Churchfields Nursing Home

Churchfields Nursing Home supports people aged 65 or over, some of whom have dementia care or mental health needs. It is registered to accommodate and support up to 32 people. At the time of the inspection, 26 people were living at the home. The home has three floors with adapted facilities and en-suite rooms.

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

We found improvements had been made in the home following our last inspection. Risk assessments for people were more thorough and detailed to protect them from coming to harm. Risks such as those related to people’s health conditions and mobility were monitored and managed so staff could support them safely. Medicines for people were managed and administered safely. Safeguarding processes were in place to protect people from the risk of abuse.

The provider recruited staff appropriately and checked they were of suitable character to support people. There were enough staff working in the home. Systems were in place to prevent and control infections. Lessons were learned following accidents and incidents in the home.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to achieve positive outcomes. They received care and support that was personalised for their needs.

People took part in activities, followed their interests and were supported to see their family and friends. We made a recommendation for the provider to look into improving the range of activities because we found some people had little to do during the day.

Systems were in place to manage and respond to complaints. People’s communication needs were met. Feedback was sought from people and relatives to help make continuous improvements to the home.

The provider and management team carried out quality audits to ensure the home was compliant with health and social care regulations and to identify areas for improvement. The management team learned lessons when things went wrong in the home. People’s dignity, privacy and human rights were respected at all times. Their equality characteristics were understood and respected.

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

Rating at last inspection

The last rating for the service was Requires Improvement, (published on 22 January 2022) and there were breaches of regulations.

We issued requirement notices to the provider for breaches of regulation 12 (Safe care and treatment) and regulation 17 (Good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Churchfields Nursing Home on our website at www.cqc.org.uk

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 30 November 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements, and the Key Question of Responsive.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Churchfield Nursing Home is a residential nursing home providing accommodation and personal care to 31 people, at the time of the inspection. The service is a three-floor building. Each floor has separate adapted facilities.

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

Risk assessments were not completed for people with certain health conditions to ensure they were safe at all times.

Pre-admission assessments were not robust to ensure people’s support needs were captured to determine if people can be supported in a person-centred way. We made a recommendation in this area.

Not all areas of the care plans were person centred. Care plans were not in place for people with dementia to ensure they received personalised support.

Quality assurance systems were not robust to identify the shortfalls we found during the inspection.

Some complaints had not been managed in a timely manner and the tone of language used when responding to some complaints would require a more courteous approach. We made a recommendation in this area.

Systems were in place to prevent and minimise the spread of infections. Medicines were being managed safely. Pre-employment checks had been carried out to ensure staff were suitable to support people. People told us they felt safe at the home and staff were aware of how to safeguard people from abuse. There were appropriate numbers of staff to support people when required.

Staff were trained to perform their roles effectively. People had choices during mealtimes and had access to healthcare services. People were supported to have maximum choice and control of their lives and were being supported in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.

People participated in regular activities and their communication needs were met. Staff had a good relationship with staff and were friendly and caring.

People received care from staff who were caring and had a good relationship with them. People were encouraged to be independent and to carry out tasks without support.

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

Rating at last inspection

The last rating for this service was good (report published 30 August 2019).

We also carried out a targeted inspection in January 2021 to respond to risks and check on the home’s infection prevention and control measures. This inspection did not change the home’s ‘good’ rating

Why we inspected

We carried out this inspection following a routine review of information we held about this service. Our intelligence indicated that that there may be a higher level of risk at this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk assessments and good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Churchfield Nursing Home is a residential care home providing personal and nursing care to 23 people at the time of the inspection. Most people living at the service were older people some of whom had dementia. The service can support up to 32 people.

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

Since our last inspection, improvements had been made with premises’ safety. Actions had been completed to ensure the building was safe in the event of a fire, new flooring was being laid and the lighting was switched on throughout the home.

Risk assessments had also been completed for people at risk of falls and malnutrition in addition to people’s health conditions. This included control measures, referral to professionals when required and monitoring the risks. People’s nutrition and hydration risks were recorded appropriately, and staff followed care plans and health professional’s advice.

Infection control procedures had been enhanced due to the risk of COVID-19 and we observed the service was clean and a cleaning schedule was in place. Personal protective equipment (PPE) was readily available and people and staff were tested regularly to help prevent the spread of infection.

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

Rating at last inspection

The last rating for this service was good (published 30 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the management of falls and nutrition and hydration. This inspection examined those risks. We found no evidence during this inspection that people were at risk of harm from this concern. We also looked at infection prevention and control measures. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively. Please look at the Safe question of this part of the report.

The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Churchfields Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Churchfields Nursing Home is a residential care home providing personal and nursing care to 31 people, aged 65 and over at the time of the inspection. The service can support up to 32 people.

People’s experience of using this service

The home was not fully protected against the risk of fire and the provider was in the process of making improvements to ensure facilities and equipment were fire safe. The home itself was not well lit and many lights were switched off during the day, making some areas dark and potentially unsafe. We have made a recommendation for the provider to look at guidance on suitable lighting in care home settings.

People told us they felt safe in the home. Procedures to protect people from abuse were in place. Risks associated with people’s needs were assessed and staff understood how to reduce these risks. People were supported with their medicines, which were stored, recorded and managed suitably. Staff followed infection control procedures. Accidents and incidents were analysed and learned from to prevent reoccurrence.

There were enough staff on duty in the home. Staff were recruited safely and their backgrounds checked before they started working in the home. They were supported with training and development to ensure their skills and knowledge were up to date. We have made a recommendation for the provider to refer to reputable sources for guidance on helping staff develop their skills and understanding of people’s specific health conditions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported with maintaining their health. Appointments were made with health care professionals, such as GPs and speech and language therapists. People could choose their meals and were supported to maintain a balanced diet that was suitable to their needs and preferences.

Staff were respectful and caring towards people. They understood the importance of promoting equality and independence. People's dignity and privacy were maintained by staff.

Care plans were personalised and people were encouraged to maintain their independence. Staff communicated with people well but some people felt staff did not fully understand them and we have made a recommendation about overcoming language barriers between staff and people. People were supported to engage in activities and entertainment within the home. People were supported to make complaints or report any concerns they had. The home supported people with end of life care and their wishes were met by staff.

Staff felt supported by the management team. Quality assurance systems included obtaining feedback from people and relatives. The registered manager and representatives of the provider carried out checks to ensure staff were providing a good standard of care and the home was safe. They learned lessons when things had gone wrong to help make improvements to the home.

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

Rating at last inspection

The last rating for this service was Good (report published 13 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

At this inspection, we found that the service had a registered manager in place. 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.

At this inspection we also found that staff had attended training in the MCA and DoLS. At this inspection, we found that improvements had been made to the systems, to ensure that people received care and support in line with the MCA and DoLS.

Churchfields Nursing Home is registered to provide accommodation and nursing care for up to 32 older people, some of whom are living with dementia. At the time of this inspection, 28 people were using the service. Accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. There are 31 single bedrooms and one double room, which two people can choose to share.

Staff understood their responsibilities to protect the people in their care. They were knowledgeable about how to protect people from abuse and from other risks to their health and welfare.

Medicines were managed and handled safely. Arrangements were in place to keep people safe in the event of an emergency. There were sufficient staff to meet people’s needs. Staff were attentive, respectful, patient and interacted well with people. People told us that they were happy and felt well cared for. Risk assessments were in place about how to support people in a safe manner.

Staff undertook training and told us that they received supervision to support them to carry out their roles effectively. Staff training records showed they had attended a variety of training.

People were supported to maintain good health. They had access to health care services when it was needed. People received a nutritionally balanced diet to maintain their health and wellbeing.

People’s needs were assessed before they moved in to the home. Care plans were person centred and were regularly reviewed. Care plans were updated when people’s needs changed.

The provider had systems in place to monitor the service provided and people were asked for their feedback about the quality of service provided.

On this visit we found that changes had been made. Records showed that the provider had undertaken all the required checks before staff started work. People were supported by staff who were suitably qualified, skilled and experienced.

People were accommodated in an environment that was appropriately maintained and suitable for their needs. Specialised equipment was available to assist people with mobility difficulties and equipment and services were serviced regularly and checked to ensure that they were in good working order and safe to use.

We found that there were not always enough qualified, skilled and experienced staff to meet people's needs and this placed people at risk of receiving an unsafe or inappropriate service.