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Archived: Donness Nursing Home Inadequate

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Inspection report

Date of Inspection: 27 September 2012
Date of Publication: 24 October 2012
Inspection Report published 24 October 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 27 September 2012, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service and talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People we spoke with who lived at the home said that their care and welfare needs were being well met.

On arriving at the home at 9.45am we saw that people were being supported to get up. The staff who were supporting them said that Donness Nursing Home was home for the people who lived there and that this should be respected.

We were told by people living at the home that staff supported them appropriately with daily living tasks, including personal care and meeting nutritional needs. During our visit we observed that staff assisted people to meet their personal needs, such as discreetly asking people and supporting them to access the toilet and meeting people’s individual nutritional needs.

We heard from people living at the home that staff spent time with people who used the service and supported them in a way they chose. Interactions between staff and people were respectful, sensitive and professional. We observed that staff took time to listen to people, and established their current needs, to help maintain their independence over the choices being made.

Care plans that we saw reflected people’s health and social care needs and demonstrated that other health and social care professionals were involved.

We specifically looked at three people’s care files, which gave detailed information about their health and social care needs. Care files were person-centred and reflected Donness Nursing Home’s ethos that people living at the home were at the heart of planning their care and support needs.

Files included personal information and identified the relevant people involved in their care. The care files were presented in an orderly, and easy to follow, format which staff could refer to when they provided care and support to ensure it was appropriate. Relevant assessments were completed and up-to-date, from initial planning through to ongoing reviews of care.

Care plans were up-to-date and were written with clear instructions. They were broken down into separate sections making it easier to find relevant information, for example, physical health and mental health needs, mobility, personal care, pain management, medication, communication and nutrition. Within daily notes there was written evidence of visits and conversations with health and social care professionals, such as GPs. These records demonstrated how others had been involved in people’s care. Additionally, care plans showed that people underwent regular reviews or in response to changing needs.

People’s individual risks were identified and the necessary risk assessments were conducted and reviewed on a monthly basis or when there was evidence of changing needs. For example we saw risk assessments for nutrition, falls, skin integrity and mobility. This demonstrated that, when staff were accessing information about a person’s needs through their risk assessments, they were able to determine how best to support them in a safe way.

We had received concerning information about the management of pain and end of life care. The information was specifically about the competence of registered nurses use of syringe drivers which are used to manage pain through the administration of analgesic medication. We spoke with the registered manager about the concerns. They explained that qualified nurses are trained in the use of manual syringe drivers but, through medical advancements, these were now digital. The registered manager informed us that staff had completed the e-learning module on digital syringe drivers, but they had not received the face to face session. They added that they had been trying to secure ‘hands on’ training for staff for 12 months. They had now managed to arrange this for 9 October 2012. The district nursing team had assisted the home recently when a person required a syringe driver to be in situ as the home’s nursing team did not have either the competency or confidence in using digitalised syringe drivers.

We saw evidence