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Inspection report

Date of Inspection: 17 March and 9 June 2011
Date of Publication: 19 August 2011
Inspection Report published 19 August 2011 PDF | 189.29 KB

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Overview

Inspection carried out on 17 March and 9 June 2011

During a routine inspection

When we asked people living at the home what they thought of it, their comments included ‘Great’, and ‘I love it here. It’s nice, and the people are nice [staff and fellow residents]’. A care manager who supported people living at the home told us they had ‘everything positive to say about the nursing home’, as in their opinion it had a most responsive, professional team of staff who were very good communicators, honest, and flexible.

People felt listened to, and that they were given choices about their daily care. One person told us ‘They always ask you what you think.’ Music was playing in a lounge, and people there confirmed they had been asked about this.

Where people had mental capacity, their decisions were respected even when they were potentially putting themselves at risk of harm. Staff tried to help them make informed decisions. The relative of someone who had cognitive impairment told us that they were invited to the person’s next care plan review. Care records did not show how decisions about individuals’ lack of mental capacity had been reached, however.

Staff knocked on bedroom doors and paused before entering, which people living at the home told us was usual practice. They felt their dignity was upheld; one person added ‘The carers are so nice and patient. They have unpleasant jobs to do and they never seem to worry.’

Some people told us that church services were held regularly at the home, and that they had enjoyed the home’s recent fete, to which the local community had been invited. One person told us that the staff posted letters for them, so they could keep in touch with family and friends.

There was a care plan for each person. One person did not recall seeing theirs but said they were happy with the care they received, adding ‘There’s no rigid routine here.’ People did not have any concerns about the service’s handling of information about them.

Some people were cared for in bed during our visit. We noted that photos, flowers and other items were placed in their sight. They looked comfortable and as though their personal care needs had been attended to. A visitor told us that they always found their relative looking comfortable.

People with mobility needs confirmed that staff assisted them gently and didn’t rush them, with medication for pain given promptly if they requested it. They felt there were sufficient aids and adaptations to help them remain safely independent where possible.

They indicated that staff were watchful of their health, as did other people. Someone had an intermittent medical condition that required immediate attention at times, and they told us they received good support from staff at such times. Although people living at the home were satisfied with how staff managed their medications, we found there was not always sufficient information or guidance for staff to ensure they would manage people’s medicines appropriately.

People’s comments about the food included ‘Very good’, and ‘I get a good choice and there’s usually something I like…I mean, definitely like and not just something I will eat.’ Someone felt there were too many non-English dishes on the menu, but knew that alternatives were available. Those who ate in their rooms told us that their meals were sufficiently hot when delivered to them.

People living at the home and visitors felt the home was kept sufficiently clean. They confirmed that staff wore disposable aprons and gloves when helping them with personal care. Information in people’s bedrooms included information on infection control measures.

People were satisfied with the facilities in their bedroom, including lighting for reading in the evenings. Some people particularly appreciated the views from their rooms, as they could see the sea.

Some people discussed that the care home was without an Activities Co-ordinator at present. Staff provided some recreational activities, such as hand massage and manicures, with entertainment by visiting musicians particularly enjoyed.

One person, when asked about the staff, told us ‘You can have a laugh and a joke with them...’ People praised certain staff for their care, approach, and willingness to listen. We asked people if they felt safe with staff and they said they did. One added that they were a nervous person but staff understood them. Two people independently told us that they wouldn’t like it if they had to move to another home.

There was a committed staff team who received training and supervision to provide safe care and treatment, although some staff lacked skills or knowledge to appropriately support people with more diverse needs.

People thought there were enough staff around, and confirmed that if they wished to talk to senior staff this was easily arranged. We asked people if they felt able to make a complaint. One said they did, adding ‘I’m able to say what I like to them.’ Another said they hadn’t needed to complain, because the home ‘dealt with the small things’.

Two people told us they would speak to the director, who ‘was on the end of the phone’.

People were also positive about the home care service. A relative who supported someone receiving a service, when summarising their overall view of this service and the support it had provided to their family, told us the manager was responsive, and the service was ‘FANTASTIC - in capital letters’.

There was evidence in people’s records that they had been consulted when senior staff had carried out assessments of their needs and written their care plan. The views of relatives and others supporting people using the service were also taken into account, particularly when people did not have mental capacity. Care records did not show how decisions about individuals’ lack of mental capacity had been reached, however.

People felt they were given enough choice in their daily lives, and that staff supported them in making decisions for themselves. Care records reflected discussions with individuals to resolve any issues or concerns and agree on the support to be provided. They had an opportunity to share if they had legally appointed someone to represent them, or if they had an advance directive.

People were happy with the support they received, and confirmed that staff were observant of their general health and mood, noticing if they were ‘under the weather’ and so on. Someone required the use of equipment to meet their mobility needs, and they were satisfied with how staff assisted them in this. Those who needed support regarding meals were also satisfied with how this was provided. There was a risk that people who required support for their medication needs might not receive this in a safe way because there was not always sufficient information for staff to ensure they manage people’s medicines appropriately.

When we asked people about measures taken by staff to prevent cross-infection, they told us that each staff member had a holdall in which they carried supplies of disposable gloves and aprons which they used at people’s homes.

Everyone we spoke with felt staff upheld people’s privacy and dignity, with one person saying about the staff member that assisted them, ‘I wasn’t looking forward to anyone helping me with a bath, but her manner is so good…’ People confirmed that staff did not talk about other people that they supported, nor did they talk about their own lives. One person added ‘They seem to like to listen to you talk.’ Read the full inspection report (PDF)