Archived: Victoria Nursing Home

Updated 24 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 and 12 October 2015 and was unannounced. The inspection was undertaken by two inspectors and a specialist nurse advisor.

The provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service. We looked at information received from relatives, the local authority commissioners and the statutory notifications the registered manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.

We spoke with one person who lived at the home and three relatives. We spoke with the provider, the registered manager, the nurse manager, one nurse, five care staff, the cook and a housekeeper. We observed care and support being delivered in communal areas and we observed how people were supported at lunch time.

None of the people living at the home were able to tell us, in detail, about how they were cared for and supported because of their complex needs. However, we used the short observational framework tool (SOFI) to help us assess whether people’s needs were appropriately met and to identify if they experienced good standards of care. SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

We reviewed four people’s care plans and daily records and 17 medicines records to see how people’s care and treatment was planned and delivered. We checked whether staff were recruited safely and trained to deliver care and support appropriate to each person’s needs. We reviewed the available records of the provider’s quality monitoring system to see what actions were taken and planned to improve the quality of the service.

Updated 24 November 2015

We inspected this service on 7 and 12 October 2015. The inspection was unannounced.

We were not able to gather all the evidence we needed to make a judgement on the first day of our inspection because the provider and the registered manager were not available to speak with us. We went back on a second day to make sure they had the opportunity to tell us how they managed the service and about their plans for continuous improvements.

There was a registered manager in post. 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.

The service provides accommodation, nursing and personal care for up to 23 older people who may be living with dementia, a physical disability or sensory impairment. On the day of our inspection, 17 people lived at the home.

The provider’s policies and procedures to minimise risks to people’s safety were shared with the staff. Staff understood their responsibilities to protect people from harm and were supported to raise any concerns. The registered manager assessed risks to people’s health and welfare and people’s care plans minimised the identified risks.

There were enough staff on duty to meet people’s needs. The registered manager checked staff’s suitability to provide care during the recruitment process.

The provider’s medicines policy included training staff and checking that people received their medicines as prescribed, to ensure people’s medicines were administered safely.

People received care from staff who had the skills and experience to meet their needs effectively. Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff until they knew people well. Staff were supported and encouraged to reflect on their practice and to develop their skills and knowledge.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had applied for a DoLS for one person to make sure they had legal authority to take the agreed actions to keep the person safe. For people with complex needs, their families and other health professionals were involved in making decisions in their best interests.

Risks to people’s nutrition were minimised because staff knew about people’s individual dietary needs. People were offered a choice of foods and were supported to eat and drink according to their needs.

Staff were attentive to people’s moods and behaviours and understood how to minimise their anxiety. People were supported to spend time with other people who lived at the home. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health and when their health needs changed.

People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed.

People and relatives told us care staff were kind and respected their privacy and dignity. They were confident any concerns would be listened to and action taken to resolve any issues.

People and relatives were encouraged to share their opinions to enable the provider to make improvements in the quality of the service. Staff were guided and supported in their practice by a management team they respected.

The provider’s quality monitoring system included regular reviews of people’s care plans and checks on equipment, medicines management and staff’s practice. The provider’s visions and values were understood and shared by the managers and staff. The focus of the service was to ensure people enjoyed the best possible outcomes from the service delivery.

Plans to improve the quality of the service included improvements to the environment to better support people with dementia and including people’s wishes for how they would like to be cared for and supported towards the end of their life.