We carried out an unannounced inspection of this nursing home on 3 and 4 January 2017. The home is registered to provide accommodation, nursing and personal care for up to 50 older people some of whom live with dementia. Accommodation is arranged over three floors with lift and stair access to each floor. At the time of our inspection the third floor of the nursing home was not open and 35 people lived in the home.A registered manager was 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.
People were supported by staff who had a good understanding of how to keep them safe, identify signs of abuse and report these appropriately. Robust processes to check the suitability of staff to work with people were in place. There were sufficient staff available to meet the needs of people and they received appropriate training and support to ensure people were cared for in line with their needs and preferences.
Medicines were administered, stored and ordered in a safe and effective way, work was in progress to improve protocols for as required medicines.
Most risks associated with people’s care were identified and clear plans of care were in place to ensure staff knew how to mitigate these risks. Staff had a very good understanding of these risks and how to ensure the safety and welfare of people. Incidents and accidents were clearly documented and investigated and work was in progress to review patterns and trends in these events. Actions and learning were identified from these and shared with all staff.
People were encouraged and supported to make decisions about their care and welfare. Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. Where people were legally deprived of their liberty to ensure their safety, appropriate guidance had been followed.
People received nutritious meals in line with their needs and preferences. Those who required specific dietary requirements for a health need were supported to manage these.
People’s privacy and dignity was maintained and staff were caring and considerate as they supported people. People were encouraged to share their views of the home at meetings and through questionnaires. Information from these was shared on noticeboards in the home.
Care plans in place reflected people’s identified needs and most of the associated risks. A new format of care plans had been introduced to provide clear and concise plans of care in line with people’s needs and preferences.
Staff were caring and compassionate and knew people in the home very well. External health and social care professionals spoke highly of the care and support people received at the home. They were involved in the care of people and care plans reflected this.
Effective systems were in place to monitor and evaluate any concerns or complaints received and to ensure learning outcomes or improvements were identified from these. Staff encouraged people and their relatives to share their concerns and experiences with them.
The registered manager was very visible in the service and provided strong and effective leadership. They promoted an ethos of open and honest communication within the home. Staff felt respected and valued in the home and this was reflected in the way they supported each other and promoted person centred and efficient care for people.
A robust system of audits was in place at the home to ensure the safety and welfare of people. Any actions required from these audits informed an overall action plan for the home which was monitored and actioned by the registered manager and registered provider.