Archived: Nevetts

Nevetts is a ‘care home’. People in care homes receive accommodation and nursing or personal 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.

Nevetts provides accommodation for up to 41 older people, some of whom live with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 32 people living there.

The service had a manager who was in the process of becoming registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People, relatives and staff felt the service was well run. There were systems in place to monitor the quality of the service and address any shortfalls. The management team worked with other agencies to improve and maintain standards.

People felt safe and were supported by staff who knew how to recognise and respond to risks. Staff were aware of fire safety but better communication in regard to individual evacuation plans was needed.

People were supported by staff who were recruited safely. However, staff told us at times that staffing had been difficult and they had depended on agency staff. People were supported by staff who were trained and had regular supervision

Medicines were managed safely and lessons learned were shared and incidents were reviewed. We found that there were effective infection control practices. The principles of the Mental Capacity Act 2005 were adhered to, people were supported to eat and drink enough and risks were monitored. There was regular access to health professionals and the design of the building suited people’s needs.

People were treated with dignity and respect. We found that staff were kind and friendly. Confidentiality was promoted and people and their relatives were involved in their care. People’s care needs were met in a way they liked and their care plans included the appropriate information to help ensure care was provided in a person centred and safe way. Where people were supported at the end of their lives, this was done with dignity and kindness. People enjoyed the activities provided. However, some people would have liked more. We found that complaints were responded to and feedback was sought.

Nevetts provides accommodation and personal care for up to 41 people older people, some of whom live with dementia. There were 38 people living at the service on the day of our inspection.

At their last inspection on 5 September 2013, they were found to be meeting the standards we inspected. At this inspection we found that they had continued to meet the standards.

There was a manager in post who had been at the service since November 2015. The manager had submitted their application to become the registered manager of the service. The previous manager had retired in December 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that the service was working in accordance with MCA and had submitted DoLS applications which some were pending an outcome.

People’s needs were met in a way that they preferred and they felt they were listened to. Staff knew how to identify and monitor risks to people’s health and welfare and respond appropriately. People had choice on how they spent their days and there were activities provided with ties to the local community. There was a good choice and variety of food and people’s health was monitored with regular contact with health and social care professionals.

People’s privacy and dignity was promoted and they were supported to maintain relationships which were important to them. Staff knew people well and they, along with the manager, had a people first approach. There were systems in place to monitor the quality of the service and address any issues that arose and there was effective leadership in the home. There were currently staff vacancies at the home but there was ongoing recruitment to try to resolve the issue. Staff were recruited through a robust recruitment procedure and received regular training and supervision.

As the purpose of this visit was to check that the provider was now compliant with these regulations, we did not request information directly from people using the service on this occasion.

During this visit 05 September 2013, we found that staffing levels had been increased and each person had received a dependency score. This ensured that people needs were being fully supported and met.

Care records provided information on how care and support needs were met by staff. We noted that daily records did not provide full details of the person's day, which would have ensured a clear picture was provided on how people's needs had been met.

Staff understood how to protect people from abuse and what to do if they suspected abuse had occurred. Complaints information was available in the hallway for people using the service and for people acting on their behalf. This made everyone aware of the process to follow in the event of them having any complaints about how the service was provided. Complaints were dealt with appropriately and well documented.

However, the number of staff on duty was not adequate to meet people's needs in a timely manner.

People said that they felt safe in the home and with staff. The Registered Manager had taken steps to reduce the risk of abuse to people and staff understood their responsibilities to report any suspicion or allegation of abuse.

Staff received appropriate training to carry out their roles. They had opportunities to talk about their work with seniors and to identify their training needs and further learning and development.