We inspected this service on 11 November 2015. The inspection was unannounced. Henry Nihill House is registered to provide accommodation and nursing care for up to thirty people, some of whom have dementia, physical disabilities and mental health needs. The service consists of three units split over two floors. At the time of our inspection there were twenty nine people living at the service.
The service is located in a purpose built block, on two floors with access to a front and back garden area. The service adjoins the Anglican convent owned by the Community of St Mary at the Cross. The service offers accommodation and care to people of all or no faiths.
We previously inspected the service on 21 March 2014 when the service was found to be meeting the regulations.
Henry Nihill House has a registered manager at the service. 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 inspection there was a calm and pleasant atmosphere. People using the service informed us that they felt safe living at Henry Nihill House.
All the people we talked with confirmed they were treated with dignity and respect, and we observed good quality interactions between staff and people using the service.
Care records including risk assessments and care plans were up to date and detailed. People were supported to maintain good health by the nursing staff at the home and through regular access to community healthcare professionals such as GPs and local hospital services.
People had their medicines managed safely. People received their medicines as prescribed and on time. Nursing staff ensured safe storage and management of medicines.
Staff had been carefully recruited and provided with training to enable them to care effectively for people. Supervision took place regularly and in different formats including observing the giving of care to people who used the service. Staff felt supported and there was always a nurse on duty.
People told us the management was a visible presence within the home. Staff talked positively about their jobs telling us they enjoyed their work and felt valued. The staff we met were caring, kind and compassionate.
Staff knew how to recognise and report any concerns or allegations of abuse and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
We saw there were enough staff to meet people's needs, although we have suggested the registered manager obtains further feedback from people using the service in relation to levels of support for care at night.
People were offered a range of activities to participate in at the home and increasingly community links were being developed. The registered manager has the financial agreement to increase staffing for leisure activities and this will be of benefit to people living at the service.
People’s religious needs were actively facilitated by staff, and staff were able to tell us how they responded to people’s cultural needs. The home prided itself on good quality end of life care and we saw that staff were able to respond well to the needs of a person receiving palliative care.
We found the premises were clean and tidy. Measures were in place for infection control. There was a record of essential inspections and maintenance carried out. The building was fully accessible and maintained to a good standard.
The registered manager was in the process of further rationalising care records relating to people using the service to ensure they were easy to read, were succinct and up to date.
The home had arrangements in place for quality assurance. Regular audits and checks had been carried out by the registered manager. It was apparent that management support at a senior level within the organisation had not been as available to the service over the last six to nine months. This had impacted on quality assurance and affected the quality of the service.
We found the provider was in breach of the standard relating to the good governance of the service.
You can see what action we told the provider to take at the back of the full version of the report.