Bybuckle Court is registered to provide accommodation for up to 17 older people. Providing care for people including those who live with dementia. At the time of the inspection there were 16 people living at Bybuckle Court. This was an unannounced inspection which took place on 15 May 2017.

Bybuckle Court was inspected in March 2016 where we found one breach of regulation this was because the provider had not ensured care and treatment was provided in a safe way for people. The provider sent us an action plan telling us they would meet this breach of regulation by May 2016. At this inspection we found that improvements had been made and the provider was meeting all regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Bybuckle Court had a registered manager who was in day to day charge of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and staff told us they found the registered manager open and approachable. Staff were regularly supported through supervision and felt involved and listened to.

Staff felt that all necessary training was available. However, improvements were needed to ensure that all staff were up to date with their training requirements and that this was maintained at all times. Staffing levels were appropriate to meet people’s needs. Staff felt that they were able to provide care for people and people told us that when they requested help this was provided promptly.

Staff knew people well and spoke kindly to people, taking the time to stop to chat and support people. People’s privacy and dignity was supported and respected. Staff spoke positively about people, and showed concern for their wellbeing. Care was person centred.

Management had an understanding of mental capacity assessments (MCA) and Deprivation of Liberty Safeguards (DoLS). And how this needed to be assessed and reviewed. People were actively encouraged to maintain relationships with family and friends and relatives or next of kin were involved in decisions when appropriate. People told us that staff provided all the care they needed and involved them in day to day choices and decisions.

Care plans were in place for people for identified care needs. These were supported by risk assessments when required. Risks were identified to help ensure people remained safe. Staff understood how to recognise and report safeguarding concerns. People had access to healthcare services to maintain good health. Some people had regular visits from community nurses and other health professionals.

Medicines policies and procedures were in place to ensure people received their medicines safely.

Information regarding relevant health conditions was included in medicine care plans to ensure staff were aware of peoples health related conditions and medicines.

People were supported to eat and drink. Meal choices were provided and people spoke highly about the meals. Peoples special dietary needs were catered for to ensure peoples nutritional needs were met.

A programme of activity was provided. People spent their time meeting up and chatting to other people living at Bybuckle or participating in organised activities. Some people went out with their relatives and visitors.

There was a system in place to assess and monitor the quality of service provided. Audit information was used to improve and develop the service. A complaints procedure was available for people to access if needed.

Bybuckle Court is registered to provide residential care for up to 17 older people. There were 14 people living at the home at the time of the inspection.

People required a range of help and support in relation to living with short-term memory loss, dementia and assistance with personal care needs.

The home is a converted building with a large communal room used as a lounge/dining area. The home has a passenger lift and wide staircases with handrails to assist people to access all areas of the building.

This was an unannounced inspection which took place on 9 and 10 March 2016.

Bybuckle Court had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The registered manager was in day to day charge of the home. People living at Bybuckle Court spoke highly of the registered manager and told us that they were always around if they needed them. Staff told us that the registered manager had a good overview of the home and knew everyone well.

People’s safety had not been maintained, we found that legionella and fire safety risk assessments had not taken place by an appropriately trained professional. Infection control systems needed to be more thorough to ensure all areas of the home and equipment used regularly were clean, tidy and safe to use.

Medicines were kept in a trolley located in the main lounge/dining area. Daily temperature monitoring had not been maintained and staff were not clear on safe temperatures for medicines to ensure they were appropriately stored.

Mental capacity assessments had not been completed to show how decisions around people’s capacity and ability to consent to care and treatment had been made. However, staff had received training around MCA and DoLS and were able to demonstrate a good understanding around capacity and choice for people.

Safe recruitment processes were in place and there were enough staff to meet people’s needs and staff had time to provide care to meet people’s individual needs. New staff completed an induction and were supported by experienced staff. There was a programme in place to ensure staff received appropriate training. Staff were encouraged to attend further training, with a number having achieved National Vocational Qualifications (NVQ) or similar. Staff received regular supervision and support. Meetings took place, these included resident, relative and staff meetings to ensure people’s views and opinions were sought and listened to.

Staff understood their roles and responsibilities. All staff displayed a good understanding around recognising and reporting safeguarding concerns.

We received only positive feedback from people, staff, relatives and visiting professionals. Everyone told us that the registered manager was really keen to make positive changes and cared about making sure people received the best care possible. This was supported by clear up to date care documentation which was personalised and regularly reviewed.

People’s nutritional needs were met. With special dietary meals and alternative meals provided for people who had specific health needs. Meal choices were available and people were encouraged to maintain a balanced healthy diet.

Staff knew people well and there was clear affection between people and staff. Staff interacted with people and encouraged them to interact and participate in activities throughout the day. When people required support this was provided with patience and understanding. If people became unwell referrals were made to other health professionals if needed.

Care documentation was person centred and aimed to support and encourage people to remain independent as much as possible. Referrals were made appropriately to

During our inspection of Bybuckle Court we found that care workers had formed close professional relationships with people living in the home. The premises were clean and reasonably well maintained. The atmosphere was found to be generally relaxed and homely.

Concerns identified during the last inspection, relating to inadequate staffing levels in the home after 8pm in the evening and the faulty call bell system had been satisfactorily addressed.

As far as practicable and in accordance with their individual care plans, people were enabled and supported to make choices about their daily lives.

Comments received from people living in the home indicated a high level of satisfaction with the home and the care provided.

“It’s alright living here, the food’s good and the staff are always around and very helpful. I’ve got no complaints”.

“I’m very happy here, everyone is so kind, they can’t do enough for you”.

Appropriate arrangements were in place in relation to storing, administering handling and recording medicines.

We found that systems for consultation, interaction and communication were effective and people were treated with respect and dignity. Care workers had developed awareness and a sound understanding of each individual's care and support needs. This was evident from direct observation of individuals being supported in a sensitive and professional manner.

During our inspection of Bybuckle Court we found that care workers had formed close professional relationships with people living in the home. The premises were clean and reasonably well maintained. However there were certain areas where attention was required in order to ensure the environment was safe through improvements being made to the standards of maintenance. The atmosphere was found to be generally relaxed and homely.

We found that care workers had developed awareness and a sound understanding of each individual's care and support needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.

However, we found that there was inadequate staffing levels to meet the needs of people after 8 pm and that 'hyper-sensitive' automatic door closures, linked to the internal call bell system, placed people at risk of harm.

Comments received from people living in the service indicated a high level of satisfaction with the care workers but identified worries over safety and staff availability during evenings and night-times.

These comments included: “It’s lovely living here and the staff are all so kind, but when there is only one on duty we sometimes have to wait a long time to get help”. “The night staff are always on their own. One lady had a fall in her room during the night and had to wait ages because the nurse was busy with someone else”.