All inspections: Neville House - Care Quality Commission

Neville House is a 'care home'. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

Neville House accommodates up to 22 older people, some of whom are living with dementia, and is situated in Chapel Allerton area of Leeds. The home is on two floors with a passenger and chair lift access to the top floor. There is a choice of single and twin-bedded rooms. The lounges, dining area, kitchen and laundry facilities are located on the ground floor. There is a garden area at the rear of the home. At the time of our inspection, 19 people were using the service.

At our last inspection in October 2015 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 on-going 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.

This inspection took place on1 and 6 February 2018. The inspection was unannounced on the first day; this meant the staff and provider did not know we would be visiting.

A registered manager was 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.

We found some improvements were needed to fully ensure the safe management of medicines. The registered manager took prompt action to ensure the concerns were addressed by the end of the inspection. We recommend that the provider keeps medicines under review to ensure the improvements made are sustained. People told us they felt safe and were supported by staff who were trained to recognise and report any signs of abuse. Risk management plans were in place to ensure people’s safe care. Staff were recruited safely and were deployed in suitable numbers to meet people’s assessed needs. The premises were in need of refurbishment in some areas. The registered manager had a plan in place to address this.

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 practice. Staff received appropriate training, supervision and appraisal to support them to carry out their roles well. People received care and treatment from a range of healthcare professionals as needed. People were encouraged to eat a healthy, balanced diet of their choice.

People were supported by caring and kind staff who understood their needs and knew their preferences. The majority of staff, including the registered manager, had worked at the service for a number of years which helped to ensure people had continuity in their care. Staff understood the importance of treating people with dignity and respect.

People or their relatives were involved in the planning of their or their family member’s care. Care plans and risk assessments were updated as people’s needs changed to ensure staff were fully aware of people’s needs. There were systems in place to ensure any concerns or complaints were responded to and acted upon. Activities based on people’s interests were available. Records needed to be improved to show how people were involved in and enjoyed activities. The registered manager introduced new documentation for this during our inspection.

Systems were in place to ensure the quality of the service could be monitored and improved. The provider took into account the views of people who used the service through satisfaction surveys and reviews. The registered manager and staff were committed and enthusiastic to providing a person centred service for people. Staff understood their roles and responsibilities and said they felt well supported by a management team who were open and approachable.

Further information is in the detailed findings below.

The inspection took place on 27 October 2015 and was unannounced. We carried out an inspection in September 2013, where we found the provider was meeting all the regulations we inspected.

Neville House is a small care home and is situated in Chapel Allerton area of Leeds. There is ample car parking and it is near to local shops, pubs and doctor's surgery. Churches of most denominations are also close by. The home is on two floors with a passenger and chair lift access to the top floor. There is a choice of single and twin-bedded rooms. The lounges, dining area, kitchen and laundry facilities are located on the ground floor. There is a garden area at the rear of the home.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). 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.

We found there were not always appropriate arrangements for the safe handling of medicines. The registered manager and deputy manager told us they would review the medication process.

People’s care and support needs were assessed and care plans identified how care and support should be delivered. People we spoke with told us they were very happy with the service they received and staff were kind and caring, treated them with dignity and respected their choices.

People who used the service told us they felt safe with the staff and the care and support they were provided with.

We found there were systems in place to protect people from risk of harm and appropriate recruitment procedures were in place. There were policies and procedures in place in relation to the Mental Capacity Act 2005. The care plans contained a record of decisions people were able to make and the ones they needed support with.

People were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. We found people were cared for, or supported by, appropriately trained staff. Staff received support to help them understand how to deliver appropriate care. People told us they got the support they needed with meals and healthcare.

The service had good management and leadership. Systems were in place to monitor the quality and safety of service provision and we found there were appropriate systems in place for the management of complaints.

We observed people were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection. One relative we spoke with told us, 'It always seems very clean and it smells nice.'

Before people received any care, support or treatment they were routinely asked for their consent. Members of staff told us they always explained all procedures and treatments. People had contributed their preferences and their experiences were taken into account in relation to how care and support was delivered. One person told us, 'I can choose what I want to do each day.' Another person told us, 'I can make my own decisions within reason.'

People had detailed care plans relating to all aspects of their care needs. They contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. We spoke with four people who used the service and they told us they were happy with the care, support and treatment they received. One person told us, 'I have been happy here.' Another person told us, 'It's cheerful and staff look after me well.'

The people we spoke with told us they had no concerns with the cleanliness of the home. However, we found that appropriate standards of cleanliness were not being maintained in some areas of the home.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work. This included carrying out a Disclosure and Barring Service check and obtaining written references.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. This provided an overview of the quality of the services provided.

People told us they were happy with the care provided and were involved with their care and support needs. Everyone we spoke with told us their dignity was respected and confidentiality was maintained. One person told us, 'Staff are very good, they always ask me what I want to do' and 'My thoughts and views have been taken into account.'

We spoke to ten people who used the service and everyone told us they were satisfied with the care they received. One person said, 'I'm happy with the help I get from the staff.' Another person said, 'Everything is sound. Staff are very helpful and nothing is too much trouble.' Another person said, 'I have medical needs and they do everything they can to make sure I get all I need.'

People who used the service told us there were enough staff working at the home and they didn't have to wait long if they wanted support. People said they received care at appropriate times. One person said, 'I get help from staff when I want it, there is never a problem.' Another person said, 'There is plenty of staff around. I spend most of my time in my room and they always keep an eye on me.'

We asked people who used the service about being involved in making decisions about their care. Four people talked to us about this. Two people said they had been involved but two said they hadn't been involved although one of these people said their relative made decisions on their behalf.

Some people who used the service were not happy with the laundry service because sometimes people were given other people's clothes and items often went missing. One person said, 'The laundry is dreadful but it has improved. Clothing goes missing for weeks and I get other people's clothes in my wardrobe.'

We spoke with four visitors who told us they were relatives of people who used the service and had visited on a frequent basis. Every visitor was complimentary about the staff and said they had only seen good care practices. One visitor said, 'The staff are tremendous.' Another visitor said, 'Every time I come Dad says he's happy. He has a great relationship with all the staff. It's given him a new lease of life.'

Although we were told people's views and experiences were usually taken into account other evidence showed that people's rights were not always respected. For example, staff had introduced behaviour charts for some people who used the service but they had not been made aware of these. It was unclear why they were introduced. People's care plans or risk assessments did not refer to the charts.

People using the service told us staff are good at explaining any changes to their care, treatment and support. They also told us that they were pleased with the standard of care and support provided and staff were approachable and listened to what they had to say.

People using the service said they would have no hesitation in talking to the manager or staff if they wanted to talk about their care. They also told us they were very happy with the care and support provided by staff and staff were kind, considerate and caring and always showed them respect.

During the visit we saw that staff interacted well with people living at the home and the atmosphere throughout the day was warm and friendly.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Neville House

All Inspections

1 February 2018

During a routine inspection

27 October 2015

During a routine inspection

9 September 2013

During an inspection looking at part of the service

23 July 2013

During a routine inspection

22 January 2013

During an inspection looking at part of the service

25 June 2012

During an inspection in response to concerns

7 February 2012

During a routine inspection

Reports under our old system of regulation