We carried out a review of the data available to us about Ilsham Valley Nursing Home 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 Ilsham Valley Nursing Home, you can give feedback on this service.
Ilsham Valley Nursing Home is a residential care home providing nursing and personal care for up to 23 older people who might also be living with a physical disability. At the time of the inspection, 20 people were living at the home. Accommodation is provided over two floors with a passenger lift and stair lift providing access to the upper floor.
People’s experience of using this service and what we found
Without exception all the people and relatives we spoke with praised the home. People’s comments included, “The home is well organised by the manager and it is homely” and “The staff here are caring and lovely, nothing is too much trouble for them, there is a lovely feel about the place.”
People felt safe and well cared for. Relatives also felt confident their relations were being well cared for and were safe. Risks to people’s health, safety and well-being were assessed and management plans were in place to ensure risks were mitigated as much as possible. Staff were aware of their responsibilities to keep people safe and protect them from avoidable harm or abuse.
People’s preferences were respected, and staff were sensitive and attentive to people’s needs. Staff were seen to be kind, caring and friendly and it was clear staff knew people and their relatives well.
There were sufficient numbers of nursing and care staff employed to ensure people’s needs were met. Staff had time to sit and engage people in conversation and to support people’s involvement in social activities. Recruitment practices were safe, and staff were well-trained.
People received their medicines safely and as prescribed. Medicine management practices were safe.
The home was clean, well maintained and pleasantly decorated. Equipment used to support people’s care and to maintain the safety of the home, was regularly serviced to ensure it remained in safe working order.
Consideration was given to providing a variety of leisure and social activities for people to enjoy.
Quality assurance processes ensured people received high quality care that met their needs and respected their preferences. People and their relatives were involved in making decisions about their care. The home encouraged people’s feedback. People said they felt listened to and, although no one we spoke with had any complaints, they felt able to raise concerns should they need to do so. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 27 November 2018) and there was a breach of regulation. We imposed a condition on the provider’s registration to carry out monthly audits and to submit reports to the CQC. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ilsham Valley Nursing 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. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The service provides care and accommodation for up to 23 people. On the day of the inspection 20 people were living at the service.
The service had a registered manager. 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.
At our last inspection in July 2017 the overall rating for the service was Requires Improvement because people were not always protected from risks associated with their care, and fire prevention and portable appliance testing (PAT) were not safe. We also found, the recruitment of staff was not always carried out safely, and people were not always protected from infection control practices. In addition, people’s records relating to their care were not always accurate and the provider’s systems to monitor the quality of care people received were not robust, in identifying when improvements were needed. Following our inspection, the provider submitted an action plan to the Commission, detailing how improvements were going to be made. However, whilst some reactive improvements had been made as a consequence of our previous inspection findings, we found there was a continued breach of regulation and 17 of the Health and Social Care Act 2008 (Regulated Activities 2014), and additional areas were now requiring action. Therefore, the rating of Requires Improvement remained.
People were not always protected from risks associated with their care. People had risk assessments in place to help guide staff to deliver safe care in line with people’s individual needs, such as moving and handling, skincare, personal care and behaviour. However, people’s risks assessments did not always provide sufficient detail about how to mitigate associated risks. This meant people may not receive consistent and safe support.
People’s medicines were not always managed safely, because the medicines fridge was found to be unlocked, people's medicine records were not always accurately and topical creams were not always dated upon opening. People were supported by sufficient numbers of staff and a consistent staff team, with one person telling us “I see the same carers and nurses, the faces don’t change much”.
People and families told us they felt “Safe”, with one person commenting “I feel safe and comfortable here”.
People were protected from abuse. Staff told us they would not hesitate to raise any concerns with the registered manager if they felt someone was being abuse, mistreated or neglected.
People, at our last inspection in July 2017, were not protected by the provider’s own recruitment procedures, but at this inspection we found action had been taken to ensure people were fully protected.
Overall, people were now protected by infection control practices. There were paper towels, soap and pedal bins in bathrooms. People now lived in a safe and secure environment. Action had been taken to ensure the premises met fire regulations and PAT had been carried out.
Overall, lessons were learnt when things went wrong, and the learning used to help improve the service. For example, the provider had acted to improve the service following our last inspection.
People’s needs were assessed prior to them moving into the service. This pre-assessment was then used to help create a person-centred care plan for all staff to follow. However, the pre-assessment was completed by either the registered manager or deputy manager who had no clinical experience. This meant, people’s clinical needs may not be effectively and correctly assessed before moving into the service.
People received care and support from staff who had undertaken training the provider had deemed to be mandatory. The registered manger was passionate about high quality training telling us “You are nothing without your staff”.
The service worked well with external organisations to the benefit of people, a GP who visited the service frequently told us they felt the service met people’s needs effectively, and that the service communicated well.
People were encouraged to live healthy lives. People were encouraged to eat a balanced diet. Overall people told us the food was lovely.
People lived in a service which had been designed to help meet people’s needs. A Summer garden project had been successful in creating a woodland garden, with raised flower beds with wheelchair access.
People’s care plans included a section regarding their mental capacity and how they should be suitably supported. The registered manager and staff had undertaken training in the Mental Capacity Act (2005) and had a good understanding.
People’s consent to their care was obtained and recorded in their care plans. This included consent to photographs being taken, and for them to be used in the promotion of the service.
People’s communication needs were documented in their care plans, and staff told us how they adapted their own communication styles to help people to understand them.
People were complimentary of the caring staff that supported them, commenting “It’s like being at home. I’m not lonely and I’m well looked after here”, “I’m treated here as well as I could be” and “I have a laugh with everyone”.
Relatives were also positive about the caring nature of the staff telling us, “She’s so happy here and really well looked after. She gets her makeup done, they all hold her hand and give her a kiss”.
Staff spoke fondly and respectfully of the people they supported. Comments included, “I love it here…I love my job”, and “I always treat people as I would want to be treated if I was in a care home”.
People were encouraged to be involved in their care, to help promote their independence. People’s privacy and dignity was promoted. Staff knocked on people’s bedroom doors prior to entering them. People looked well dressed and staff made people feel and look nice.
People’s religious, spiritual and cultural needs were detailed in their care plans, and visiting clergy attended each month to carry out a service and to meet with people on a one to one basis, should they wish.
People had care plans in place to help provide guidance and direction to staff about how they wanted to receive their care and support. Care plans detailed people’s health and social care needs, and were updated and reviewed on a monthly basis.
People told us they felt confident to raise any concerns. Telling us, “I’ve never had a complaint but if I had I’d ring for the senior person in charge” and “It’s very nice here, I have no complaints.”
People were supported with dignity, at the end of their life. Staff had received palliative care training and the service had a close link with the local hospice.
The registered manager had a variety of quality audits which were used to help monitor the quality of the service. Audits were completed on a monthly and annual basis by the registered manager, and designated staff. However, despite these being in place, they had failed to identify the areas found to require improvement as part of this inspection, as cited above in each key question.
Despite the registered manager and deputy manager having many years of care home management experience, they had no nursing qualifications, and formal arrangements had not been made for any clinical input to feed into the provider’s overall governance framework. For example, clinical staff were not always involved in the monitoring of clinical provision.
The provider carried out a visit to the service to monitor quality and to obtain people’s views. However, the most recent visit which had taken place in September 2018 had failed to identify the areas found as part of this inspection.
The registered manager ensured that they kept their knowledge up to date. People lived in a service with a positive, empowering and inclusive culture which had been created by the registered manager.
Staff were motivated by the people they supported and wanted to do a good job. Staff told us they enjoyed working at the service, and felt supported.
People's feedback about the service was sought and their views were valued and acted upon. The service worked positively with external agencies in order to help continuously learn and improve. A GP told us the service engaged positively and that they had no concerns.
The service held a strong link with the local community. The registered manager had notified the Commission appropriately in line with their legal duties. For example, when someone had passed away. The rating of the provider’s last inspection was displayed in line with legal requirements.
We found a breach of regulation. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
In addition, we recommend the provider ensures the pre-assessment processes takes account of clinical expertise. We also recommend the provider takes account of the Accessible Information Standard (AIS) in the design and delivery of the service, and that they consider guidance set out by the Royal College of Nursing (RCN) and the National Institute for Clinical Excellence (
The service is set over two floors, with a lift to access the first floor. It is set in the Wellswood area of Torquay, close to the sea and local shops and services.
At the last inspection on 15 and 19 May 2015 the service was rated as good in all areas apart from well led, where it was rated as requires improvement. The overall rating was good. At this inspection in July 2017 we found the service had not sustained some of this good practice. We also identified a number of concerns and breaches of legislation. The service has been rated as requires improvement overall.
We found the service did not have strong, effective and robust systems of governance and management. Although we did not identify that people had suffered harm as a result, the failure to have clear accountability for actions within the management structure left people at risk of receiving poor or unsafe care. Some systems for audit had lapsed, and where concerns had been identified by the organisations own processes, such as with fire precautions or infection control there was no clear and well understood plan of action shared within the management team to address them.
Risks to people’s health or well-being were not always robustly assessed and managed and some records regarding their care were inconsistent or did not contain easily available information on people’s current needs. This meant the records could not always be relied upon to provide evidence of changes in people’s needs or health conditions. We have made a recommendation about the updating of care plans. The service had activities available for people to take part in and people’s care plans contained contain information about what interests people had, so staff could tailor these accordingly.
Incidents such as falls or accidents were not currently being analysed and an incident where a person had suffered harm when a bed rail was not put in place had not been reported to the appropriate agencies as it should have been. The service had investigated and taken appropriate action themselves. This did not demonstrate openness or transparency as a service.
People did not always receive safe care in an environment where action was consistently taken to reduce assessed risks. The service had undertaken audits or commissioned risk assessments, some of which had identified concerns about the premises, such as fire precautions, carpets needing replacing or the laundry and sluice areas. While some smaller actions had been taken there was no available or well understood action plan in place for when larger areas would be addressed. This could leave people at risk, and does not demonstrate effective management of the service. The environment was however, homely and comfortable.
We also had concerns there was no person at the service with nursing experience leading the nursing team or assessing the quality of their clinical practice. The provider has told us the registered manager, deputy and nursing staff “work collectively as a Nursing Team to lead the service on a collective basis” and have taken advice from Skills for Care on how this can be demonstrated.
Records were not all well maintained, and appropriate notifications had not always been made to the Care Quality Commission or other services as required by law.
People told us the service met their needs and they were happy with their care. We saw many examples of positive practice in place, with staff supporting people in a gentle and caring fashion. People and staff had developed good relationships and staff told us it was a happy place to work.
People received their medicines safely and as prescribed. We saw people being given their medicines at their own pace, including medicines that needed to be given at specific times, such as antibiotics. People’s healthcare was supported and we saw evidence of people receiving support from paramedics, GPs and other specialist community support teams.
There were sufficient staff on duty, with a registered nurse available 24 hours a day. Staff were working through a programme of training and told us they felt they had received enough training at Ilsham Valley Nursing Home or at other services to give them the skills and knowledge they needed. Systems were in place for the recruitment of staff and we have made a recommendation in relation to these to ensure they are robust in keeping people safe.
People received a well-balanced and nutritious diet. People told us they ate well. Staff understood when people had specific dietary needs or swallowing difficulties and how to support them with this.
People‘s rights regarding capacity and consent were understood and supported. Relatives were able to continue to be involved with their relations care and could visit the service after 11am or at other times in particular circumstances. People’s privacy and dignity was respected, however we have made a recommendation in relation to the use of positive and respectful language when completing records or discussing people’s needs.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Ilsham Valley Nursing Home is situated in a residential area of Torquay, Devon. It is registered to provide accommodation, personal and nursing care for up to 23 people. There is a registered nurse on duty at all times.
This inspection took place on 15 and 19 May 2015. The service was last inspected on 7 May 2014 when we found some improvements were needed. We found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Regulation 18 was breached in that there was no written record of people’s consent to care and treatment. Regulation 21 was breached in that recruitment practices were not robust. Regulation 23 was breached in that staff were not supported to deliver good care. Regulation 10 was breached in that there was no effective quality assurance system in place. The registered provider wrote to us and told us they would have addressed the required matters by June 2014. At our inspection in May 2015 we found that most improvements had been made, but further improvements were still needed in relation to the quality assurance systems.
Since our inspection in May 2014 the service had identified poor practice by a member of staff. A full investigation had been carried out by the local safeguarding team with the cooperation of the service and this had resulted in action being taken to protect people.
There had been no manager registered at the service since October 2013. A manager had been employed by the service, but had not yet registered. It is a condition of the service’s registration that a manager is registered. 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.
Some aspects of the service were not well led. There was a system in place designed to audit the care provided at the service. However, audits were not regularly completed. This meant there while there were some measures in place to check the quality of care, there was no overall method by which the service could check, maintain or improve the quality of care provided by the service. However, people and their representatives told us they rarely had to raise issues and when they did so, things were quickly put right.
There was an effective system in place to help staff manage medicines safely. However, we found there was no indication of how staff would recognise when a person was beginning to become distressed, or if alternative interventions should be used, before medicine that was prescribed to be taken as required was given.This meant the person was at risk of being given their medicines inconsistently as staff may interpret the person’s distress differently.
At our inspection in May 2014 we found that recruitment procedures were insufficient to ensure people were protected from the risks of unsuitable people being employed by the service. The registered provider told us they would have procedures in place to protect people by June 2014. At our inspection in May 2015 we found that improvements had been made and people were protected by robust recruitment procedures.
People’s risk assessments contained good details on how risks were managed. Moving and transferring and pressure area assessments were in place and had been updated when risks had changed. For example, one person’s moving and handling and pressure area assessments had changed as they were spending more time in bed.
The environment was safe and secure and there were arrangements in place to manage the premises and equipment. Procedures were in place to protect people in the event of an emergency. Staff had been trained in first aid and there were first aid boxes easily accessible around the home.
People’s needs were met in a timely manner as there were sufficient staff on duty. On both days of our inspection there were 17 people living at the home. Only three people routinely spent time in the lounge, with other people spending their time in their rooms. Two visitors told us they felt there could be more staff especially at weekends, but that generally there were enough to meet people’s care needs. People and staff told us they felt there were enough staff on duty. One person said “If I need help they come in pairs” another said “Just press the buzzer and they are there”. During the inspection, call bells were answered quickly and staff spent time talking with people and were on hand to provide support with care needs when required.
People received effective care and support from staff that had the skills and knowledge to meet their needs. Staff had received a variety of training including moving and transferring, dementia care, end of life care and safeguarding adults. There was a system in place to identify when any training was due to be updated. People were protected from the risks of abuse as staff demonstrated a good knowledge of different types of abuse. They told us how they would recognise abuse, and what they would do if they suspected abuse was occurring within the service.
Staff were skilled in meeting people’s needs and regularly offered care to people. Everyone we spoke with told us that people were well cared for. People told us staff knew how they liked things done. One person told us “All the staff know how to help me move”. One visitor told us “Staff are very pleasant and helpful and nothing is too much trouble”. Staff received supervision from more senior staff and an annual appraisal. Regular supervision ensured staff had the opportunity to discuss their work and learning and development in a measured, monitored and supported way.
Staff had a clear understanding of the Mental Capacity Act 2005 (the MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. When people were assessed as not having the capacity to make a decision, a best interest decision was made involving people who know the person well and other professionals, where relevant.
At our inspection in May 2014 there was no written evidence that people had consented to receive care and treatment. At our inspection in May 2015 there was written evidence that people or their representatives had consented to receive care and treatment as described in their care plan. Throughout our inspection people were asked for their consent before staff provided personal care. Staff also offered choices about where the person wanted to sit and what they wanted to eat or drink. People told us that staff often asked them for their views about their care. One person told us they had been involved in developing their care plan.
People were supported to receive a balanced diet with sufficient to eat and drink. People were offered plenty of snacks and drinks through the day. One person told us “meals are very good, plenty of choice”.
People were supported to maintain good health and had access to healthcare services where required. Records showed people had seen their GPs and health and social care professionals as needed. One professional told us staff always contacted them appropriately and followed any instructions they were given. They said they had never had any cause for concern when visiting the service and had nothing negative to say about it.
People and their visitors told us staff were very good and caring and all the interactions we saw between people and staff were positive. Comments from visitors included “I couldn’t do better myself”, “It’s like a great big happy family” and staff are “all very nice, caring and friendly”. One visiting professional told us the staff not only cared for the person living at the home, but for all their family as well.
Visitors told us they could visit the home at any time and were always made welcome. One visitor told us they visited every afternoon and another told us they visited at all times on all days, so staff never knew to expect them. They said things were always just as good whatever time they visited. They told us staff always kept them informed about any changes to their relative’s care.
People’s privacy and dignity was upheld. One person told us “They [staff] always knock on my door even when I’ve called them”. All personal care was provided in private and staff took care to ensure people’s appearance was clean and tidy and that their hair was combed. Staff enabled people to maintain as much independence as possible. One person told us how the service was supporting them to return to a more independent living setting.
People’s care plans were maintained and reviewed regularly. The plans contained comprehensive assessments of the person’s needs and detailed instructions for staff on how to meet personal care needs. Social care needs were not so well assessed on some and there were few details on the person’s past life. This meant staff may not have all the information they need in order to maintain all aspects of well-being. New in depth personalised assessments had been completed for some people and care plans had been developed based on these assessments. Staff were working to complete the new assessments for everyone.
People received individualised personal care and support delivered in the way they wished and as identified in their care plans. Staff told us they always asked people what they wanted and how they wanted their needs met. Where people could not tell staff what they wanted, staff told us they followed the person’s care plans.
People's bedrooms contained personal possessions and were arranged according to their needs. Staff told us how one person’s bed had been moved to make more room for them to move around. Staff and people told us they had time to spend with people on an individual basis. During our inspection we saw that staff spent time chatting to people and helping them complete puzzles.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.
Staff personnel records did not contain all the information required by the Health and Social Care Act 2008. This meant the provider could not demonstrate that the staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. The manager had been trained to understand when an application should be made, and how to submit one.
Is the service effective?
We found that people's consent was obtained verbally for care and treatment provided to them by the service. Staff supported people to make choices and decisions about their daily lives. However, where people did not have the capacity to consent to care and treatment, the provider did not have documentary evidence they had acted in accordance with legal requirements. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
People told us that they were happy with the care they received and felt their needs had been met. One person said "I get great care". It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. We found that staff had not received regular supervision and training that would support them to do their jobs effectively. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. We saw and heard positive interactions between staff and people who lived at the home. People told us 'I love the friendliness ' it's not stiff and starchy'.
Is the service responsive?
People's physical and health care needs were well met. However, there was little evidence that people's social care needs were given as much priority. People told us there had been a recent meeting with the new manager to discuss how the service was going to move forward. A relative told us that the manager had already identified the garden needed to be tidied up. People told us they had never had anything to complain about. However, one relative told us they felt the environment was 'looking tired'.
Is the service well-led?
The home had been without a Registered Manager since October 2013. A new manager had been in post for a month prior to our inspection in May 2014. A quality assurance process had only recently been put in place and it was not possible to tell if this would be effective. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
The information we had received related to the recruitment of workers, medication administration, training, induction of new workers and systems to monitor the service not being current and in date.
We carried out our inspection over two days. On the first day of our visit there were 17 people living at the home. We spoke with six of these people.
People told us they thought the care workers were kind and nothing was too much trouble for them. One person told us, 'all of the staff are very pleasant, they work very hard'.
The lack of a permanent manager at the home since our last inspection meant that nobody had consistently looked at the quality audit systems at the home to establish areas where improvements were needed. We saw at this visit that the provider had been actively working to recruit a new manager.
We found there were systems in place to ensure people had their medication safely and appropriately. A person staying at the home complimented the nurses saying, 'They are very good, they know what they are doing, I feel very safe in their care'.
We found that the home did not have systems in place to ensure thorough recruitment, induction and training of workers.
Policies and procedures were out of date and did not contain relevant accurate Information to guide people and staff.
Following the inspection the provider wrote to us and, in a detailed action plan, described the arrangements that would be put in to place to achieve compliance. We reviewed copies of the action plans. We found that they provided evidence to demonstrate that staff had received further training to enable them to care for people properly.
One person described the home as a "top notch" Another person told us the staff were 'lovely' and that the care was "excellent".
People had clear assessments of their needs and plans and strategies were in place to meet them. We saw that care workers interacted with people in a relaxed and respectful manner. People had access to age appropriate social activities. We saw people had a choice of suitable and nutritious food and drink available in sufficient quantities. People said the food was good. One person said "the food is gorgeous."
People who lived at the home told us that the staff were very good. One person said 'they are the best'. There were sufficient numbers of staff on duty. Established staff that had been employed for some time had been appropriately trained and had regularly received supervision and appraisal. However we spoke with three newly appointed staff (appointed within the past three months), they had not received any training or supervision. This means that people could be at risk from receiving poor or inappropriate care.
Staff were knowledgeable about people's needs and accessed additional health and social care services where required. People felt involved in planning their care and could decide how to spend their day. They also appreciated the activities provided at the home.
People said they felt safe living at the home and knew how to raise any concerns or complaints. People said they could share their views about the care. Staff had received training in the safeguarding of vulnerable adults and knew how to report any concerns.
The environment was safe, clean, tidy and free from obvious hazards. Systems were in place to maintain this safe environment.
All records and documents seen were well maintained, accurate, securely stored and reflected the care people received.
There had been a change of management at the home since our last visit.
We visited the home with an expert by experience. The Care Quality Commission (CQC) describe an expert by experience as "people who have in-depth experience of using services, and have been trained in their expert role by voluntary organisations."
During the visit we spoke with 8 people who live at the home, 7 members of staff and 2 visitors.
People were happy with the standard of care they received at the home and told us they felt safe living at the home. They said that staff listened and acted on what they said and were respectful when providing care. People were also happy with the way their medicines were managed.
People were also full of praise for the quality and quantity of the food with comments of, 'The food is excellent', 'Really good', and, 'You can have seconds'.
The increasing activity programme had also proved popular with people at the home.
People living at the home and their relatives had noticed changes in recent months. One person said, 'Things are becoming a lot better now. The new manager is making changes gradually rather than all at once.' A relative said, 'We are delighted in the changes that have taken place.'
There were no unpleasant odours and the premises were clean and tidy. One person said, 'My room is cleaned every day and sometimes twice a day'. A visitor said, 'The standard of cleanliness has improved greatly of late'.
People told us that usually there were sufficient staff on duty but occasionally someone may fail to come on duty because of illness. People had also noticed there had been a change of some staff but said these changes had slowed down in recent weeks, and that they liked the new staff.
A visitor commented, 'This place is now run better and more professionally. There have been a lot of little improvements and I understand that staff training is now planned'.
People told us they were able to share ideas or make suggestions and these were listened to. We were also told they would speak to the manager or a named member of staff if they had any concerns.
One person said they liked living at the home but when asked about being respected and treated politely said 'It depends on who it is. Some staff are better than others.'
People do not always have a clear plan of care which may place them at risk of receiving unsafe care. Other people do not feel involved in their plan of care. One person told us they had blood taken, but added they did not know why this had been done. Another person said 'I just let them do what they need to do.'
There is not a wide variety of activities at the home. One person said there 'Is not a lot to do apart from watch TV and read books'. Another person said 'Many a time I get bored. I'm stuck in my chair and don't go out because I have wobbly legs.' Another person said 'I stay in my room all day, but I don't get bored.'
The people we spoke with said they felt safe and thought the staff were 'kind' and 'patient.' We were also told that people felt able to talk to any of the staff if they were unhappy or felt unsafe. One person said 'The staff are very good, I have no grumbles about that', whilst another said 'they are simply lovely.' One person said they thought the 'night staff were very helpful.'
People told us they were satisfied with the level of cleanliness at the home. One person said 'The cleaning is very good'.