Studley Bethesda Home situated in Calne, is one of three homes run by the Gospel Standard Bethesda Fund who provide personal care and accommodation for people over the age of sixty five, who are members of Gospel Standard Strict and Particular Baptist Churches; or who regularly attend Gospel Standard Strict Baptist chapels. Studley Bethesda Home provides care for up to thirteen people. At the time of our inspection there were eleven people living there, ten people being permanent residents and one person having respite services, in one adapted building.

Studley Bethesda Home 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.

Studley Bethesda Home was last inspected in October 2015 and was rated as Good overall. This inspection was unannounced and took place on 18th January 2018 and we found that standards had been maintained.

A registered manager was not in place at the time of our inspection. 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. An interim manager was in post and worked alongside the registered manager throughout December 2017, to complete a full handover. The interim manager will remain in post until a new registered manager is appointed.

People told us they felt safe. Staff knew, and understood their responsibilities for safeguarding people against potential risk, or harm and were able to tell us how they would report any concerns. Staff received individual support meetings and training to support them in their role and staffing levels were appropriate to meet people’s needs. Risk assessments were in place which identified specific risks for individuals and detailed the support required.

Medicines were administered, recorded, stored and disposed of safely. People were encouraged to self-administer their own medications and were supported by staff in a safe manner. Protocols were in place for PRN (as required) medications, instructing staff on how and when to administer them.

People had access to food and drink throughout the day and were encouraged to make their own hot and cold drinks using the resident’s kitchen. People had been consulted about their meal preferences and were offered choices. People were supported to follow specific diets necessary to maintain their health and well-being.

People were supported to make their own decisions and staff had a sound knowledge of the Mental Capacity Act (2005) and how to apply this to the support they provided. Care and support plans were personalised and reviewed regularly.

There were auditing processes in place to monitor the quality of the care and services delivered. People and relatives were encouraged to give their views and ideas for change. People and their relatives were complimentary about the staff and the care they received.

Providers are required, by law, to display their CQC rating to inform the public on how they are performing. The latest CQC rating was displayed in the service and these details were also on the provider's website.

Studley Bethesda provides personal care for up to 13 people who are practicing Strict Baptists. At the time of this inspection there were eight people living in the home. A breach in medicine management was found at the last inspection and a follow up inspection visit took place in February 2014 where we found safe systems of medicine management.  

This inspection was unannounced and took place on the 10 October 20015.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People said they felt safe living at the home. Members of staff knew the signs of abuse and the actions they needed to take should they suspect abuse. Safeguarding adults procedures were in place for staff's reference.

People were protected from potential harm. Risks were assessed and action plans were developed on how to lower the level of risk for example, for people at risk of malnutrition. People were encouraged to take risks safely and risk assessments on how staff were to support the person were in place. For example, self administration of medicines.

People received care and treatment in a timely manner from sufficient numbers of staff who were skilled to meet their needs. The staff team was stable and people said they had the attention they needed from staff. Two staff were on duty throughout the day. Staff said they had time to sit and chat with people. They said training to meet people’s needs was provided and they were supported by the registered manager to undertake their roles and responsibilities. One to one meetings were regular with their line manager and during these meetings issues of concern, their performance and training needs was discussed.

Safe systems of medicine management were in place. Where people were able they self-administered their medicines with support from the staff. Staff signed the medication records to indicate they had administered medicines as prescribed. Protocols were in place for prescribed “when required” medicines which gave staff direction on administering medicines.

People were supported to make decisions. They knew who helped them make difficult and important decisions. Members of staff showed sound knowledge of the principles of the Mental Capacity Act (2005). The staff said people had capacity to make decisions and they helped people make informed decisions by explaining the consequences of the each option available.

People’s dietary requirements were catered for. Menus were devised to meet people's preferences. There was a choice of meals on weekdays, on Saturdays a roast meal was served and a casserole on Sundays which met with people’s preferences.

People were supported with their ongoing healthcare. People were registered with a local GP and had access to other NHS facilities such as dentists, optician and chiropodist.

People were at the centre of their care. Care plans reflected people’s preferences and current needs. Life Stories were part of their care plans and included background information about their employment, hobbies and routines which gave staff an insight into people’s identity. People were consulted on how staff were to deliver their care and they signed the care plans to show their agreement with the action plans.

People practiced the S

trict Baptist Gospel values and beliefs. Religious services and readings were daily with weekly activities such as arts and crafts. Staff respected people’s rights, their beliefs and maintained a quiet and calm atmosphere.

The complaints procedure was on display in the foyer. The registered manager investigated complaints received. People who complained received a written response telling them the outcome of the investigation and a resolution to their complaint.

A system to gain people’s views was in place. House meetings, questionnaires and suggestion boxes were used to gain feedback. Positive feedback was received from the questionnaires on the standards of care at the home.

Quality assurance arrangements in place ensured people's safety and well-being. Systems and processes were used to assess, monitor and improve the quality, safety and welfare of people. There were effective systems of auditing which ensured people received appropriate care and treatment. The system of audits included complaints, care plans and medicine management.

At our last inspection in November 2013 we found people were not protected against risks associated with medicines. This was because the provider did not have appropriate arrangements in place to safely manage medicines in the home. The provider sent us an action plan to show how they planned to address these concerns. This inspection was to follow up on the shortfalls identified and actions subsequently taken by the provider.

At the time of our inspection, eight people were living at Studley Bethesda. We used a number of different methods to help us understand the experiences of people using the service. These included observations and looking at records. This was because two of the eight people were not able to tell us their experiences of care. We spoke with four people and one relative of a person who lived at Studley Bethesda. All these people spoke positively about care and staff. People told us, “staff are always very helpful” and “I have no doubts about how I am treated. The staff are all very kind”.

All the people we spoke with told us they felt staff treated them with kindness, respect and dignity. Staff told us they got to know people and their families very well. Staff said they used this knowledge to engage with people in meaningful conversations and to support people with their care appropriately. All the staff we spoke with told us it was important to treat people as individuals. People told us they liked living at the home and had opportunities to engage with a range of activities both within the home and local community.

We looked to see how people were supported to access other services. Some people told us they choose to make their own health appointments independently and others told us they required more support from staff. We observed the provider fully supported people’s individual needs to access health services. This included making phone calls on behalf of people, making charitable donations for transport to appointments and attending appointments with people.

We spoke to people and staff to see how safely medicines were managed in the home. Most people chose staff to support them with their medicines. During our visit we observed medicines being administered to people. We found the provider’s processes for the dispensing, administration and recording of medicines needed improving. We saw medicines were stored safely and disposed of appropriately.

We spoke with the manager about recruitment when we visited. We looked at records which showed there were effective recruitment and selection processes in place.

We looked at how the quality of the service was maintained and audited. We saw care plans had been reviewed and individual risks assessed for people. We saw the provider had recorded information about accidents and incidents and evaluated these for potential service improvements. The provider had a range of other records to show the upkeep of the building and equipment had been maintained.

When we visited Studley Bethesda Home the home was accommodating eight people. We met and talked with five people and visited another who could not talk with us and was in bed due to poor health. People who were able to talk with us said they were happy living at the home and their needs were being met. One person told us “the staff are lovely” and another said “I feel very safe and there’s nothing I need”.

People said they were treated with privacy and dignity. Staff knocked on doors before entering rooms and made sure any intimate care was delivered in private. People were able to choose how they lived and how they spent their day. They could get up when they wished and retire to bed at any time to suit them. We were told staff respected and accommodated people’s specific religious beliefs and practices.

People had a choice of food for their main lunchtime meal and also their lighter evening meals. We were told the choices suited people and they had been able to contribute to the type of meals served. If there was nothing on the menu they wanted on a particular day, they were able to discuss having something else with the cook.

We were told the home was warm and comfortable. People said their rooms were “always clean and tidy” and the communal parts of the home were “how we like them” and “suit me very well”. People said they felt part of the home and were able to be involved in how it was run.

People spoke about the importance of moving into a Gospel Standard home with one person saying that they chose the home for that reason and that “it provides a good life for them”. Other people also described the home positively telling us that they are “looked after very well”.

People described the food as very good and told us how they are asked to contribute to the menu.

People told us that they were being supported to attend appointments related to their health on the day off our visit and said that they feel safe and comfortable in the home.

People described the staff as nice and told us that they are well cared for. One person said they are ”friendly and helpful” and another told us they are “all very willing”. They told us that they had no reason to complain but that if they did they would be listened to.