Bethany House Limited

Updated 16 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: Two adult social care inspectors and an expert by experience conducted the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This person had experience of caring for an older relative living with dementia.

Service and service type: Bethany House is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service did not provide nursing care.

The service had a manager who had applied to be registered with the Care Quality Commission. This means they that when they are registered, both 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: This inspection was unannounced.

What we did: We reviewed information we had received about the service since the last inspection and completed our planning tool. This included the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We checked the action plan the provider sent to us to address the shortfalls identified after the last inspection. We sought feedback from the local authority and professionals who work with the service.

During the inspection, we spoke with 16 people who used the service and four relatives to ask about their experience of the care provided. We also spent time observing how people spent their time and how staff interacted with them.

We spoke with six members of care staff, the manager, operations manager, the nominated individual (owner), shift supervisor, cook, domestics and maintenance staff. We reviewed a range of records. This included six people's care records and medication records, five staff files and records related to the management of the home. In addition, we spoke with a visiting healthcare professional during the inspection.

As part of the inspection process we walked around the building to carry out a visual check. We did this to ensure the home was clean, hygienic and a safe place for people to live.

Updated 16 March 2019

About the service: Bethany House is a residential care home providing personal care for a maximum of up to 18 people aged 65 and over. At the time of the inspection there were 16 people living at the home; some of who were living with dementia.

People’s experience of using this service:

At the last inspection we found the service did not always meet people’s needs because care plans were not up to date. We also found the way the home monitored the quality of the service was not effective at identifying and sorting out any shortfalls. We made two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we found these breaches and shortfalls had been put right and many other improvements had been made to the quality of the service and running of the home.

There was a new manager in post, who along with the provider’s operations manager, had brought about clear leadership and an improved system to ensure people received good quality care. People who lived in the home, their relatives and professionals were impressed with the new manager and spoke of her being very approachable with an open management style.

Everyone we spoke with told us this was a good home and said people were well cared for. People’s needs were now being well met through up to date care plans, care being offered by a well-trained and supported staff team and by sufficient numbers of staff on duty to respond to their needs.

Staff knew how to keep people safe and this included having a good knowledge of safeguarding people from abuse. Risks to people were now well managed, with a particular focus on reducing people’s risk of falls and managing behaviours that maybe challenging to the service.

Care was person-centred, based around each individual’s personal care and health needs and to also meet their social needs and interests. Care planning had improved with particular attention paid to including instructions from healthcare professionals.

People rights were respected and protected because the service had a good understanding of the Mental Capacity Act. 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.

People were treated with dignity and compassion. They told us the staff team knew them well, took a genuine interest and were kind and caring. People looked well-groomed and well cared for.

There was a good choice of meals and people said the food was very good and they liked that it was ‘home cooked’. Support was provided which ensured people received food and drink when they needed this.

Good working relationships had been developed with health and social care professionals that meant people were supported to stay well and any health issues were quickly addressed.

People’s medicines were being better managed with a focus on staff training and competency.

The service was well-maintained, comfortable, clean and odour free. Since the last inspection a number of improvements had taken place. These included internet access and the improved use of technology which had benefited people in the home and the staff team.

Rating at last inspection: Requires improvement (09/03/2018).

Why we inspected: We inspected the service as part of our inspection schedule methodology for ‘Requires Improvement’ rated services and to check the provider had made the improvements they told us they would, following our last inspection.

Follow up: We will monitor as part of the inspection programme for a Good service. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk