We carried out a review of the data available to us about Butterfly House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Butterfly House, you can give feedback on this service.
Butterfly House is a residential care home providing personal and nursing care up to a maximum of 36 people. The service provides support to people with dementia. At the time of our inspection there were 29 people using the service.
The service was located in a residential area of Weston-Super-Mare and was undergoing renovation to create an additional two rooms and an office for staff. Refurbishment of the home had been undertaken recently and provided a dementia friendly environment for people. The home had three floors with communal and dining areas on the ground and first floor.
People’s experience of using this service and what we found
Risks to people were assessed and action taken to reduce or mitigate these. This included risks associated with COVID-19. People were protected from abuse. There were enough staff in number and experience to meet people's needs. People's medicines were managed safely. People's care was delivered in a personalised way, recognising and respecting people's individual choices, preferences and protected characteristics. Staff were trained and supported to deliver care in line with best practice guidance and the law.
The provider had infection control procedures in place to protect people and prevent the spread of infection. Staff accessed personal protective equipment (PPE) and acted in accordance with government guidance.
Robust quality assurance systems and a strong learning culture across the organisation contributed to continual development and improvement of the home.
There were arrangements in place to support people's end of life care and wishes. Staff were kind and patient towards the people they looked after. Staff understood how to support people with the challenges that living with dementia could bring. A relative said, "Butterfly House is more the small, family friendly and relaxed culture than big institutional care homes, and all the staff and the managers are very friendly and respectful to residents and visitors.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Rating at last inspection and update
The last rating for this service was requires improvement (published 1 May 2020) and there was a breach of Regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider referred to current guidance on ‘as required’ and topical medicines and updated their systems and practice accordingly. At this inspection we found that the provider had made this improvement.
Why we inspected
The inspection was prompted in part due to concerns received about the management and leadership within the home and concerns around providing 1:1 care. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well led sections of this full report.
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 based on the findings of 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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Butterfly House provides accommodation and personal care to adults whom are living with dementia. The service can support up to 36 people. At the time of the inspection 16 people were living at the service.
The service was located in a residential area of Weston-Super-Mare and was undergoing renovation and refurbishment to all rooms, communal areas and gardens.
People’s experience of using this service:
The service was in a transition period. Changes were being made to systems and processes, including the way people’s care and support was delivered. Staff were supported through induction, supervision and training. The provider was engaged in further development of the staff culture to support these changes.
Systems in place to monitor the and review the quality of the service were not fully effective. Further provider oversight was needed to ensure all areas were monitored and actions taken where required.
Care plans were being moved to a new system. Additional details were needed to ensure they were fully person centred and up to date. People received their medicines which were stored safely. We identified improvements needed in protocols for as required medicines and topical creams.
The service was clean and tidy. Extensive refurbishment work was in progress, which upgraded all facilities and improved accessibility. The environment and outdoor areas had been designed to support people’s needs who were living with dementia and promote people’s independence.
People spoke positively about the food provided. Feedback received demonstrated the service was proactive in regards to people’s health and social needs.
People received care and support from staff who were caring. People and relatives said there was enough staff to support them safely. Visitors were welcomed at the service. People said they enjoyed the activities facilitated.
People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on CQC website at www.cqc.org.uk
Rating at last inspection and update:
This service was registered with us on 28 February 2019 and this is the first inspection.
The last rating for this service was Good (published 21 November 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning process.
Why we inspected:
This was a planned inspection based on the date of registration.
Enforcement:
We have identified a breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection. Please see the action we have told the provider to take at the end of this report. We made two recommendations in relation to person centred care and current guidance in relation to as required and topical medicines.
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.