West Eaton Nursing Home

We found the following examples of good practice.

¿ People were supported to keep in touch with others who were important to them in a variety of ways. This helped to reduce people's social isolation during the pandemic.

¿ There was sufficient space within the building for people to socially distance to keep themselves and others safe during the pandemic. Meal times were also staggered to promote and encourage social distancing.

¿ Staff followed current guidance to facilitate safe visits to the home by professionals.

¿ ‘Whole home’ Covid-19 testing was undertaken in line with current guidance to prevent the transmission of infection. Workmen who were refurbishing part of the home during our visit were also tested.

¿ The registered manager had delivered creative infection prevention training sessions to staff using specialist equipment to demonstrate to effective handwashing. The training had helped staff to better understand how Covid-19 could spread and the importance of effective handwashing to prevent this.

Further information is in the detailed findings below.

People’s experience of using this service:

• People told us West Eaton Nursing Home was a good place to live and they had developed close bonds with the staff who cared for them.

• Staff spoke respectfully about the people they cared for and supported people to maintain their independence and dignity.

• People were involved in decisions about their care. Where people needed help to make their own choices, staff supported them to do this.

• There were enough staff to meet people’s safety needs, but people told us there were busy periods when they occasionally had to wait for staff assistance. The manager provided assurances they would check the deployment of staff, so people would continue to have their preferences met.

• Staff knew people’s individual safety risks and understood how to recognise the signs of abuse. Staff were confident if they raised any concerns these would be promptly addressed.

• People were supported to have the medicines they needed to remain well, and people’s medicines were administered as prescribed.

• Staff acted to reduce the likelihood of people experiencing infections by using equipment provided to do this.

• The views of people, their relatives and other health and social care professionals were considered when people’s needs were assessed, and their care plans developed. This helped to ensure people’s care was provided in the ways they preferred.

• Staff were supported to develop the skills and knowledge they needed to provide good care to people living at the home.

• People enjoyed their mealtime experiences, which were based on their own choices and were supported to have enough to eat and drink, so they would remain well.

• Staff reviewed people’s health needs regularly and adjusted the care they needed as people’s health needs changed. People were supported to see other health and social care professionals when needed, to ensure their health and well-being would be promoted.

• 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.

• Staff understood what was important to people and how they enjoyed spending their time. Staff supported people to go on enjoyable trips out, and to benefit from visits from local voluntary organisations and schools. Opportunities for people to continue to express their faith were available. The activities arranged enhanced people’s sense of well-being and quality of life.

• Concerns and complaints were addressed, and systems were in place to take any learning from these and accidents and incidents, and to drive through improvements in people’s care.

• Staff gave us examples of the sensitive care provided to people at the end of their lives, so people’s wishes would be met.

• The manager and provider checked the quality of the care provided. Where areas had been highlighted for further development action plans were put in place.

• The provider and manager reflected on feedback received and used this information to develop people’s experience of care further.

• We found the service met the characteristics of “Good” overall.

Rating at last inspection: Good. The last report for West Eaton Nursing Home was published on 22 October 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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

The inspection took place on 13 and 27 July 2016 and was unannounced.

At the time of our inspection there was 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.

People and their relatives we spoke with felt people were safe living at the care home. Staff who worked at the home were knowledge about how to keep people safe and were aware of the action they would need to take in the event of abusive practice taking place.

The atmosphere in the home was calm and people were seen to be relaxed and at ease with members of staff. There was laughter and friendly banter between people and staff members. Staff were seen to be kind and caring towards people. People felt their privacy and dignity was maintained by staff members and staff were able to give examples how they achieved this.

There were sufficient staff on duty to support people in their personal and social care needs. We saw people participating in events within the home or engaged in their own personal hobbies and interests. Staff received training and support from the management to enable them to have the skills and knowledge needed to care for people.

People had access to healthcare professionals and their medicines were administered by nursing staff in a safe way. People enjoyed the food and were assisted as needed to maintain their nutritional requirements. Staff were aware of people’s individual likes and dislikes.

Staff consulted with people before they provided any care or support. Where people were needed support with making decisions this was done in their best interests. Staff were aware of people’s needs and of recent changes in people’s care. The registered manager was aware care plans and risk assessments were in need of updating.

The registered manager and the deputy manager were knowledgeable about people’s care needs and were known to people who lived at the home. Regular checks and audits were carried out by the registered manager and others to monitor the quality of the care provided. Action plans were devised and suitable action taken to make improvements where required.

Relatives were confident they could raise any concerns they may have about the care of their family member and believed they would be listened to.

' 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?

The people who lived in the home and their relatives were pleased with the care provided and felt that their views were respected and listened to.

The people told us they were kept safe and were listened to. We saw that people were free to go about their daily routine as they wished. One person told us, 'The staff are very caring'. Another person said, 'It's beautiful here'.

Recruitment processes showed that staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home.

The registered manager and the staff we spoke with understood the importance of safeguarding vulnerable adults, could identify potential abuse and knew how to report any incidents of abuse.

Staff understood about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how they would be put this into practice. No DoLs applications had been submitted or were in place at the time of this inspection.

Is the service effective?

People told us that they were happy with the care they received. They told us that the registered manager and staff had asked them what their needs were and how they would like them met. A relative said, 'Mum is well looked after.' Another relative said, 'They keep people as active as they can'.

Care records confirmed people's preferences and needs had been recorded and care and support had been provided in accordance with people's wishes. One person said, 'I'm waited on hand and foot.'

People and their relatives were involved in the assessment of their needs and one person said, 'We talk about how mum likes things done and they do their best to accommodate'.

People and their relatives told us they were happy to discuss their personal preferences with staff. They said that staff monitored them and obtained medical help for them if they were unwell. We saw how the service had referred a number of people to health professionals when their health had deteriorated. This meant people were supported to maintain good health, have access to health care services and received ongoing support.

Is the service caring?

The people we talked with told us they felt that their wishes were respected and they were helped to live their lives as they wished. Staff took the time to find out people's personal social histories. Staff we spoke with knew people's needs well and how they wished to be cared for. This meant that staff cared about the person as an individual and showed concerned about their well-being.

People and their relatives were encouraged to make their views known about their care. People that we talked with told us that they found the registered manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People's needs had been assessed before they moved into the home so that arrangements could be made to meet them.

People and their relatives told us they regularly talked with the staff about what was important to them. They had talked about such things as the time they got up in the morning and how they liked their food prepared. They told us that staff had changed their care routines as a result.

Records confirmed people's preferences, interests, wishes and needs had been recorded.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well led?

The registered manager and the staff demonstrated values that included involvement, compassion, dignity, respect and independence. Staff we spoke with showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as they were able.

Concerns were listened to. The service hadn't received any complaints but people told us they would, 'Go straight to the manager' if they were unhappy.

The provider had systems in place to assess and monitor the home so that potential improvements in meeting people's care needs could be identified and put into place.

People told us that they were happy at the home. One person said, "It couldn't be any better than it is" and another told us, "I do like it here, they look after us so well".

Staff were careful to make sure that people were able to make decisions for themselves whenever possible. If people were unable to make informed decisions, staff knew how the law protected people and made sure that decisions were taken in each person's best interests.

The home was clean and hygienic, and staff used personal protective equipment, such as gloves and aprons, whenever necessary.

Medicines were managed safely, and there was an effective system in place to monitor the management of medication.

There were effective systems in place to monitor the quality of the service. People living at the home were asked for their views about the service. The manager used all this information to make improvements so that the home provided the care and support that people needed.

We saw people offered choices about how they spent their time. Staff were polite, helpful and provided personal care in a way that respected people's privacy.

Most of the care records gave staff clear and detailed information about people and guidance for staff on how to meet people's needs. People said that they were "well looked after" and said staff were "kind and helpful". People also told us that staff were very busy and they had to wait for care. People were left alone in communal areas without staff supervision or support for long periods of the day.

People were provided with a varied menu to suit their needs.

Systems were in place to protect people from the risk of abuse and support people to raise any concerns or complaints.

Measures were not in place to prevent the spread of healthcare associated infections.

People were able to personalise their bedrooms and bring in their own possessions. Some areas of the home needed attention to make sure that a good standard of environment was provided. Health and safety was taken seriously and the home's equipment such as the lift and fire equipment were serviced and maintained.