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Verulam House Nursing Home Good

Reports


Inspection carried out on 29 May 2019

During a routine inspection

About the service

Verulam House is a nursing home. It provided accommodation and nursing care to 43 people aged 65 and over at the time of the inspection. The service can support up to 50 people.

Verulam House offers accommodation to people over three floors. A lift and stairs provide access to all floors and communal areas. People had access to a landscaped garden with patio and seating areas as well as other communal areas where they could spend time and socialise with others in the home.

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

People felt safe and happy with the way staff supported them. Staff knew how to keep people safe and how to report their concerns internally and externally to local safeguarding authorities if there was a need for it.

Everyone told us they were happy living in Verulam House because staff were kind and all their needs were met.

People told us staff helped them re-gain or maintain their independence. Staff were kind and caring when supporting people with daily living activities.

Staff promoted people`s privacy and dignity. Care and support were delivered in a personalised way by staff who knew people`s likes, dislikes and preferences, however this was not always evidenced in care plans.

Risks to people`s well-being and health were well managed and regularly reviewed to ensure they were safe and protected from the risk of harm. Staff received training and had their competencies assessed to ensure they were skilled and knowledgeable to meet people`s needs effectively.

The environment was homely, clean and welcoming. Staff used effective infection control measures to protect people from the risk of infections. Appropriate equipment was in place where needed for people to receive support in a safe way.

People had opportunities to take part in organised group activities or pursue their hobbies and interests. Staff had a genuine interest to keep people involved and occupied.

People and relatives told us there were enough staff in the home to meet people`s needs.

Everyone we spoke with praised the management team for being approachable, supportive and placing people in the centre of the care and support they delivered.

Complaints and feedback were used in a constructive way and lessons were learned to ensure improvements were made.

The registered manager and the provider used a range of effective audits and governance systems to check the quality and safety of the care people received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People`s consent to the care and support they received was sought by staff before they delivered any care, however care plans were at times signed by relatives and some decisions were taken without involving people who were deemed to have capacity.

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 (last report published [date?]).

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.

Inspection carried out on 21 April 2016

During a routine inspection

The inspection took place on 21 and 22 April 2016 and was unannounced. The inspection team consisted of one inspector, a specialist advisor with clinical experience of this type of service and an expert by experience who also had experience of this type of service. The service is registered for 50 people and on the day of our inspection there were 45 people living at the home.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People spoke positively about the standards of care they received at Verulam House. Relatives were also happy with the standards of care and support their family members received. The home and the environment was clean and well maintained and there were no odours. Fresh flowers were used in many of the communal areas, creating a homely feel. People had been assisted with personal care and looked well-groomed with clean and appropriate clothes.

People’s bedrooms were personalised and people told us they were able to have any personal items including items of furniture in their room. We observed that people had a choice about how they spent their time and what activities, events or hobbies they wished to participate in.

People told us they felt safe living at Verulam House, and staff were able to demonstrate that they knew how to keep people safe. Staff had received training in how to safeguard people from potential abuse and were able to describe the process for reporting concerns both internally and externally if required.

Safe and effective recruitment practices were followed to help ensure that prospective staff were suitable to work in a care home environment. We saw that there were adequate numbers of staff on duty and people confirmed this to be the case. Call bells were answered in a timely way and staff responded efficiently to people’s requests for assistance.

People were given a choice or food, drinks and snacks. We observed people could choose where they ate their meals. Hot and cold snacks and healthy option snacks were available to people throughout the day. People told us they were able to discuss menus and food planning at residents meetings or through the committee.

Staff were trained to assist people with taking their medicines safely and people confirmed they received their medicines regularly. Potential risks to people’s health and well-being were assessed and where risks had been identified, remedial actions had been put in place to reduce risks. These were reviewed regularly to help keep people safe and to reduce the risk of harm or injury.

People, their relatives and commissioners were very positive about the standards of care in the home. Staff demonstrated that they had the right skills and abilities to support people appropriately. Staff were well supported and received training relevant to their roles and responsibilities. They had regular supervision with their line manager to discuss and review their performance and any development needs.

People had developed positive and caring relationships with the staff who supported them. Care and support was provided in a way that took account of their individual needs and preferences and the staff and management team knew people very well.

Staff obtained people’s consent before providing care and support to them. People and their relatives were involved in the planning, delivery and review of the care and support provided. Information held about people’s medical and personal histories was securely maintained. People had consented to the sharing of their personal information with other professionals who were involved in their care.

People told us that they felt their dignity and priv

Inspection carried out on 03 March 2015

During a routine inspection

This unannounced inspection was carried out on the 03 March 2015.

Verulam House provides accommodation and personal care for up to 50 older people. At the time of the inspection there were 42 people living in the home.

The service has 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.

The provider had effective recruitment processes in place, and there were sufficient numbers of staff employed and they were deployed effectively on a day to day basis.

People were protected from avoidable risks and staff were aware of their duty of care to the people. Staff were trained to recognise and respond to signs of abuse. Risk assessments were carried out and reviewed regularly.

There were sufficient staff on duty to ensure the safety and welfare of people. Staff were appropriately allocated to ensure a good skills mix.

Medication was administered, recorded and managed appropriately.

The staff had appropriate training, supervision and support, and they understood their roles in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

There was a variety of choices available on the menus and people were supported to have sufficient food and drinks to meet their dietary needs.

People were supported to access other health and social care professionals when required. The people were supported to continue their relationships with their family members and friends.

Staff were caring, kind and compassionate and cared for people in a manner that promoted their privacy and dignity. People told us that they felt listened to and had their views and choices respected.

People were involved in the decisions about their care and their care plans provided information on how to assist and support them in meeting their needs. The care plans were reviewed and updated regularly.

The home was managed in an inclusive manner that invited comments from people, their relatives and staff.

The home had a system in place to assess, review and evaluate the quality of service provision.

Inspection carried out on 13 February 2014

During an inspection to make sure that the improvements required had been made

We inspected Verulam Nursing home on 3rd December 2013 and found that they were not meeting the standards required for protecting people against the risks of malnourishment. We asked the provider for a plan of action and we re-inspected the provider on 13 February 2014. We found that the provider had taken steps to protect people from the risk of malnourishment. People were weighed regularly and their weights were records within their care plans and food within the kitchen was now stored correctly.

We spoke with five residents at the service. They told us that � it�s very good here� and �I wouldn�t say its 5 star food but it is 4 stars� . People said that they had a choice of food and that they were weighed regularly. If they lost or gained weight and this was not planned they were referred to the doctor and dietician for additional support. We spoke to staff at the service; they were very enthusiastic about their job. Staff we spoke with said that there was enough staff to assist over the lunch times did not feel rushed and fed people at their own pace. Staff told us that it was �a very good home� and that the �staff are nice and friendly�.

Inspection carried out on 3 December 2013

During a routine inspection

We inspected Verulam Nursing Home on 03 December 2013, we found the home to be clean and well presented. We noted that the home had a main reception area which provided people with information about the history of the home and what activities were available during the week. We also saw that there was a newsletter available at reception for people to view.

People who used the service told us that it was 'very nice' and that they enjoyed the food because it was 'home cooked' and 'not sloppy'. During the day we saw that people were free to move about the home and that staff were interacting with people in a positive way. People told us that the home had a 'good staff team' who were 'willing, polite and able'.

We found that the provider was gaining consent from people before any care was provided and that the care and support was available for people who required additional nutrition during the day. We found that the home had an infection control policy in place and that the cleaning staff followed strict guidelines to support infection control. We did however find that the provider had not been monitoring and recording people�s weight which could put people at risk of becoming malnourished.

Reports under our old system of regulation (including those from before CQC was created)