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Inspection carried out on 27 September 2018

During a routine inspection

Currergate is a ‘nursing home’. People in nursing homes receive accommodation and nursing care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. In partnership with a local NHS Trust, Currergate also provides assessment beds in which people stay on a transitional basis following discharge from hospital before moving back to their own home or onto nursing and residential care.

The home is registered to accommodate up to 38 people at any one time. On the day of the inspection there were 31 people living in the home. This included 23 permanent residents, seven people using the assessment beds and one person on a respite stay.

The inspection took place on 27 September 2018 and was unannounced. At the last inspection in October 2016 we rated the service as ‘Good’ overall, but found a breach of regulation as staff training was not kept up-to-date. Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key question ‘Is the service Effective? to at least good. At this inspection we found improvements had been made and staff training was now up-to-date.

At this inspection we found that overall the service had maintained its rating of Good. However the responsiveness of the service had deteriorated as care records were not always kept up-to-date and were not always subject to regular review. Whilst we did not identify this had a direct impact on people, it needed addressing to reduce the risk that inappropriate care would occur. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Medicines were managed safely and people received their medicines consistently as prescribed. Staff knew people well and the risks that they were exposed to. People said they felt safe and systems were in place to help protect people from abuse. Overall there were enough staff deployed to ensure safe care. Staff were recruited safely to ensure they were of suitable character to work with vulnerable people. The premises was safely managed and fit for purpose.

People said staff provided effective care and had the right skills to care for them. Staff had received a range of training which was kept up-to-date. Staff said they felt well supported. People had sufficient choice and variety of food. The service was compliant with the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). The service worked effectively with other professionals to help meet people’s healthcare needs.

Staff were kind and caring and treated people well. We saw staff turnover was low which meant people and staff got to know each other well. The service promoted people’s independence and gave people choice and control over their lives.

People’s care needs were assessed prior to admission. People, relatives and health professionals said the service provided appropriate care. Staff knew the care people needed. Some care plans needed updating and other charts such as food and fluid charts needed regular reviewing by nursing staff. This had been identified by the registered manager and a plan was in place to address. People had access to a good range of activities and social opportunities.

People, relatives and staff said the service was well managed. They said the management team was visible and approachable should they need them. The service undertook a range of audits and checks. These had been effective in identifying areas for improvement.

Inspection carried out on 3 October 2016

During a routine inspection

This inspection took place 3 October 2016. This inspection was unannounced.

Currergate Nursing Home provides care for 38 people over the age of 65. The service is split into 24 nursing care beds and 14 intermediate beds. Established as a nursing home in 1982, it was purchased by the Czajka Care Group in 2003. On the day of inspection there were 35 people living in the home.

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.

People were supported by staff who had a good understanding of how to keep them safe, identify signs of abuse and report these appropriately.

Robust processes to check the suitability of staff to work with people were in place. There were sufficient staff available to meet the needs of people and they received support to ensure people were cared for in line with their needs and preferences.

Staff training was not always completed in line with the provider’s date of expiry.

Medicines were administered, stored and ordered in a safe and effective way. Some documentation was not in place for peoples ‘as required’ medicines.

Risk assessments in place informed plans of care for people to ensure their safety and welfare, and staff had a good awareness of these. Incidents and accidents were clearly documented and investigated. Actions and learning were identified from these and shared with all staff.

People were encouraged and supported to make decisions about their care and welfare. Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. Where people were legally deprived of their liberty the service ensured their safety and appropriate guidance had been followed.

People received a wide variety of nutritious meals in line with their needs and preferences. Those who required specific dietary requirements for a health need were supported to manage these.

People's privacy and dignity was maintained and staff were caring and considerate as they supported people. Staff involved people and their relatives in the planning of their care.

Care plans in place for people reflected their identified needs and the associated risks. Plans were written in a person centred way listing peoples personal preferences.

Staff were caring and compassionate and knew people in the home very well. External health and social care professionals spoke highly of the care and support people received at the home. They were involved in the care of people and care plans reflected this.

Effective systems were in place to monitor and evaluate any concerns or complaints received and to ensure learning outcomes or improvements were identified from these. Staff encouraged people and their relatives to share their concerns and experiences with them.

The service had a good staffing structure which provided support, guidance and stability for people, staff and their relatives. Relatives spoke highly of the registered manager and all staff.

A system of audits in place at the home had identified improvements required with care plans and records in the home and these were mostly being addressed.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 18 September 2013

During a routine inspection

People told us that they were happy living at the home and satisfied with the care and support they had received. Their comments included, "It is very satisfactory here, in fact better than that, it’s good, I’m very happy here”, “staff are friendly and supportive ”, “very good here, would recommend Currergate to anybody” and “all the staff are excellent, they are very caring.”

Relatives we spoke with said that they were happy with the care their loved one received. They told us, "the care here is very good”, “we are very happy he is a resident here, we think it is the best home around, they provide good care.”

During the inspection we were able to observe people's experiences of living in the home. The interactions between people living at the home and staff were positive. We found that care and support was offered appropriately to people.

Records checked showed that before people received any care, support or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's needs were identified in care plans. Records showed that people had been involved in the care planning process.

Medication records checked were up to date and medication was stored securely.

The provider had an effective recruitment and selection procedure in place to ensure that staff were appropriately employed.

All of the people we spoke with said they had no complaints or concerns about the home.

Inspection carried out on 26 February 2013

During a routine inspection

We spoke with six of the 37 people who lived at Currergate Nursing Home. They told us that they were happy living at the service and that they received the care and support that they needed.

These are some of the things people who used the service told us: “The manager is excellent, she is very approachable." “This place is a place to put your loved one in” and “I feel safe.”

People we spoke with told us they received care that was appropriate to their needs. One person told us “The care here is second to none.”

Visitors told us they were involved in making decisions about their relatives care and treatment. They also said they were kept informed of any changes in their relatives needs. One person told us "We come every day, we can come and go as and when we want.”

People told us their room was always kept clean. One person told us “I love the view from my room”.

Staff we spoke with told us they felt supported and had the knowledge and skills to appropriately support people who lived at the home. One staff member said “I am happy here and love coming to work.”

Inspection carried out on 18 October 2011

During a routine inspection

All of the people we spoke to told us that they felt included in their care, were satisfied with the care provided by the staff and they felt comfortable at the home. People also felt safe and comfortable in speaking to staff about concerns or problems.

Reports under our old system of regulation (including those from before CQC was created)