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Inspection Summary


Overall summary & rating

Good

Updated 19 July 2016

We undertook an unannounced inspection on 21 June 2016. At our previous inspection on 21 August 2014 the service was meeting the regulations inspected.

Nower house is a non for profit charitable service. They provide accommodation and support for up to 50 adults, some of whom have dementia. At the time of our inspection 44 people were using the service. Nower house is split into two units – Woodcote and Newra. Generally people stayed on their own units, but they were able to mix if they wished to and to participate in activities.

The service had a registered manager. However, they were on annual leave during our inspection. The rest of the management team ensured the service was adequately managed whilst they were on leave. 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 received their medicines as prescribed. However, some of the medicines management processes were not robust and we recommend that the provider reviews their practice in line with good practice guidance for managing medicines in care homes.

People were happy staying at the service and enjoyed the interactions they had with each other and the staff. Staff were knowledgeable about the support people required and provided them with this. However, we identified that one person’s care records did not accurately reflect the support people required or what was delivered.

People were supported to have their health needs met and staff liaised with healthcare professionals as required. Staff accompanied people to hospital appointments if people wanted them to.

Staff supported and encouraged people to manage their nutritional needs. Staff were aware of people’s dietary requirements and supported them appropriately, this included supporting people to put on weight when required and helping those who required a diabetic diet.

Staff treated people with kindness and respect. Staff were patient and polite when supporting people, and respected their decisions. People were given choice about how they spent their time and how they were supported. Staff adhered to the Mental Capacity Act 2005 and best interests decisions were made for people who were unable to make decisions for themselves.

Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff were supported by senior staff members and received regular supervision. Knowledge and competency checks were undertaken to ensure staff retained the information they received on training courses.

Staff, people and their relatives were able to feedback their views on the quality of the service. This was achieved through regular meetings, the use of suggestion boxes and completion of satisfaction surveys. A process was in place to acknowledge, investigate and respond to complaints.

Checks were undertaken on the quality of the service. This included regular visits by a board member. Where improvements were required, actions were taken to address these. Systems were in place to record and respond to incidents that occurred, and a member of the management team ensured that notifications of all serious incidents were made to the Care Quality Commission, as required by their registration.

Inspection areas

Safe

Requires improvement

Updated 19 July 2016

Some areas of the service were not safe. People received their medicines as prescribed. However, some practices in relation to medicines management were not in line with recognised good practice.

There were sufficient staff on duty to meet people’s needs. Staff were aware of the risks to people’s safety and supported them to minimise those risks, using equipment where appropriate. Staff were knowledgeable about what to do if they had concerns a person was being harmed or abused and the associated reporting procedures to ensure the person was protected.

Staff followed good practice to protect people from the spread of infection.

Effective

Good

Updated 19 July 2016

The service was effective. Staff had the knowledge and skills to meet people’s needs. Staff were appropriately supported by senior members of staff in their roles and received regular training and supervision.

Staff were aware of and adhered to the Mental Capacity Act 2005. Staff ensured they obtained people’s consent before providing care, and if people were unable to do this, care was delivered in the person’s best interests.

People received support with their dietary requirements and were able to access healthcare professionals when needed.

Caring

Good

Updated 19 July 2016

The service was caring. Staff had built positive caring relationships with people. Staff were kind and considerate, and treated people with respect.

People were involved in decisions about their care and how they spent their time. Staff supported and encouraged people to build friendships at the service, but respected their decision if they wanted to spend time in the privacy of their room. Staff supported people to maintain their dignity.

Responsive

Good

Updated 19 July 2016

The service was responsive. People enjoyed staying at the service and felt it met their needs. Staff were knowledgeable about the support people required, however, we found for one person this was not reflected in detail in their care records.

There were a range of activities on offer which provided opportunities for group and one to one stimulation. Activities were held at the service and there were opportunities for people to participate in activities in the local community.

People were aware of how to make a complaint and suggestions about service delivery. Any complaints made were investigated and promptly responded to.

Well-led

Good

Updated 19 July 2016

The service was well-led. There was clear management and leadership at the service. Staff were aware of their responsibilities and received support from their seniors as and when needed.

Staff, people and relatives were able to feedback about the service. This was obtained through meetings, and completion of satisfaction surveys.

Processes were in place to review the quality of service delivery, and where required action was taken to make improvements.