We carried out a review of the data available to us about Hythe View on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hythe View, you can give feedback on this service.
Hythe Nursing Home is a large detached house in a quiet residential area. It provides nursing care and support for up to 40 older people, most of who are living with dementia and people who require support with additional health needs such as diabetes. There were 39 people living at the service when we visited.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Staff knew how to recognise abuse and told us they would report any concerns. The manager was aware of their responsibilities in relation to safeguarding people and staff told us they were confident the manager would take appropriate action. Risks to people and the environment are assessed and plans are in place to mitigate risks. People’s medicines were managed safely and in the way they preferred.
Staff were recruited safely, there were enough staff on duty to keep people safe and meet their needs. Staff had the training they needed to meet people’s needs and competency was assessed by the senior staff. Nursing staff each took a lead role in areas of care such as end of life or wound care and received additional training to support them to do so. Staff told us they felt supported and valued by the manager and the providers.
People were supported to make their own decisions and remain as independent as possible. Staff supported people in the least restrictive way possible. Staff treated people with dignity and respect. People’s privacy was protected and promoted by all staff. People could have visitors whenever they liked and were supported to maintain relationships with family and friends. There were dedicated activity staff and they offered a wide variety of activities, in and out of the service and often linking with the local community.
People had a choice of meals and told us the food was of a good standard. People’s food choices were appropriate for their health needs. People’s health needs were managed well by the nursing staff. Referrals were made to health professionals as soon as concerns arose and any advice given as a result was followed.
People were involved in developing and updating their care plans, the service had a new online system for care plans and recording the care people received. People's care plans were person centred and showed what people could do for themselves and how they preferred to be supported. Staff knew people well, interactions between people and staff were affectionate and relaxed. Staff offered people reassurance and encouragement. People were laughing with staff throughout the day.
People, their relatives and staff told us the manager and providers were accessible and approachable. People and relatives told us they knew who to speak to if they had a complaint and were confident any issues would be addressed. People were encouraged to give their views of the service through surveys and regular meetings. Changes had been made as a result of people’s feedback. The manager was going through the process of registering with the Care Quality Commission, and had previously been in the role of registered manager. They met regularly with the providers and managers of the provider’s other two services to receive support, share good practices and plan improvements for the service.
The inspection visit was carried out on 08 January 2015 and was unannounced. The previous inspection was carried out in July 2013, and there were no concerns.
Hythe Nursing Home provides accommodation and nursing care for up to 40 older people. The premises consist of an older detached house, with the addition of two newer built wings at either side. The home is situated in a residential area of Hythe, set back on a hill. Accommodation is provided on two floors, with access to all areas via two passenger lifts. One of the communal rooms and access to the garden is on the lower ground floor.
The service is run by a registered manager, who was present on the day of the inspection visit. (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 Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). No applications had been made to the DoLS department for depriving people of their liberty for their own safety.
Staff had been trained in safeguarding adults, and discussions with them confirmed that they understood the different types of abuse, and knew the action to take in the event of any suspicion of abuse. Staff were aware of the service’s whistle-blowing policy, and were confident they could raise any concerns with the registered manager, or with outside agencies if they needed to do so.
The service had systems in place for on-going monitoring of the environment and facilities. This included maintenance checks, and health and safety checks. The premises were well-maintained, and had undergone a complete renovation during the past year. Risk assessments were implemented for each person living in the home, highlighting specific concerns which could affect their welfare and safety. This included the risk of falls, risks associated with using bed rails, and risks with the facilities and equipment within their own rooms. Some people had specialist pressure-relieving mattresses and cushions, and checks included ensuring there were no trailing wires which could lead to accidents. The registered manager monitored any accidents to assess the frequency and location of these. She identified if there were any patterns, and if there was action which could be taken to prevent future accidents.
People spoke highly of the staff, and said they felt safe and secure with them. People who were asked if they felt safe in the home all responded positively, with comments such as “Oh yes, it’s all safe here”. There were sufficient numbers of staff to meet people’s needs, and to give them time, and not to rush them. This included nurses throughout the twenty-four hours. The service had robust recruitment procedures to ensure that staff were suitable for their different job roles. Records of on-going staff training, supervision and appraisals confirmed that staff were working to appropriate standards and were supported by their line managers. Staff were encouraged to attend meetings, and to take their part in the development of the service.
Nursing staff managed and administered medicines for people using safe practices. People received their medicines on time.
People and their relatives said that they were invited to discuss their care planning, and that staff provided good communication about any changes needed. Records confirmed that people were asked for their consent and agreement to different aspects of their care.
The food was well presented and people said that the food was good. It included sufficient choice to provide people with a varied and nutritious diet. The chefs were familiar with people’s different dietary needs and their likes and dislikes; and spoke to people every day to obtain their feedback about the food.
Nursing staff carried out on-going checks for people’s health needs, and contacted other health professionals for support and advice. Nurses held responsibility for different areas of health care, such as wound care, medicines and continence care. This enabled them to concentrate on specific aspects of the work and to inform other nurses of updates and changes in their given subjects. Other health professionals who came into the home included hospice nurses, who assessed people in regards to end of life care. They advised staff about keeping people comfortable and pain-free.
The staff treated people with respect, dignity and gentle affection, and people spoke positively about them with comments such as “They are all good to me, and very caring”. Staff were well informed about people’s previous lifestyles and the subjects that interested them. Two activities co-ordinators managed events and day to day activities. People were supported in carrying out their own interests, such as knitting, playing ‘scrabble’, and reading newspapers; and in taking part in group activities such as listening to a pianist, reminiscence and exercises. The activities co-ordinators spent time with people who were confined to their own rooms due to their frailty or their personal choice, so that they did not feel isolated.
People were confident that they could raise any concerns with the staff or registered manager, and that these would be properly dealt with. The registered manager had a visible presence in the home, and it was evident that people and their relatives knew her well. She told people at the time of admission that she had an open door policy, and encouraged people to voice any concerns or complaints so that they could be addressed. The complaints log demonstrated there were reliable processes to follow up complaints appropriately.
People and their relatives were asked to express their views every day about how they were feeling and how they felt their needs were being met by the home. There were processes in place to obtain people’s views in writing, using in-house questionnaires, and encouraging people to voice their opinions to external websites such as NHS Choices. The provider had recently engaged an external company to carry out additional satisfaction surveys so that this would be clearly seen as an independent process, enabling people to fully express their views. People spoke highly of the home with comments such as, “At every visit I see how caring everyone is. Everyone is there to please. My relative is very happy and content.” And, “Relaxed and caring professionalism. We could not have wished for a better place for our relative”.
Records were neatly and accurately maintained, and were up to date and correctly signed and dated. There were systems in place for the on-going monitoring of the service through daily, weekly and monthly checks and audits. The manager and staff maintained a culture of continuous improvement, and in ensuring that ‘people came first’ in all aspects of the service.
We spoke with seven people who used the service and three visiting relatives. People we spoke with told us that they were happy with the care and support they received. One person told us "I'm very happy and looked after very well". Another person told us 'I can't say anything but praise' and 'the staff are charming and lovely'.
We looked at people's care plans and saw that they were individualised and contained people's choices and preferences. Risk assessments were in place to identify and minimise risks as far as possible to people who used the service.
The home was clean and tidy and had systems and procedures in place to manage infection control and minimise cross-infection. Staff had received training and understood their responsibilities in how to keep people as safe as possible in the prevention and spread of infections.
We spoke with people who told us there were enough staff on duty and that they had a good understanding of people's needs.
The home had a range of checks and audits in place to monitor the quality and safety of the service provided.
People told us that that they were treated with respect, kindness and dignity. Individual preferences concerning food were met, reviewed and changed if necessary.
People had the freedom of choice over how and where to spend their day in the home and were actively involved in the planning of the care they received.
People told us that they felt safe and we observed that people who used this service were very relaxed and comfortable within the environment. They interacted well with the staff who worked with them and staff encouraged their independence.
We were told that that people were treated with respect, kindness and dignity. Individual preferences concerning food were met, reviewed and changed if necessary. People had the freedom of choice over how and where to spend their day in the home and were actively involved in the planning of the care they received.