14 February 2023
During an inspection looking at part of the service
People’s experience of using this service and what we found
The registered manager had left the service since the last inspection. The provider was advertising for a new manager. They were staying at the service for part of each month, managing the service along with the support of a deputy manager.
The recording of assessments and the monitoring and oversight by staff, of stocks of medicines, when people self-administered their own medicines was now effective. People were regularly reviewed to ensure they were safe to administer their own medicines.
Staff training was accurately recorded and closely monitored. All the nurses had received medicine update training since the last inspection.
The provider had an accurate record of all staff supervision and appraisals that had been completed.
The management of risk had improved. Care plans contained risk assessments and there had been recent reviews when people’s needs had changed. Staff were provided with guidance and direction on how to reduce identified risks.
The provider had improved the recording and oversight of monitoring records. For example, when people were having their food and drink intake recorded. However, these records were not always totalled each day, so it was not always clear if the person had had sufficient intake or not and any gaps in recording would not always be identified in a timely manner. The provider assured us this would be addressed immediately.
The process for monitoring people’s weight had improved. There were clearer records and guidance in care plans to ensure this took place when required.
Accidents and incidents that took place at Caritate were recorded by staff. These records were then reviewed by the provider and audited for any patterns or trends. Any action taken was recorded.
The was a robust programme of audits now in place. All aspects of service delivery were being reviewed by the providers. Where improvements had been identified as being necessary, action was taken appropriately.
There was a system in place to monitor the Personal Identification Numbers (PIN) of all employed nurses. The PIN is compulsory for nurses working in the UK.
The provider had ensured that all the staff were aware of the current government guidance for staff in care homes regarding the use of Person Protective Equipment (PPE). Staff were not required to wear masks at the time of this inspection.
Deprivation of Liberty Safeguards (DoLS) records were being closely monitored by the provider. They were working with the DoLS team, at the local authority, to ensure any required authorisations were applied for appropriately.
The provider had ensured that staff were aware of the statutory guidance ‘Right support, right care, right culture’ as the service supported people who had a learning disability. The provider and staff were working with external healthcare professionals to ensure they were supporting people in line with the principles of this guidance.
The service website contained the required link to the latest CQC report. The provider had updated their Statement of Purpose (SOP) since the last inspection to ensure it clearly stated what care and support was provided at Caritate Nursing Home.
The provider had reviewed the content of the governance report required to be completed by all management each month, in order to inform the provider of the quality of the service provided.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was requires improvement (Published 31 December 2022)
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.
The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
We use targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caritate Nursing Home on our website at www.cqc.org.uk
Recommendations
We have made a recommendation about the recording and oversight of monitoring records.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.