This inspection visit took place on 18th March 2015 and was unannounced.
When we last inspected the service we found breaches of legal requirements relating to the care and welfare of people who use services, requirements relating to workers and assessing and monitoring the quality of service provision. This was because we identified some issues with care delivery and a lack of social activities being organised to entertain and stimulate people. The services recruitment procedures were unsafe because required recruitment checks had not been undertaken.
The service had limited records available to show how identified problems and opportunities to change things for the better were addressed promptly. There were no procedures in place to gather information about the safety and quality of service provided. People supported were not asked for feedback about the quality of service provided. The Care Quality Commission (CQC) had not been notified of any incidents or issues relating to the home since October 2013. This meant that we did not receive all the information about the service that we should have done.
The provider responded by sending CQC an action plan of how they had addressed the breaches identified. We found the improvements the provider told us they had made had been maintained during this inspection
The New Victoria Nursing Home is situated in a residential area of Blackpool. The home is purpose built and provides care and accommodation for up to thirty people. At the time of our visit there was twenty four people who lived there. People are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single accommodation.
There was 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.
The registered manager had arrangements in place to protect people from abuse and unsafe care. The registered manager and her staff had received safeguarding training. Staff we spoke with understood their responsibilities to report any unsafe care or abusive practices. People we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, “I have no concerns about any of the staff or the care they provide me with. They are nice people.”
The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required.
Equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.
We observed staff being kind and patient when supporting people. One person requesting to go to the toilet was assisted by two staff members. We observed the person was assisted on to a stand and turn aid and safely transferred from their armchair into a wheelchair.
We looked at how the home was staffed. We found sufficient nursing and care staff levels were in place to provide the support people required. We saw the deployment of care staff throughout the day was organised. People who had been identified as being at risk from poor nutrition had a care worker allocated to assist them to eat their meals.
We saw staff members were responsive when people required assistance. Call bells were answered quickly and people in the lounge requesting help were responded to in a timely manner. A visiting relative told us they visited the home most days and always found plenty of staff on duty. They told us they never had to wait long if they wanted to speak with a staff member or request assistance for their family member.
People told us they were happy with the variety and choice of meals available to them. During the morning we observed the cook going around the home informing people about the meal choices for the day. We saw an alternative meal was offered if people wanted something different. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.
People’s care and support needs had been assessed before they moved into the home. We looked at the care records for three people receiving nursing care. We found the care plan records were informative and enabled us to identify how people were being supported with their nursing needs. The records were up to date, being kept under review and updated if a persons care needs had changed. This ensured staff supporting people with their care had appropriate information about the level of care people required.
The environment was generally well maintained when we visited. However we did notice some areas where improvements were required. These included a window in one person’s room which couldn’t be opened because it had been sealed with silicone to prevent drafts.
We found medication procedures in place were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place. People told us they received their medicines at the times they needed them.
We found recruitment procedures were safe with all appropriate checks undertaken before new staff members could commence their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.
The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. When we undertook this inspection no applications had needed to be submitted.
The registered manager used a variety of methods to assess and monitor the quality of the service. These included annual satisfaction surveys, house meetings, relatives meetings, care reviews and audits. We found people were satisfied with the service they were receiving.