Bywell House is a residential care home registered for up to 20 people living with dementia. At the time of our inspection, the home was fully occupied. Bywell House is situated close to the centre of Worthing and the seafront. Communal areas include a sitting room, dining room and a further small sitting room. People have access to the gardens at the home.

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

People were protected from avoidable abuse and harm by trained staff. Risks were assessed, identified and managed appropriately, with guidance for staff on how to mitigate risks. Premises and equipment were managed safely and work was in progress to install a new wet room. Staffing levels were sufficient to meet people’s needs and new staff were vetted as to their suitability to work in a care setting before commencing employment. Medicines were managed safely.

Staff had been trained in a range of areas to enable them to provide effective care to people in line with their support needs. Staff received regular supervision and appraisals of their work and performance. Staff meetings were organised. 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 support this practice. Menus provided people with a range of food choices and people enjoyed the food on offer at the home. Healthcare professionals were consulted as needed and people had access to a range of healthcare services.

Staff were kind, caring and compassionate with people. Relatives visiting the home were welcomed and included in the activities. People and their relatives were supported to express their views and encouraged to make decisions about their care. They were treated with dignity and respect.

Care plans were detailed and provided comprehensive information about people, their personal histories and preferences. Staff demonstrated that they had a good knowledge of people’s care needs and that they knew people well. Activities were organised by care staff and entertainers visited from outside the home. Complaints were managed in line with the provider’s policy.

People and their relatives were involved in developing the service; their views and feedback were obtained and acted upon. Residents’ meetings took place and questionnaires were completed by relatives. Feedback was overwhelmingly positive. A registered manager was in post and was freely available to people, relatives and staff. Good quality care was delivered and a system of audits was in place to measure and monitor the service overall. Any actions identified were acted upon.

Further information is in the detailed findings below.

Bywell House is a residential care home registered for up to 20 people living with dementia. At the time of our inspection, the home was fully occupied. Bywell House is situated close to the centre of Worthing and the seafront. Communal areas include a sitting room, dining room and a further small sitting room. People have access to the gardens at the home.

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

People were protected from avoidable abuse and harm by trained staff. Risks were assessed, identified and managed appropriately, with guidance for staff on how to mitigate risks. Premises and equipment were managed safely and work was in progress to install a new wet room. Staffing levels were sufficient to meet people’s needs and new staff were vetted as to their suitability to work in a care setting before commencing employment. Medicines were managed safely.

Staff had been trained in a range of areas to enable them to provide effective care to people in line with their support needs. Staff received regular supervision and appraisals of their work and performance. Staff meetings were organised. 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 support this practice. Menus provided people with a range of food choices and people enjoyed the food on offer at the home. Healthcare professionals were consulted as needed and people had access to a range of healthcare services.

Staff were kind, caring and compassionate with people. Relatives visiting the home were welcomed and included in the activities. People and their relatives were supported to express their views and encouraged to make decisions about their care. They were treated with dignity and respect.

Care plans were detailed and provided comprehensive information about people, their personal histories and preferences. Staff demonstrated that they had a good knowledge of people’s care needs and that they knew people well. Activities were organised by care staff and entertainers visited from outside the home. Complaints were managed in line with the provider’s policy.

People and their relatives were involved in developing the service; their views and feedback were obtained and acted upon. Residents’ meetings took place and questionnaires were completed by relatives. Feedback was overwhelmingly positive. A registered manager was in post and was freely available to people, relatives and staff. Good quality care was delivered and a system of audits was in place to measure and monitor the service overall. Any actions identified were acted upon.

Further information is in the detailed findings below.

We spoke with the manager, three staff, three relatives and four people who used the service. Some people who used the service were not able to talk with us in detail about the care they received, due to conditions such as dementia. We also spoke with a health care professional and a social care professional who had visited the home. There were 19 people living at the service at the time of our inspection.

One person told us “Care is very good, I can’t fault it. My mother loves the staff, they always have a smile.” Where people were not able to understand their care and treatment choices, records showed that there was consultation with relatives.

People and relatives consistently told us that the staff sought prompt medical advice and assistance. One person who used the service said “I see the doctor when I need to.” A visiting nurse told us that one person’s end of life care needs had met very well by the service. They said “Our treatment plans were followed, and pressure areas improved.”

We found that the provider had responded appropriately to allegations of abuse. We spoke with a member of staff for the local authority who investigated safeguarding alerts. They told us that the service had cooperated in investigations and had appropriately reported concerns. This meant that the service had acted to protect the people living at Bywell House.

People we talked with felt that staff did a good job. A person who used the service told us “Staff are very helpful and friendly”. A relative said “Staff have a good understanding of dementia and my mother.” We found that staff received appropriate professional development such as training and support.

A survey of people’s views about their experiences at the service had been recently carried out. The analysis of the feedback received showed that responses had been received from ten relatives of people who used the service, five members of staff, and four visiting professionals. One member of staff had written “The home is running well, and many families comment on this.” Compliments from relatives had included “Your resilience, patience and tolerance as well as your kindness have been so appreciated.”

There were 18 people living at the service at the time of our inspection. We were unable to speak with other people at length due to their dementia. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We examined the care records of four people who used the service. We also spoke with four staff working at the time of our inspection.

We were able to speak with four people who used the service. One person told us, “They serve up some good meals.” Another person told us that, “Some of the staff are wonderful.”

We found that people’s dignity and independence was respected in the service. We observed instances during our inspection where people were provided with a choice and were mostly treated with respect.

People experienced care, treatment and support that met their needs and protected their rights. We saw evidence that care provided to people met their individual needs.

We found that there was a sufficient number of staff on duty for each shift to support the needs of people in the service. We viewed the staff roster, spoke with four members of staff and four people who used the service.

We found that people’s personal records including medical records were accurate and fit for purpose.

We did not, on this occasion, speak to people so cannot report what the people using this service said.

We spoke to 2 people who said that they are satisfied with the care and support they receive. One person said that it is ‘very good, and another person said, ‘The staff are very supportive.’ People also made favourable remarks about the staff, such as, ‘They treat me well,’ and, ‘The staff are very good.’

People told us that there are enough staff on duty to meet peoples’ needs although one person said that staff are sometimes rushed.

We were told that people can choose what they do. For instance, one person said that he/she can get up when he/she wants.

People said that they like the food, commenting that it is tasty and that there are ample portions.

People said that they feel safe at the home.

Social services reported that the home has improved its performance under the new acting manager and that there have been no more safeguarding incidents or referrals to deal with. The provision of food was said to have improved as well as the care of the people. At the time of this review social services did not have any concerns about the service and confirmed their view that peoples’ needs were now being met.

At the time of this visit the service had an acting manager. It was unclear when a permanent manager will be appointed to run the home.

We were only able to speak to one person about his/her views of living at the home. Comments made by this person included, ‘I am quite happy here. I am satisfied with the care and support. The food is excellent. The staff are kind. You can have a laugh. There are always two staff on duty at night. I can choose what I want to do.’

The Commission has received information from social services regarding the home’s lack of ability to meet people’s care needs to the extent that social services have concluded that several people’s needs have been neglected. In addition, social services’ investigations have concluded that one person was assaulted by a member of staff and that the home’s staff have had an attitude to people that is described as abusive. This has resulted in decisions being made that several people’s needs cannot be met by the service and alternative placements have been sought. At the time of this review social services were looking to move two more people. As a result of this, the registered manager has left the service and the provider has appointed an interim acting manager to oversee improvements at the home. Social services report their confidence in the new manager’s ability and competence to improve the home’s performance. An action plan has been drawn up by social services and agreed with the providers so that improvements can be made to the home’s management, staff performance, staffing levels and to the environment. The acting manager stated that she is working with social services to improve the standard of care at the service. At the time of this review social services report that the service is making progress in working to the agreed action plan.

We did not, on this occasion, visit this service so cannot report what the people using this service said.