Archived: Ellesmere Community Nursing Home

Ellesmere Community Nursing Home provides nursing and personal care for up to 9 people. Prior to this inspection the provider had made the decision close Ellesmere Community Nursing Home. As a result people were in the process of moving to alternative accommodation and care provision. It was on day one of this inspection that we were informed of the imminent home closure. At the end of day two of this inspection three people were living there.

A registered manager was in post and present throughout this inspection. 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 were kept safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns. People were supported by enough staff to meet their needs and who responded to them promptly.

The provider followed safe recruitment procedures when employing new staff members. People were assisted with their medicines safely by staff who were deemed competent to do so.

The provider had infection prevention and control systems in place including staff link persons and cleaning schedules.

People were supported to have enough to eat and drink to maintain health. People were supported by a kind and respectful staff team. Staff members knew those they supported well and respected their privacy and dignity. People were encouraged to be as independent as they felt able to be.

People received care from staff that had the skills and knowledge to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to the people they supported and any additional training needed to meet people’s needs was provided.

People took part in social activities they found enjoyable and stimulating. People had access to facilities in their local community including areas of interest, shops and health care facilities.

People were involved in the development of their care and support plans which were individual to them. People received care from staff members who knew their individual likes and dislikes and histories. People and their relatives were encouraged to raise any issues or concerns. The management team had systems in place to address any concerns or complaints.

People had regular contact with the registered manager whom they found approachable. The provider had systems in place to monitor the quality of support given and to make changes when needed.

People’s rights were maintained by staff members who were aware of current guidance and legislation directing their work. People were involved in decisions about their care and had information they needed in a way they understood.

Staff received support and guidance from a management team who they found approachable. People and staff felt able to express their views and felt their opinions mattered.

Ellesmere Community Nursing Home provides accommodation and personal care with nursing for up to nine older people. There were nine people accommodated at the time of the inspection. There is a registered manager in post. 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.

A system was not in place to monitor the overall quality of service delivery. The provider acted on any issues as they arose with people on an individual basis. This was acknowledged by the registered manager who agreed to address this. The registered manager developed staff to embrace ‘extended roles’ within the service to give them more responsibility and enhance the service provision.

People who lived at the home felt safe and secure with the staff that supported them. People had been assessed before moving to the home so they knew what they needed help with. Care records contained details of people’s preferences, interests, likes and dislikes.

Staffing levels and the skill mix of staff were sufficient to meet the needs of people and to keep them safe. Staff recruitment followed procedure with required checks completed for new staff.

Medicines were stored and administered safely. Nursing staff dealt with one person at a time in the home to minimise risks associated with this process. Nurses had received training updates to ensure they were confident and competent to assist people with their medicines.

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were available between meals to ensure people received enough to eat and drink.

People were encouraged and supported to maintain relationships with their friends and family members. Relatives and visitors were always made welcome when they visited their loved ones.

The care plans were centred on people’s healthcare needs and gave staff direction to provide effective care. People were confident that their care was provided in the way they wanted.

Staff provided some group activities and there were opportunities for social stimulation from visiting entertainers and a complimentary therapist. The registered manager acknowledged that they could do more to meet individual preferences for people in addition to providing group activities.

The provider had regular surveys in place to obtain the views of people who received a service. The registered manager spoke with people individually on a daily basis to seek their views about their care.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. Care plans identified people's needs and were reviewed regularly. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. Risk assessments were in place and control measures identified. One person said, 'I have a call bell, the staff come quickly when I call it'. This meant that people's needs were met and people were kept safe.

The home had systems in place in relation to people consenting to the care and treatment provided. Where people lacked capacity decisions were made in their best interests. However, we were not able to see a documented procedure for Mental Capacity Act and Deprivation of Liberty Safeguards. Staff received ongoing training in the Mental Capacity Act and Deprivation of Liberty safeguards. This meant that systems were in place to safeguard people as required.

People were protected against the risks associated with medicine because the provider had appropriate arrangements in place to manage medicines. Only staff that had been trained administered medication. One person told us they preferred staff to sort out their medicine.

Robust recruitment procedures were in place. New staff underwent an induction and shadowed other staff. We saw that legal checks and Disclosure and Barring Service (DBS) checks were made. This meant that people received care and support from staff who were competent and of good integrity.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People experienced care, and support that met their needs. People were encouraged to remain as independent as possible and to participate in activities and outings Equipment such as plate guards and mobility aids were available to help people retain their independence. This meant that people's needs were met.

People who were able to could move around the home freely and safely. Regular audits and checks took place. We saw that issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People told us they were supported by kind and friendly staff. We saw that support workers showed patience and gave encouragement when supporting people. We saw people responded positively to staff. People we spoke with told us the staff were kind and caring.

Life story books were being developed. These gave details of people's preferences, likes, dislikes and diverse needs. People were involved in their day to day care and were supported to maintain relationships that were important to them. One person said, 'The vicar comes to give me Holy Communion, this is very important to me'. We saw that people's diversity and individuality were promoted and respected.

Is the service responsive?

We saw staff responded quickly to meet people's needs and ensured people's safety was maintained. For example, we saw staff respond quickly to call bells. We saw that people were supported to express their views and these were acted on. People had the opportunity to engage in activities both in the home and within the community.

People were aware of the complaints process but no complaints had been made. This was confirmed by people we spoke with.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles and felt their views were listened too. A new member of staff said, 'I knew the home was well run'. One person we spoke with said, 'Yes I think it is well led, it is run by a committee'.

The service had a quality assurance system. Trustees conducted regular quality audits. We saw that recommendations made were acted on. This meant the quality of the service was continually improving.

People were cared for in a clean, hygienic environment. Staff had received training to reduce the risk of cross infection.

The service was well-organised and there were sufficient staff to care for people's individual assessed needs.

The complaints process was accessible to people and their representatives. People told us they had not had cause to complain. They were confident they would be listened to if they raised any concerns.