Buchan House provides accommodation and care, including nursing care, for up to 66 people, some of whom live with dementia. There were 58 people living at the home when we visited.

This unannounced inspection was carried out on13 July 2017. At the last inspection on 10 February 2015 the service was rated good. At this inspection we found the service remained Good.

People told us they felt safe living at the home. Staff knew the procedures to protect people from harm..Risks to people were appropriately assessed and managed. Medicines were administered as prescribed.

There were sufficient numbers of suitably qualified staff employed at the home. The recruitment and selection procedure ensured that only suitable staff were employed to provide care and support to people living at the home.

People received appropriate support to maintain healthy nutrition and hydration.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). 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 kindness by staff who respected their privacy and upheld their dignity.

People were given the opportunity to feed back on the service and their views were acted on.

People received personalised care that met their individual needs. People were provided with appropriate support and encouragement to access activities and follow their individual interests.

People told us they knew how to complain and were confident they would be listened to if they wished to make a complaint.

The management team created an open, transparent and inclusive culture within the service. People, staff and external health professionals were invited to take part in discussions around shaping the future of the service. There were quality assurance systems in place and any shortfalls identified were promptly acted on to improve the service.

Further information is in the detailed findings below

Buchan House provides accommodation, support and care, including nursing care, for up to 66 people, some of whom live with dementia. At the time of our inspection there were 60 people living at the care home.

The purpose-built home is situated in a residential suburb of the city of Cambridge. The home is divided into three individual units which are located on the ground and first floor. The external parts of the premises include enclosed gardens and courtyards. All bedrooms are for single occupancy and have en suite facilities.

This inspection was unannounced and was completed by two inspectors and an expert-by-experience. At our last inspection of 18 August 2014 the provider was meeting all the regulations we looked at.

Buchan House had a registered manager in post. 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 were safe living at the service as staff were knowledgeable about reporting any abuse. There were a sufficient number of staff employed and recruitment procedures ensured that only suitable staff were employed. Arrangements were in place to ensure that people were protected from unsafe management of medication.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS applications had been made to ensure people’s rights were protected.

Staff were supported and trained to do their job. People were supported to access a range of health care professionals. Health risk assessments were in place to ensure that people were supported to maintain their health.

People were provided with adequate amounts of food and drink to meet their individual likes and nutritional and hydration needs.

People’s privacy and dignity were respected and their care was provided in a caring and compassionate way.

People’s hobbies and interests had been identified and a range of in-house facilities and activities supported people with these.

A complaints procedure was in place. Complaints had been recorded and responded to the satisfaction of the complainant. People could raise concerns with the staff at any time.

The provider had quality assurance processes and procedures in place to improve, if needed, the quality and safety of people’s support and care.

A staff training and development programme was in place and procedures were in place to review the standard of staff members’ work performance.

The inspection team was made up of one inspector. As part of this inspection we spoke with the manager, five staff, five people who used the service together with two relatives and one visiting friend. We looked at five people's care records and checked the provider’s arrangements to obtain and act in accordance with people’s consent.

We reviewed information about staff recruitment and training. We also confirmed how the provider monitored the quality of the service provided together with record keeping. Below is a summary of what we found.

If you wish to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe and were involved in decisions about their care. One person said, “Staff do involve me. They check if I need to see a doctor and support me.” A relative confirmed, “I am involved and informed. I can e-mail the manager if I need to know anything.” Staff we spoke with told us they enjoyed their work and we found they were appropriately trained.

We saw that staff were provided with regular mandatory training in safeguarding vulnerable adults from abuse together with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. This meant that staff had the knowledge that they needed to ensure that people were kept safe.

Is the service effective?

We observed a good rapport between staff and people who used the service. The five staff we spoke with demonstrated a good understanding of people’s individual needs. Care plans were up to date and a range of health care professionals were accessed when required. One person told us, “It’s very good at Buchan House.”

People’s care records showed that care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. Care records were regularly reviewed which meant that staff were provided with up to date information about how to support people.

Is the service caring?

We saw that people were supported by staff who were kind and respectful. One person commented, “The staff are very kind. I am well looked after.” Care records showed that people’s individual choices were noted and followed. One relative told us, “The staff are very good.”

We observed that staff treated people with dignity and respect, for example when they became confused or needed assistance with their daily routines.

Is the service responsive?

People received an assessment prior to their move to Buchan House and care records included detailed information about their needs and preferences. We saw that care was provided in a way that was intended to ensure people’s safety and welfare.

People told us that they were involved in decisions about their care. One person told us, “Staff do involve me. They check if I need to see a doctor and support me.” A visiting doctor told us that the service was organised and caring.

Is the service well led?

People told us they had no complaints and were well looked after. One person said, “I like living here. There are activities for us to do.”

We found that the provider had a number of systems in place to ensure that the quality of the service was regularly assessed. For example, a survey of people who used the service, relatives, staff and health care professionals took place twice a year. There was evidence that the provider took action to improve the service when this was required.

One person we spoke with during our visit described the care as, “First class” and told us her general health had improved since she had moved in to the home. One person told us that he loved living at Buchan House, that staff did everything for him and were all very kind. However he did express some frustration with the difficulty of communicating with some staff whose first language was not English. Another person told us that when she first moved into the home she only wanted to have female staff support her. She told us this wish had been respected and accommodated by staff.

We received many positive comments from people’s family members. One family member told us, “It’s the attention to detail that’s so good, for example they cover people’s water jugs with cling film, they didn’t do that in the home mum was in before”. However, one family member told us that the home’s laundry management wasn’t good and that so many of her mum’s t-shirts had been shrunk that she now took them home to wash herself. The friend of one person who had lived at the home told us, “Staff checked on my friend every 15 in the last few days of her life; it was so good to know she didn’t die alone”.

We spoke with a district nurse who knew the home well. She told us. “They’re on the ball with palliative care patients and involve people and their families well”. However, she told us she had concerns about the high turnover of staff and the management of people’s pressure sores. However she acknowledged that things had improved and that training in pressure sore management had been organised by the tissue viability team to improve staff’s knowledge on the matter. She stated that she met weekly with the home’s manager to ensure that people’s needs were identified and acted upon quickly.

A GP who knew the home well told us he had no concerns about the quality of care there and that staff were knowledgeable and caring. He told us, “The home has come on massively in the last five years”.

During our inspection on 06 December 2012 we spoke with eight people who lived at the home, we also spoke with the manager, four members of staff and two visiting health care professionals. We spent time in all of the communal areas of the home.

People who lived at Buchan House had a range of needs including needs associated with dementia. People who were able to speak with us told us that they felt cared for, that staff had been kind and respectful and that they were given choices about their every day activities. One lady told us, “When the priest came today I asked him to bless all the people here who look after me.”

Some people at Buchan House were not able to tell us directly about their views and experiences. However, we observed that they were relaxed and interacted in a positive way with staff and other people.

Buchan House had policies and procedures, records, and monitoring systems in place for the protection of people who used the service. Staff were trained and well supported by the manager so that they could carry out their caring responsibilities effectively.

The purpose of this review was to assess improvements made in relation to shortfalls identified during our previous review of this home in October 2011. In addition to assessing improvements, we spoke with three people specifically about a recent shopping trip that had been organised by staff at the home and all three people told us they had enjoyed it immensely.

People we spoke with told us they were happy living at Buchan House and spoke highly of the staff. They also told us the food was good and they got plenty of choice of what to eat. One person reported, “I find it really nice here. I used to come here for my respite care and liked it so much that I wanted to come here. I find it really good. The staff are really kind and helpful.” Another person stated, “I can’t think of anything that would make it better”. However one person told us they sometimes, “Had a long wait” for help.

Relatives told us that staff were friendly and welcoming (although one stated he would like to be offered a cup of tea when visiting) and kept them up to date with what was happening with their family member. One relative was pleased that the home had Polish speaking staff who were able to talk to her mother in her native language. Another relative told us, “My sisters and I sit back with ease, knowing mum gets excellent care”. However, one relative reported that it sometimes took a very long time for the phone to be answered when she rang the home to find out how her husband was. Another relative told us she wasn’t sure who the current manager of the home was, and hadn’t been informed that the previous manager had left.