Bayford House Care Home is a residential care home with nursing, registered to care for up to 63 people. The service comprises of two units, one known as Bayford House and the other as Newdale Court. At the time of the inspection there were 35 people living in Bayford House and ten in Newdale Court. Most people living in Bayford House required nursing care for various health conditions while those people living in Newdale Court received support with daily living activities and did not require nursing care. The service is set in picturesque grounds which are well used by people and visitors.

The home manager had applied to the Care Quality Commission to become the registered manager. 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.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

People continued to receive safe care. Staff were knowledgeable about how to keep people safe from harm. Risks to people's safety were assessed and plans were in place to manage and reduce risks. Staff were recruited safely using robust procedures. There were sufficient numbers of staff to keep people safe and meet their needs. Medicines were managed safely by staff who had received appropriate training and had their skills monitored. Staff were aware of and had practised emergency procedures.

People continued to receive effective care. Staff were trained and competent to carry out their roles effectively. They were supported in their job roles through one to one meetings, appraisals and team meetings. People were supported to eat a choice of freshly prepared meals. They were supported with special diets if required and when necessary their dietary intake was monitored. Frequent snacks and drinks were available. People were supported to maintain their health and wellbeing. Advice was sought from healthcare professionals when necessary.

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.

The service remained caring. Staff were kind, considerate and compassionate in the way they delivered support to people. They encouraged people to be as independent as they possibly could be. People’s privacy and dignity were maintained. Staff addressed people in the way they liked. They spoke respectfully to and about people. People's relatives and visitors were welcomed into the home whenever they wished to visit.

The service had made improvements and was now responsive. Activities were designed to take people’s individual interests into account. The range of activities had been widened and included more opportunities for trips out and community involvement. One to one sessions were now a regular feature for people who were at risk of being isolated. People received person centred care. This focussed on their individual needs and recognised their preferred routines. People and their relatives were comfortable to raise concerns and speak with the staff team or home manager if they wished.

The service remained well-led. There was good leadership in place and the staff team worked well together. There were systems in place to assess, monitor and analyse the service in order to make improvements. Links were maintained with the local community to provide support to people living at Bayford House Care Home.

Further information is in the detailed findings below.

We spoke with five people who lived in Bayford House or Newdale Court and five members of staff. We also spoke with the regional manager and quality lead. People who lived in the home told us that they were generally happy. Those who were able to discuss their care told us that they understood what was happening and were involved as much as they wanted to be. One person said “there’s not much wrong here, if there was I would soon complain”. Another said “the girls are very nice, there’s no one I would have a bad word against.”

People were treated with respect and dignity. They were called by their preferred name and offered choices. There were a range of activities for people to get involved in. We spoke with the activities coordinator who was very enthusiastic and had a very positive influence on the residents.

People were offered a choice of food and drink. The provider had taken steps to ensure variety and incorporate people’s likes and dislikes. People’s weights and risk of malnutrition and dehydration were monitored so that action was taken swiftly when necessary. One person said “the food has very much improved. You get a choice from the menu but you can still change your mind”.

Staff told us that they felt supported and that communication within the team was very good. They confirmed that they had regular supervision meetings which fed into an appraisal.

The provider had an effective means to monitor and assess the quality of the service.

The people we spoke with said that in general they were happy at the home and liked living there. They said that most of the staff were “kind and caring, couldn’t do enough for you”. Some said they thought the food could be better, others said they liked it.

We spoke with people who were able to give us their view of the services provided at Bayford House Nursing Centre. They told us that they were treated with respect by staff. They told us they were involved in the decisions made about their care and had no concerns or worries about the care they received. They told us that they were kept fully informed and could approach staff if they were worried or concerned.

This inspection took place on the 12 and 13 February 2015 and was unannounced. Bayford House Nursing Centre is set within six acres of landscaped gardens on the fringes of Newbury. The home is registered to provide personal care and nursing for up to 63 people and is divided into two areas. The main building provides accommodation and nursing care, whereas the adjoining building, Newdale Court, provides residential care only. Accommodation is provided over two floors; all of the rooms on Newdale and most of the rooms within the main building have en-suite facilities. There are spacious communal areas throughout the home.

On the day of our visit 28 people were using the services on the nursing wing and 15 people were using the services provided at Newdale Court.

There is a registered manager. 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.

People’s care plans detailed how the person wanted their needs to be met. Risk assessments identified risks associated with personal and specific health related issues. They helped to promote people’s independence whilst minimising the risk identified. People told us that sometimes they feel isolated as staff were busy and did not always have time to “stop for a chat”. Comments included: “I don’t think they have time for chatting, but they are nice”. The manager told us that this was an area that they planned to improve. We have made a recommendation that the provider seek guidance from a reputable source, about promoting activities and contact for people who use the service.

People told us they felt safe and secure. They said they would approach staff if they were worried about their safety or about the services provided and felt they would be listened to. The recruitment and selection process helped to ensure people were supported by staff of good character and there was a sufficient amount of qualified staff to meet people’s needs safely. Staff knew how to report any concerns they had about the care and welfare of people to protect them from abuse. Learning from incidents and investigations took place. The manager had kept a track of incidents and accidents which were analysed monthly to identify any patterns. Appropriate changes were implemented to promote people’s safety.

The service had taken necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLs provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm.

Staff were supported to receive the training and development they needed to care for and support people’s individual needs. The manager made reference to the In-Reach Team (partnership working with West Berkshire Health and Social Care Professionals) and stated: "I think support has been enormous delivering training and assessing resident’s needs, they have been very approachable. What has been particularly good about this was having another professional’s view coupled with the training they had delivered to staff.”

People told us they were happy living in the home and that staff were attentive, kind and respected the decisions they made. Comments from people included: “as you know things in life don’t stay the same, I’m not worried about anything and I get all the support I need. I’m very happy”. People’s families also told us that they were involved in the decisions made about there relatives care and were kept informed. Comments from people’s families included: “I visit most days, the reason (name) is here is to be closer to home. I don’t think we could possibly find a better place”.

People received good quality care. We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care.