Archived: Polefield Nursing Home

We met with eight people who used the service, observed their experiences of care and asked them about their experience to support our inspection. We spoke with the new manager, five care and nursing staff, and two visiting relatives. We looked at records and followed up on information we had received from the home about improvements they were going to make.

We considered our inspection findings to answer questions we always ask:-

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe?

At the inspection in May 2014 we found the service was not safe because people were cared for in an environment which was not was not clean and hygienic and found the provider had not ensured people living in the home were in a safe environment.

At the inspection on 30 September 2014 we found significant improvements had been made to ensure people were kept safe.

Is the service effective?

At the inspection in May 2014 we found not all staff had received appropriate training to meet the needs of the people who lived at the home. We found that people's care records were not kept securely and we found that the provider's statement of purpose was not up to date.

At the inspection on 30 September 2014 we found staff had received training or were planning to have training to ensure they had the necessary skills and knowledge to deliver effective care and support. The statement of purpose had been updated and records were stored securely.

Is the service caring?

We saw positive interactions taking place and staff responding in a kind manner to people who lived at the home. The feedback we received about the home was positive and the home had a calm relaxed atmosphere. We were aware that staff had experienced some challenges over the previous few months yet had remained focused on ensuring the people living at the home were not affected.

Is the service responsive?

We found the service was responsive as staff ensured people received additional support from other health or social care professionals when they needed it. We saw an example of this at our inspection on 30 September 2014.

People who lived at the home held meetings with staff to discuss their views on living at the home and relatives we spoke with told us the home had listened to them and involved them in different aspects of the running of the home and the support offered.

Is the service well-led?

Staff told us things were much better now and people using the service told us they knew there was a new manager and there had been problems which were now getting sorted out. This told us the management was open and transparent and were keen to work together to ensure people continued to receive a good service and that staff received the appropriate level of support.

The new manager was in the process of submitting an application form to the Care Quality Commission (CQC) to become the registered manager. The operational manager told us there were plans to sell the home. We saw systems and policies had been introduced to enable the new manager to deliver a good standard of care.

We considered our inspection findings to answer questions we always ask:-

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found. If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

People were cared for in an environment that was not clean and hygienic.

We asked people if they had any concerns about the care provided by the home and they told us that were happy with the care provided and that the staff were caring. One relative told us, 'I am happy with the care provided here.' They also said that their relative was safe while living at the home.

Appropriate risk assessments were in place, and the registered manager had suitable arrangements to safeguard people from foreseeable emergencies.

We saw safeguarding procedures were in place and that staff understood how to safeguard the people that they supported. At the time of the inspection, there was one person at the home subject to Deprivation of Liberty Safeguards and correct procedures had been followed.

We found safeguarding concerns but the provider had not followed the correct procedures.

There were quality checks and audits completed to make sure the building was maintained and procedures were followed. However, we found the provider had not ensured people living in the home were in a safe environment.

Is the service effective?

All of the people we spoke with, told us they were happy with the care that was delivered and their needs were met. We noted all of the people who lived at the home had a named nurse.

We saw people walking around the home freely and making their own decisions about where they wanted to go, including some people going out to smoke or go to the local shops or community groups. We also saw people had a choice of where they ate meals.

Not all staff had received appropriate training to meet the needs of the people who lived at the home.

We found that people's care records were not kept securely.

We found that the provider's statement of purpose was not up to date.

Is the service caring?

Observations during the visit showed staff and people who lived at the home were comfortable in each other's company. During the day and we saw some positive interactions taking place and staff responding in a kind manner to people who lived at the home.

Is the service responsive?

Regular reviews were carried out with the people who used the service and their representatives to make sure the person's care and treatment needs had not changed. This helped ensure staff supplied the correct amount of care and treatment.

When a person who lived at the home needed other professional input, we saw the staff had ensured this happened.

Information within the care plan gave staff an insight into the interests, likes and dislikes and areas of importance to the people in their care. This meant staff had an insight into the person they were supporting which enabled them to better support their needs.

Meetings took place with staff to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people who used the service.

People who lived at the home held meetings with staff to discuss their views on living at the home. This meant that people were involved in communications about the running of the home and staff listened.

Is the service well-led?

There was a registered manager in post at the home.

People who used the service had regular contact from the registered manager and other senior staff to check their wellbeing. The quality of service provided by care givers was monitored and this was done through quality audits and also through meetings arranged with the people who used the service.

One relative told us that they were kept regularly updated by the staff team if any changes occurred. The relative told us, 'I did not know there were any meetings, other than what my relative goes to. I don't need to go anyway though as staff tell me what's going on.'

We carried out this inspection to check the provider had taken action to address the compliance action issued at our last inspection on 20 May 2013.

During our previous inspection we had moderate concerns about this outcome. We found that adequate systems were not in place to ensure the people using the service were protected against the risks associated with medicines.

During this inspection we found that the provider had improved the way medicines were managed and nursing staff had received further training so they were aware of their responsibilities and knew how to work safely.

Information was available to guide staff on how and when to give medicines prescribed on the basis of 'as and when required' and how to apply creams properly.

The way medicines were audited was more thorough and records of the medicines given to the people using the service were well maintained.

Relatives spoken with during the inspection said they were happy with the care provided. One person said, 'I'm happy with the care my relative is getting'. Another person told us, 'They look after my relative very well, they are angels'

People's emotional care needs were met through a range of social activities being provided. Staff consulted with health care professionals to ensure people's physical care needs were met.

Staff were trained on how to safeguard people from abuse and harm and knew to report any signs or the suspicion of abuse to a senior member of staff.

A range of equipment was available to support people with their mobility and physical care needs and to minimise the risk of them coming to any harm.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Staff were provided with a range of training for their professional development.