This inspection took place on 10 May 2016 and was unannounced.
Loose Valley Nursing Home is registered to provide nursing care for up to 39 older people. Most bedrooms are for single use, but shared rooms are available. Accommodation is provided on two floors, with a passenger lift providing easy access between floors. It is situated just outside Maidstone town centre, and offers easy access to local amenities and public transport links. There is a garden to the rear of the building. At the time of our visit, there were 29 people who lived in the home. People had a variety of complex needs including communication difficulties, physical health needs and mobility difficulties.
There was a registered manager at the home. 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.
Medicines had not always been given to people as prescribed by their doctors and adequate records were not always kept.
One to one staff supervision had not been consistent. There were gaps in supervisions which showed that staff had not sometimes had supervision for six months or more. Yearly appraisals were inconsistent. We have made a recommendation about this.
There were sufficient numbers of qualified, skilled and experienced staff to meet people’s needs. However, staff felt hurried or rushed and when people requested care or support, this was not delivered quickly. We have made a recommendation about this.
Systems were in place to enable the registered manager to assess, monitor and improve the quality and safety of the service. However, some shortfalls identified in medicine management had not been identified by the registered manager.
The provider had systems in place to manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies. All of the people who were able to converse with us said that they felt safe in the home; and said that if they had any concerns they were confident these would be quickly addressed by the registered manager. Relatives felt their people were safe in the home.
Safe recruitment processes were in place. Staff files contained all of the information required under Schedule 3 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The home had risk assessments in place to identify risks that may be involved when meeting people’s needs. The risk assessments showed ways that these risks could be reduced. Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards and the home complied with these requirements.
The food menus offered variety and choice. They provided people with nutritious and a well-balanced diet. The chef prepared meals to meet people’s specialist dietary needs.
People were involved in their care planning, and that staff supported people with health care appointments and visits from health care professionals.
People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed. Staff encouraged people to make their own choices and promoted their independence.
People knew who to talk to if they had a complaint. Complaints were managed in accordance with the provider’s complaints policy.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person and their relatives. People were encouraged to take part in activities and leisure pursuits of their choice, and to go out into the community as they wished.
People spoke positively about the way the home was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the registered manager was very approachable and understanding.
During this inspection, we found breaches of regulations relating to fundamental standards of care. You can see what action we told the provider to take at the back of the full version of this report.