Background to this inspection
Updated
3 September 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 25 and 26 June 2015 and was unannounced. The inspection team consisted of three inspectors.
We looked at the information we held about the service and the provider. We looked at statutory notifications that the provider had sent us. Statutory notifications are reports that the provider is required by law to send to us, to inform us about incidents that have happened at the service, such as an accident or a serious injury.
We spoke with 10 people who lived at the home, and five relatives. We observed how staff supported people throughout the day. We observed staff interactions with the people who lived in the home.
We spoke with the manager, unit manager, chef and 15 staff. We also spoke to the pharmacist that supports the home. We looked at seven records about people’s care and three staff files. We also looked at staff rosters, complaint files, minutes for meetings with staff, and people who lived at the home. We looked at quality assurance audits that were completed.
Updated
3 September 2015
Court House Nursing Home provides personal and nursing care for a maximum of 60 people. The home was split into three units; two were for older people and one for younger adults. Midsummer Unit provided accommodation for 25 older people, on the day of our inspection there were 23 people living on this unit. Brecon Unit provided accommodation for 16 older people, and there were 16 people living on this unit on the day of our inspection. The third unit, Holly Bush Unit provided accommodation for 19 younger adults and there were 18 people living on this unit on the day of our inspection. On the day of our inspection there were a total of 57 people living at the home.
The inspection took place on the 25 and 26 June 2015 and was unannounced.
There was not a registered manager in post when we inspected, however the provider was taking all reasonable steps possible to remedy this. The provider was advertising the position to be filled as soon as possible. There had not been a registered manager in post since 15 January 2015. The provider had made suitable arrangements by covering the post with an experienced registered manager from another 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.
People who lived at the home and their relatives said they felt safe and staff treated them well. Relatives told us staff were kind and caring and thoughtful towards people. Staff we spoke with understood they had responsibility to take action to reduce the risk of harm for people. They demonstrated awareness and recognition of abuse and systems were in place to guide them in reporting these.
People who lived at the home were supported by staff with up to date knowledge and training. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. We saw the manager had a system to ensure there were enough trained staff on duty.
People were protected against the risks associated with medicines because the manager had appropriate arrangements in place to manage medicines. People’s preferences were taken into account and respected. We saw staff treated people with dignity and respect whilst supporting their needs.
The manager had followed the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards when assessing people’s ability to make specific decisions for most people living at the home. Applications had been submitted to the supervisory body for most of the people living at the home where their liberty was restricted. However we found that this was not universal and other people who were subject to some restrictions also needed to be referred to the local authority. This was to ensure that any decision to restrict somebody’s liberty was only made by people who had suitable authority to do so.
People had food and drink to maintain a healthy diet. We saw at mealtimes there was a relaxed atmosphere and people and their relatives told us they enjoyed the food. People were supported to eat and drink well and had access to health professionals in a timely manner.
All the visitors we spoke with told us they were made welcome by the staff in the home. People were able to see their friends and relatives as they wanted. There were no restrictions on when people could visit the home.
People and relatives knew how to raise complaints and the provider had arrangements in place so that people were listened to and action taken to make any necessary improvements.
The provider promoted a positive approach to including people’s views about their care and service development. People who lived at the home and staff were encouraged to be involved in regular meetings to share their thoughts and concerns about the quality of the service.
The provider had systems were in place to monitor and improve the quality of the service, however these systems did not always identify short falls in assessments to ensure people were not deprived of their liberty unlawfully.