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Nower House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 August 2019

About the service;

Nower House is a care home providing accommodation and personal care for up to 50 older people with a wide range of care needs. At the time of our inspection 46 people were using the service. Nower House is one large house which is split into two sections called Woodcote and Newra.

The building is laid out over two floors, with two large lounges and two large dining areas on the ground floor. One smaller lounge, two TV rooms, a conservatory and a lift for people to use.

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

We found there was a lack of risk assessments for people and their ongoing care needs. Nobody had risk assessments in place for things such as requiring a hoist, falls, moving and handling, risks relating to pressure damage and MUST (malnutrition universal screening tool) and other health concerns.

Medicines were not managed and administered safely. We found shortfalls with the processes in place to account for how much medicines were in the home. We also found people had the wrong amount of medicines stored for them and staff were unable to account for these errors. We raised this with the nominated individual who addressed this immediately..

People who were receiving end of life care did not have a person-centred end of life care plan in place. We raised this with the nominated individual and have signposted the service to linking in with local hospices with a view to developing end of life plans with people.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People did not have decision specific capacity assessments or detailed best interest decisions.

Although several audits existed they had not picked up the errors that we noticed during the inspection with regards to medicines, consent to care and risk assessments.

People told us they felt safe and protected from harm and abuse. Staff were confident about identifying potential abuse and actions they would take if abuse was witnessed or suspected.

Staff did know the people they cared for well and were able to demonstrate detailed knowledge of peoples’ needs which lowered the risk around people not having risk assessments.

People told us staff were caring. We observed caring interactions between staff and people during our inspection. Although people were not always aware of what a care plan was, they told us they were involved with making decisions about their care. People told us they were treated with dignity and respect. Relatives also told us that they found staff to be caring and kind.

People were supported to express their views through residents’ forums which were reviewed by the service to identify areas for improvement. We received positive comments from staff about the registered manager. Staff told us they worked together as a team to achieve good outcomes for people.

Staff received training relevant to their roles. People were supported to eat and drink and provided with a variety of food choices at mealtimes. Staff worked well with external healthcare professionals to ensure good outcomes for people. People's needs were met by the home environment. Staff ensured consent was gained before providing care.

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

The last rating for this service was good (published 19th July 2016. There were no previous breaches from the last inspection.

Why we inspected;

We inspected this service in line with our inspection schedule for services currently rated ‘Good’.

We have identified breaches in relation to the safe management of medicines, safe care and treatment, need for consent, person centred care and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up:

Inspection areas

Safe

Requires improvement

Updated 21 August 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 21 August 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 21 August 2019

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 21 August 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 21 August 2019

The service was not always well-led.

Details are in our well-led findings below.