Archived: Little Court Nursing Home

We set out to answer our five key questions:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and a visiting relative, the staff and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was not safe because practices in the service did not fully protect people and staff from the risk of harm.

We saw that that some medicines were not stored safely. For example - creams were stored randomly in a plastic container which was overflowing. Open bandages were found which were not stored appropriately. Cupboard space was limited for creams and bandages not allowing clinical staff the opportunity to find items with ease.

The fridge was not fit for purpose in that it was overloaded, the seal to its edge was not sealing properly with the case and the thermometer on the front was broken.

PRN (as required) medication did not have any protocol for staff to follow to ensure it was offered and given in a manner which ensured consistency and flagged up to staff any concerns re over use. Five medicines were found without any label indication for which person they related. A first aid box found within the medication room contained bandages which had expired.

Systems were in place to make sure that managers and staff learned from accidents and incidents, concerns, complaints, whistleblowing and investigations.

Each person had a care plan detailing their support and care needs. There was guidance for staff to follow to reduce risks and strategies implemented to make sure people were as safe as possible.

CQC monitors the operation of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Care documentation viewed showed that mental capacity had been considered. Where people lacked capacity and decisions were made on people's behalf the documentation reflected that the service had consulted with relatives / friends or advocates.

Is the service effective?

The service was effective overall. People told us that they were happy with the care that they received and that their care needs were met. One person we spoke with told us, 'I am very happy here I have no concerns'. A relative said, " Staff treat my mother well". We saw that staff were attentive to people using the service and responded promptly when needed. People's health and care needs were assessed with them and /or their representatives where possible.

Is the service caring?

The service was caring. People were supported by kind and attentive staff. Staff showed patience and gave encouragement when supporting people. People we spoke with said they felt staff respected their privacy and dignity and staff were polite and caring.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed and discussed with staff the care records of four people who lived within the service. These had sufficient detail and guidelines about the support needed to meet the people's needs.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. It was clear from observations and from speaking with staff that they had a good understanding of people's care and support needs.

We found that the manager and staff were approachable and encouraged people to voice any concerns or ideas for change. People were consulted and were given the opportunity to contribute towards the running of the service. We noted evidence of regular meetings which enabled people to air their views.

We found that people were supported to attend health appointments, such as, doctors or dentists. We saw records to show that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

Is the service well-led?

Staff we spoke with had a good understanding of the different policies and procedures. They knew where to access them and where they get further advice from. Staff told us that they felt well supported and were given the information they needed to support the people who lived in the service.

The manager took an active role in the running of the home and met with staff and people who lived in the service to listen to what they had to say. We saw minutes of regular staff meetings where changes or issues with peoples' care were discussed. In addition, we saw evidence of meetings with people who used the service to ensure they were consulted and encouraged to contribute their ideas about running the service.

The people who used the service we spoke with told us they were treated with kindness and respect. One person said, "I enjoy living here, the staff understand my special needs". Another person told us, "I am so well looked after, my health is really improving". A relative told us, " My Mum is well looked after". We saw care and treatment was delivered in line with updated care plans which reflected individual needs.

We saw that Little Court had a policy and procedures in place for safeguarding vulnerable adults at risk. The staff knew where to access this information if they suspected abuse.

We observed care being given to people and found there were sufficient numbers of suitably qualified, skilled and experienced persons employed. A person said, "The staff answer my bell within minutes". A relative told us, "My Mum is never rushed by the staff, there is always a member of staff nearby she can call if in need of attention".

Staff were supported and received appropriate induction, training, supervision and appraisal as well as opportunities for professional development. A staff member told us, "We get a lot of support and can talk freely to the manager".

During our inspection of the service we spoke with 12 people who lived in the service and three relatives.

People told us that they were very satisfied with the way in which they were cared for. They said they found staff kind and helpful. They said they were never made to feel uncomfortable with the way care was delivered, and felt confident of asking about their care and that they would be told.

People said they found the home clean and said they had seen staff wearing aprons and gloves. People told us that there were always enough staff and that call bells were answered promptly most of the time.

Most people we spoke with could not recall if they had or had not been asked to comment about the quality of the service but, were satisfied with the care provided to them and thought it could not be improved upon.

We were satisfied from our review of records, and discussions with people in the home, that they were appropriately consulted about the delivery of their care and support, and that their needs were appropriately met. The home had taken action to address one outstanding compliance action but had made insufficient progress with another in regard to supporting staff. We have therefore issued a further

minor compliance action.