We carried out an unannounced comprehensive inspection at Bowood Court and Mews in May 2017 and rated the service as ‘Good’. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bowood Court and Mews on our website at www.cqc.org.uk

This inspection took place on 11 September 2019 and was unannounced.

The inspection was partly prompted by an incident which had a serious impact on a person using the service. This indicated potential concerns about the management of risk in the service. While we did not look at the circumstances of the specific incident, we did look at associated risks.

We focused on two of the five key questions we ask of services. Is the service ‘safe,’ and is the service ‘well-led.’ This report only covers our findings in relation to these topics.

The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Bowood Court and Mews is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Bowood Court and Mews accommodates 90 people across two units, each of which have separate adapted facilities in a separate building. One of the units is called Bowood Court and the other is called Bowood Mews.

At the time of our inspection, there were 83 people living at the home, a number of whom were living with dementia.

Shortly before the inspection the registered manager resigned from their post. At the time of the inspection an interim manager was in charge at the home. We refer to this person as the manager throughout the report. 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.

Since our last there had been a number of changes in the overall management of the service. This had impacted the effectiveness of the governance and working practices. Experienced and long-standing staff members no longer worked at the home and this posed challenges to the management team.

People’s experience of care at the home was not always reviewed and updated in a systematic manner. Where people had accidents and incidents, these were recorded by staff however were not always reviewed and analysed promptly so that action could be taken to reduce the risk of further occurrences.

Care planning and recording did not reflect people’s experience of care. Accurate fluid and food charts were not maintained. Opportunities to engage with families were not always promoted. Whilst meetings with families had been planned, they did not always take place. Although the registered provider was able to evidence how reviews of care delivered at the home occurred, we saw people’s care was not always reviewed and updated accurately and promptly. Action was being taken to improve people’s experience of care at the home.

People felt safe around staff that understand how to protect people from abuse. People were relaxed and comfortable around the staff supporting them. Staff knew how to report concerns both within the home and to external organisations like the CQC if needed. Training had been provided to staff about keeping people safe and the manager understood their obligations in reporting concerns reported to them.

Staff understood people’s identified risks of harm or injury and overall supported people in line with actions described to mitigate those risks. Risks were recorded in care plans for staff to refer to. People were able to access support from staff when needed. Staff recruited to work at the home had undergone background checks

The inspection took place on 16 and 17 May 2017 and was unannounced.

personal care. The home was split across two building called Bowood Court and Bowood Mews. At the time of the inspection, Bowood Court offered Nursing and personal care and there were 53 people living at the home. Bowood Mews offered specialist Dementia Care and there were 33 people living at that building when we visited. A registered manager was not in post when we inspected the service as they had recently left. However, a new manager had been appointed and was due to commence employment at the home. 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 and associated Regulations about how the service is run. The home is run across two buildings with one registered manager overseeing both sites.

People felt safe around the staff supporting them and relatives felt assured that they could leave their family members there safely. Staff had received training and guidance on protecting people from harm. Staff recognised the signs of abuse and understood how their concerns needed to be escalated to management in order to protect the person from harm. Risks to people’s health had been identified for staff to refer to in order to support people appropriately. People had access to support from staff when they needed and staff underwent background checks to assure the registered provider of their suitability to work at the home. People received help to take their medicines and regular checks were made to ensure people received their medicines correctly.

People felt confident that staff had the training needed to support them. Staff had access to training which was reviewed and updated regularly. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were offered choices in the meals and drinks they were offered and alternatives were suggested where people did not like any of the meals on offer. Where special diets were needed, people were catered for. Staff worked with other health care professionals to ensure people had access to services that met their healthcare needs. Advice suggested by professionals was incorporated into people’s care.

People liked the staff caring for them and enjoyed their company. People explained to staff how they needed help and staff supported accordingly. Relatives were kept informed about their family member’s health and were involved in making decisions about their care, where appropriate. People were treated with dignity and respected and staff understood how to enable people to maintain their independence.

People’s care needs were assessed and care provided in response to their needs. As people’s needs changed, care was adjusted to ensure people had access to the support they needed. People had access to a variety of activities that they enjoyed taking part in. Friends and relatives were encouraged to visit whenever they chose to. People and their families were offered opportunities to feedback what they thought about the service they received at the home. A number of different methods were used by the management to gather views about the service.

There had been a number of changes within the home in terms of staffing, management and in the ownership of the home. The registered provider had recognised some areas of care at the home needed improvement and was putting into place measures to address these areas. Plans were in place to improve the overall appearance of the home as well as people’s experiences of care.