Archived: Pavillion Residential and Nursing Home

Pavillion Residential and Nursing Home provides care and accommodation for up to 68 people with nursing care needs and people who are living with dementia. At the time of the inspection the service supported 57 people.

People’s experience of using this service and what we found

People felt very safe and secure living in the home. They were happy with the service and spoke highly of staff members, describing them as “really nice”, “lovely” and “kind.”

Risks were well managed. Staff felt confident safeguarding people from abuse and the registered manager raised safeguarding alerts in a timely way. Arrangements were in place for the safe administration of medicines. Staff were recruited in a safe way and there were enough staff on duty to meet people’s needs. The provider learned from previous accidents and incidents to reduce future risks. The premises were clean and tidy.

People’s needs were assessed before they received support. Staff were suitably trained and received regular supervisions as well as annual appraisals. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported with their nutritional needs and to access a range of health care professionals.

People were well cared for and supported in a dignified manner. Staff treated people with respect and promoted their independence by encouraging them to care for themselves, where possible. People were supported to access advocacy services, when needed.

Care plans were person-centred and detailed. People’s communication needs were assessed, and staff knew how to communicate with them effectively. People and relatives had no complaints about the service but knew how to raise concerns. Any complaints received were fully investigated and subsequent action was taken. The service organised a wide range of activities for people to enjoy both inside the home and in the local community.

People and relatives were complimentary about the service. One person said, “It is well led. I would recommend it here.” An effective quality assurance process was in place. People and relatives were regularly consulted about the quality of the service through surveys and meetings. Staff were involved in the ongoing development and improvement of the service through regular meetings.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 19 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Pavillion Care Centre provides nursing and residential care for up to 68 older people, some of whom were living with dementia. At the time of this inspection there were 56 people living at the home.

The home had a registered manager. 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 said they received good care from kind, caring and considerate care workers. They also confirmed they were treated with dignity and respect. People, relatives and care workers also told us the home was safe.

Care workers knew how to report safeguarding and whistle blowing concerns. We found the provider had dealt with previous safeguarding concerns appropriately.

Where potential risks had been identified an assessment had been completed. The benefits of people taking risks and the measures needed to keep them safe were considered as part of the assessment.

We found there were sufficient care workers deployed to provide people’s care in a timely manner. People, relatives and care workers felt staffing levels were appropriate.

There were effective recruitment checks were in place to help ensure new care workers were suitable to be employed at the home.

Medicines were managed safely. Only trained nurses and senior care workers administered medicines. People confirmed they received their medicines at the correct time.

Accidents and incidents were logged and investigated with appropriate action taken to help keep people safe.

Health and safety checks were completed and procedures were in place to deal with emergency situations

Care workers received the support and training they required. Records confirmed training, supervisions and appraisals were up to date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People gave positive feedback about the meals they were served at the home. People received the support they needed with eating and drinking. Some people had been referred to external healthcare professionals for additional specialist support.

The home had been adapted to better suit the needs of people living with dementia.

People’s needs were assessed to enable personalised care plans to be developed. Care records contained a life history for each person and details of their preferences. Care plans were reviewed regularly to keep them up to date.

Activities were available for people to take part in, such as coffee mornings, a singing group, dominoes, skittles, pampering and a men’s club.

Regular residents’ meetings were held so that people could share their views and suggestions.

People did not raise any concerns about their care and knew how to complain. Previous complaints were investigated and resolved in line with the provider’s complaints policy.

People, relatives and care workers said the registered manager was approachable. The home had a homely and friendly.

A range of internal and external quality assurance audits were carried out to check on the quality of people’s care.

Pavillion Care Centre provides nursing and residential care for up to 68 people. The home provides care and support for people, some of whom were living with dementia. At the time of this inspection there were 61 people living at Pavillion Care Centre.

The home had a registered manager. 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 told us they received good care from kind and considerate staff. They went on to tell us they were treated with dignity and respect. One person commented, “[Staff were] very kind, very caring. They are a good set of lasses.” Another person said, “[Staff member] is lovely, she is a good lass. I like [staff member], she has a lovely personality.”

People, family members and staff told us the home was safe. One family member told us, “I know [my relative] is safe, they have one to one observations, there is always someone here.”

Staff showed a good understanding of safeguarding adults and whistle blowing, including how to report concerns. They said they felt concerns would be dealt with effectively. One staff member said, “[Registered manager] is a responsive manager, approachable. She would listen and do the right thing.”

Medicines records supported the safe administration of medicines. We found records were accurate and medicines were stored safely.

People said staff responded to their needs quickly. However family members gave mixed views about the appropriateness of staffing levels in the home.

Family members gave us good feedback about the home’s environment. One family member commented, “It’s a lovely large room with an en-suite toilet, and [my relative] has a lovely big window.” We found the home was clean and tidy.

Effective recruitment and selection procedures had been followed to check prospective new staff were suitable to care for vulnerable people. References had been received and Disclosure and Barring Service checks carried out.

The registered provider carried out regular health and safety checks, such as checks of fire safety, emergency lighting, gas safety and electrical safety. A specific plan had been developed to deal with emergency situations. Personal Emergency Evacuation Plans (PEEPs) had been written for each person using the service.

Staff were well supported and received the training they needed to care for people appropriately. One person said, “The staff are well trained, I can’t fault them, they just have too much paperwork.” One family member commented, “They all work together, the girls work well as a team.”

The registered provider followed the requirements of The Mental Capacity Act 2005 (MCA). Deprivation of Liberty Safeguards authorisations were in place for those people requiring authorisation. Staff supported people to make decisions in people’s ‘best interests'. People received care and support only when they had given consent.

Staff had a good understanding of how to support people with behaviours that challenged.

People received the support they needed from staff to ensure their nutritional needs were met. People gave us positive feedback about the meals provided in the home. One person said, “Meals are very good. You can have any amount, seconds if you like.”

People had regular access to a range of health care professionals including community nurses, dietitians, speech and language therapists and GPs.

Further improvements were required to the care and support of people living with dementia. The home did not have a specific dementia strategy and meaningful engagement for people living with dementia was inconsistent. We have made a recommendation about this.

Care records contained detailed information about each person to guide staff about people’s needs. People needs had been assessed and the information used to develop care plans. Care plans were up to date but did not always contain personalised information about people’s specific needs. We also found support plans were not always updated in a timely manner to reflect people’s current needs.

Family members had opportunities to give their views about their relative’s care and to meet with other family members. People and family members knew how to complain. One family member said, “If I have had problems they have been sorted straightaway.” Another family member commented, “I have no complaints.”

Family members said the registered manager was approachable. One family member said, “The manager is very approachable.”

Staff had the opportunity to give their views about people’s care through attending regular staff meetings. One staff member said, “People [staff members] get their say. You can always get your say.”

The registered provider carried out a range of audits and checks to help ensure people received safe and appropriate care. These included checks carried out by the registered manager and senior managers external to the home. These had been successful in identifying areas for improvement.

Incidents and accidents were logged and investigated. These were monitored regularly to check action had been taken to keep people safe.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Pavillion Care Centre on our website at www.cqc.org.uk.

We found the quality of medicines records had improved. Medicines administration records (MARs) had been completed correctly with no gaps or omissions in the records. MARs were in line with people’s ‘blister packs’. A blister pack is a method used by some pharmacists to pack medicines in sealed compartments, ready to be administered by a third party.

A system of daily, weekly and monthly medicines audits were in place to check on the quality of medicines management. These had been effective in identifying issues with medicines and ensuring action was taken. The in-house quality development team had carried out a specific medicines audit in October 2015. The home received a quality score of 95% for compliance with medicines.

The registered provider had spent time with staff individually to assess their knowledge of the MCA. The required documentation was now in place to show decisions to deter people from leaving the home had been made in line with the MCA, including evidence that a decision had been made in people’s best interests. MCA assessments and best interest decisions had been made for a range of other decisions where people lacked the capacity to make their own decisions.

One relative we spoke with said, 'This is a nice home, very friendly with good staff and good care. I am content leaving my mum in here.' Another relative told us they were 'happy' with the home.

We found people's privacy, dignity and independence were respected and people experienced care, treatment and support that met their needs and protected their rights. We found medicines were safely handled and people were cared for by staff who were supported to deliver care and treatment safely. The provider had an effective system to regularly assess and monitor the quality of service that people receive.

We spoke with relatives who told us they had the opportunity to visit and see the home for themselves before making their decision.

People told us they were 'happy' at Pavilion Care Centre. They told us staff supported them appropriately with their healthcare needs. Comments from people relating to the care they received included, 'The girls are lovely and they are always there for us'; 'You can't complain about the care here. It is excellent'; 'Mom is well care for and we are grateful for the excellent care she gets here'.

People told us they liked their room and were happy with the home. People told us the staff kept them informed about the refurbishment work that was going and they felt safe and secure.