knowledge to provide care to people in the way they preferred. Retention of staff was good and supported continuity of care.
There were robust procedures and processes to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised but also ensured their rights and choices were respected.
Staff had received safeguarding training and understood what actions to take to protect people from abuse. They were able to confidently describe the different types of abuse that may occur and how it should be reported.
Where people required assistance to take their medicines there were appropriate arrangements in place to provide this support safely.
People were encouraged and supported to attend appointments with health care professionals to maintain their health and well-being. Where people required assistance with their dietary needs there were systems in place to provide this support safely.
There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. Feedback including comments, concerns and complaints were appropriately investigated and responded to and used to improve the quality of the service.
The management team demonstrated an open, reflective leadership style working in partnership with other stakeholders to drive continual improvement within the service and local community. Feedback from healthcare professionals cited collaborative and highly effective working relationships.