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Ealing Manor Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 January 2019

We inspected this service on 15 and 16 November 2018. The inspection was unannounced.

At our previous inspection on the 18 September 2017 we found a breach of the regulations in Good governance. This was because not all risks were being identified and appropriately mitigated by the registered person.

Following the last inspection, the provider had completed an action plan to improve the key questions of ‘is the service safe, responsive and well-led?’ to at least good. They told us measures would be in place by 8 January 2018. During this inspection we found the measures had been put in place and there was a good standard of risk assessment with guidance for staff that was detailed and thorough about minimising the risks.

Ealing Manor Nursing Home provides nursing care for up to 33 older people and younger adults with a physical disability. It is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 32 people were living at the home.

There was an experienced registered manager 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.

During the last inspection we found that there were not sufficient activities for all people living in the home to enjoy. At this inspection we saw this had been addressed. There was evidence of varied activities and people who remained in bed had regular staff interaction throughout the day.

During this inspection we found that some records were not being kept in a robust manner for people’s ongoing safety. This was because there were not always weekly fire alarm check recordings that demonstrated the alarms had been tested and were in working order. In addition, deep cleaning of the premises were not recorded so their regularity and effectiveness could be evidenced during audits and checks.

There were some infection control and some medicines management issues that were identified during the inspection. These were addressed by the registered manager on the day of inspection.

There was a programme of redecoration and this had refreshed the look of the premises. However, some window restrictors and other implements had been removed during the redecoration work and had not been replaced. This was brought to the registered manager’s attention and they were replaced the same day.

People and their relatives described staff as caring and kind. We observed care was offered in a polite and respectful manner. People were supported to be as independent as possible by staff.

The registered manager and staff could recognise signs of abuse and reported concerns to the appropriate authorities. The registered manager held reflective meetings when errors had occurred to promote good practice and to help ensure mistakes did not reoccur.

Medicines were administered appropriately and although we identified a few minor errors the registered manager audited monthly and addressed any errors with the nursing staff.

Staffing levels were assessed by the registered manager who ensured there was a suitably skilled staff team. Staff absence was covered by known bank staff. Recruitment processes were safe as checks were undertaken to ensure staff were of good character before they were employed. Staff were provided with an induction and ongoing training to equip them to undertake their role.

The registered manager worked in line with the Mental Capacity Act 2005 and applied for authorisations to deprive people of their liberty appropriately when this was indicated and people lacked the capacity to decide about

Inspection areas

Safe

Requires improvement

Updated 16 January 2019

Some aspects of the service were not always safe.

Staff had received infection control training. We found some infection control concerns and these were addressed immediately by the provider on the day of inspection.

Medicines were administered to people in a timely manner. We found some minor recording errors that the manager said they would address.

The registered manager had undertaken an assessment of the risks to people and put measures in place to mitigate those risks identified.

The registered manager assessed staffing levels to ensure there were enough staff to meet people’s needs. Staff were recruited in a safe manner following the provider’s procedures.

The registered manager demonstrated they held group reflective sessions when there was an error or practice concern identified. They and the staff team worked together to find ways of improving the service and preventing further mistakes.

Effective

Good

Updated 16 January 2019

The service was effective.

When people required support to eat and drink this was provided appropriately by staff. People told us they enjoyed the food served and we saw staff supporting people to eat in a sensitive manner.

The registered manager undertook initial assessments to ensure they could meet people’s care needs.

The registered manager was working in line with the Mental Capacity Act 2005 to help protect people’s rights.

Staff received training and supervision to equip them to undertake their role.

Caring

Good

Updated 16 January 2019

The service was caring. People and relatives told us staff were caring and kind.

People’s care plans contained guidance for staff about how people communicated their choices.

Staff encouraged people to retain their independence and this promoted people’s self-respect.

Responsive

Good

Updated 16 January 2019

The service was responsive. People had person centred care plans that gave clear guidance for staff as to how they wanted their care provided.

People had end of life care plans and staff had received training to provide end of life care.

People and relatives told us they knew how to complain and felt any concerns would be addressed.

Well-led

Requires improvement

Updated 16 January 2019

Some aspects of the service were not always well led.

There were checks and audits in place but some weekly recordings such as fire alarm testing was erratic and it was not recorded when deep cleaning had taken place.

People, relatives and staff spoke positively about the registered manager. They found them approachable and supportive.

The registered manager met with registered managers from other providers in the area to share their learning and keep up to date with changes in health and social care.

The registered manager and staff worked in partnership with health and social care professionals and the commissioning bodies for the benefit of people using the service.