Cholwell House Nursing Home

We found the following examples of good practice.

All staff used the appropriate Personal Protective Equipment (PPE) in line with current government guidance. Staff changed into and out of their uniform in the workplace to minimise the spread of infection.

Staff had received training on the signs, symptoms and management of COVID-19. Training to don and doff PPE had been completed by all staff. PPE stations were located throughout the home.

There was an infection control policy and contingency plan in place that had been updated as guidance had changed. We found the home to be clean with regular cleaning taking place throughout the day.

There was a clear process for visitors; the environment for visitors followed national guidance for visitors to care homes. Families were able to book a visiting slot and followed a process which included a temperature check and the wearing of PPE. They were required to take a lateral flow COVID-19 test with a negative result before entering. Full PPE was also worn. Protective screens were available to facilitate some pre-booked visits. Seating areas were available outside if people preferred to be outdoors. The provider had created a well-ventilated visiting area with access from outside, so visitors didn’t need to walk through the home. However, at the time of our visit, external work was being done which meant visitors had to walk through to the visiting area.

People were able to access tablet devices from the home to partake in video calls if they wished. The registered manager and staff communicated regularly with the families of people living in the home. The provider had installed an additional telephone line, so families had a dedicated line to speak with their loved ones. For people who were receiving end of life care their loved ones were able to visit.

Social distancing measures were in place to protect people. Lounge chairs were distanced from each other.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

The home continued to ensure people were safe. There were enough suitable staff to meet people’s needs. Risk assessments were carried out to enable people to stay safe and receive care with minimum risk to themselves or others. People received their medicines safely. People were protected from abuse because staff understood how to keep them safe, including more senior staff understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.

People continued to receive effective care. People who lacked capacity had decisions made in line with current legislation. Staff received training to ensure they had the skills and knowledge required to effectively support people. People told us, and we saw, their healthcare needs were met. People were supported to eat and drink according to their likes and dislikes. People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

The home continued to provide a caring service to people. People and their relatives told us, and we observed that staff were kind and patient. People’s privacy and dignity was respected by staff and their cultural or religious needs were valued. People or their relatives were involved in decisions about the care and support they received. People’s choices were respected and staff encouraged choice for those who struggled to communicate with them.

The home remained responsive to people’s individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Some records needed to be improved; however the registered manager was aware of this. People were supported to follow activity programmes. These considered people’s hobbies and interests and reflected people’s preferences. People knew how to complain and there were a range of opportunities for them to raise concerns with the registered manager and designated staff.

The home was well led. People, their relatives and staff spoke very highly about the management and told us they felt the service was outstanding. Staff were highly valued and appreciated and morale was very high. Staff told us they were very well supported and the management went out of their way to help. The registered manager continually monitored the quality of the service and made improvements in accordance with people’s changing needs.

Further information is in the detailed findings below.

We saw that people who used the service had their dignity maintained and that their care was planned and reviewed as their needs changed.

One relative told us "I feel 110% confident that my wife is safe and happy here" and a member of staff told us "I love working here, it's like being part of a big family".

We saw procedures that were in place to protect vulnerable people from abuse, and we spoke to staff who confirmed that they had been trained and regularly updated on how to identify and report safeguarding issues.

We saw that staff had been trained in infection control procedures and that people were protected from the risk of the spread of infection. We saw evidence that staff received regular support to perform their role and that they all had regular appraisals.

We saw how the manager monitored the quality of service provided to people and relatives told us they felt happy to speak to anyone if they had any concerns about any aspect of their relative's care.

People told us that they were assessed before they came to live at Cholwell Nursing Home.They said they were involved with developing their care and support plan and that staff treated them kindly and politely. For example one person said 'I am happy here I have no complaints'. Another person said 'I am happy this place is perfect for what I wanted'.

We saw the provider had a policy on safeguarding people from abuse. The staff had attended training to ensure people who lived in home were protected from the risk of abuse.

We found staff were trained and supported to deliver care to an appropriate standard.

We saw people were protected from the risk of spread of infection. Staff followed the infection procedures and received appropriate training.

We found the provider had an effective system in place to regularly monitor the quality of service that people received.

We spoke with two relatives who all spoke positively about the support their relatives received. Comments included, "the staff are all good with my relative' and 'I wouldn't let my relative come here if I didn't have the confidence in the home. People with dementia need to be treated as friends rather than patients and that is what is happening here'.