Background to this inspection
Updated
23 February 2016
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.
Our inspection was unannounced and took place on 18 and 19 January 2016. The inspection was carried out by three inspectors and a nurse specialist advisor. The specialist advisor provided specialist nursing advice and input into our inspection processes. Our inspection team also included a pharmacist, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had personal experience of supporting an elderly relative.
We asked the provider to complete 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. The form was completed and returned so we were able to take information into account when we planned our inspection. We asked the local authority and Clinical Commissioning Group (CCG) who both fund placements at the home their views on the service provided. We reviewed the information we held about the service. Providers are required by law to notify us about events and incidents that occur; we refer to these as ‘notifications’. We looked at the notifications the provider had sent to us. We used the information we had gathered to plan what areas we were going to focus on during our inspection.
We spoke with 12 people who lived at the home, 13 relatives, nine care staff, four nurses, five unit managers and the registered manager. We also spoke with three health care professionals one of whom was a community matron. We viewed care files for eight people, medicine records for 22 people, recruitment records for two care staff and two nurses and staff training records. We looked at complaints systems, completed provider feedback forms, and the processes the provider had in place to monitor the quality of the service.
Some people were unable to verbally tell us their experiences of living at the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the needs of people who could not talk with us. In addition we observed staff administering people’s medicines, carrying out activities and supporting people during their breakfast and lunchtime meal.
Updated
23 February 2016
Our inspection was unannounced and took place on 18 and 19 January 2016.
The home is registered to provide accommodation and nursing care to a maximum of 142 people. On the last inspection day 142 people lived at the home. Some people lived with conditions that related to old age whilst other people had dementia or a physical disability. Care provided was within five different units. On Bloomfield and Heronville units care was provided to people who lived with dementia. On Palethorpe unit care was provided to younger adults who lived with a physical disability and on Haines unit care was provided to people who lived with elderly frail conditions. On the fifth unit Mamby the care provided was intermediate and step down support which was for a short duration of time only. Some people on this unit had been discharged from hospital but for various reasons were not yet ready to return to their own homes. Other people required short term support to regain their health and/or mobility.
At our last inspection of August 2014 the provider was not meeting one regulation that we assessed relating to medicine management and safety and improvements were required regarding the quality monitoring of the service. Following our inspection the provider sent us an action plan which highlighted the action they would take to improve. Our inspection findings confirmed that the improvements had been made.
The manager was registered with us. 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.
Staff knew the procedures that they should follow to ensure the risk of harm and/or abuse was reduced.
Kind and caring staff in sufficient numbers were available to meet people’s individual needs.
Medicine systems were well managed and safe and ensured that people were given their medicines as they had been prescribed.
Staff received induction training and the day to day support they needed to ensure they met people’s needs and kept them safe.
Staff felt that they were trained and supported to enable them to care for people in the way that they preferred.
Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This ensured that people received care in line with their best interests and would not be unlawfully restricted.
People were enabled and encouraged to make decisions about their care. If they were unable to their relatives were involved in how their care was planned and delivered.
Staff supported people with their nutrition and dietary needs to promote their good health.
People received assessments and/or treatment when it was needed from a range of health care professionals which helped to promote their health and well-being.
Systems were in place for people and their relatives to raise their concerns or complaints.
People and their relatives felt that the quality of service was good. The registered manager and provider undertook regular audits and took action where changes or improvements were needed.