The Care Quality Commission
  • Care Home
  • Care home

Archived: Victoria Nursing Home

Overall: Good read more about inspection ratings

31 Kenilworth Road, Leamington Spa, Warwickshire, CV32 6JG (01926) 420688

Provided and run by:
Albemarle Rest Home Ltd

All Inspections

7 and 12 October 2015

During a routine inspection

We inspected this service on 7 and 12 October 2015. The inspection was unannounced.

We were not able to gather all the evidence we needed to make a judgement on the first day of our inspection because the provider and the registered manager were not available to speak with us. We went back on a second day to make sure they had the opportunity to tell us how they managed the service and about their plans for continuous improvements.

There was a registered manager 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.

The service provides accommodation, nursing and personal care for up to 23 older people who may be living with dementia, a physical disability or sensory impairment. On the day of our inspection, 17 people lived at the home.

The provider’s policies and procedures to minimise risks to people’s safety were shared with the staff. Staff understood their responsibilities to protect people from harm and were supported to raise any concerns. The registered manager assessed risks to people’s health and welfare and people’s care plans minimised the identified risks.

There were enough staff on duty to meet people’s needs. The registered manager checked staff’s suitability to provide care during the recruitment process.

The provider’s medicines policy included training staff and checking that people received their medicines as prescribed, to ensure people’s medicines were administered safely.

People received care from staff who had the skills and experience to meet their needs effectively. Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff until they knew people well. Staff were supported and encouraged to reflect on their practice and to develop their skills and knowledge.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had applied for a DoLS for one person to make sure they had legal authority to take the agreed actions to keep the person safe. For people with complex needs, their families and other health professionals were involved in making decisions in their best interests.

Risks to people’s nutrition were minimised because staff knew about people’s individual dietary needs. People were offered a choice of foods and were supported to eat and drink according to their needs.

Staff were attentive to people’s moods and behaviours and understood how to minimise their anxiety. People were supported to spend time with other people who lived at the home. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health and when their health needs changed.

People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed.

People and relatives told us care staff were kind and respected their privacy and dignity. They were confident any concerns would be listened to and action taken to resolve any issues.

People and relatives were encouraged to share their opinions to enable the provider to make improvements in the quality of the service. Staff were guided and supported in their practice by a management team they respected.

The provider’s quality monitoring system included regular reviews of people’s care plans and checks on equipment, medicines management and staff’s practice. The provider’s visions and values were understood and shared by the managers and staff. The focus of the service was to ensure people enjoyed the best possible outcomes from the service delivery.

Plans to improve the quality of the service included improvements to the environment to better support people with dementia and including people’s wishes for how they would like to be cared for and supported towards the end of their life.

31 July 2013

During a routine inspection

We spoke with three people who lived at Victoria Nursing Home about their experiences of the service. We also spoke with three relatives about their family member's experience. We observed the care that was given to people during our inspection. We spoke with a range of staff including the registered manager.

People and relatives we spoke with told us that the care planning was discussed with them. We saw that people or relatives were involved with the reviews of people's care. We noted that staff listened to people about their care needs and their wishes.

We found that the care plans were person centred and reflected people's individual needs. We saw the members of staff supported people as detailed within their care plans. We observed that staff were compassionate and caring when supporting people. We found that staff had involved appropriate health professionals to review their support needs and help support that person.

We noted the home was clean and there was a cleaning schedule which staff followed. We saw checks were made to review the cleanliness of the home.

We saw the provider ensured that the appropriate checks were undertaken before a new member of staff was employed. New members of staff told us about the induction plan they had completed during their employment.

We found the service was well led and had systems in place to monitor the quality of service being provided.

9 January 2013

During an inspection looking at part of the service

We used a number of different methods to help us understand the experiences of people using the service, because most of the people using the service had complex needs which meant they were not able to tell us their experiences.

We found that the management of medicines by the service had improved and people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

9 October 2012

During an inspection looking at part of the service

We used a number of different methods to help us understand the experiences of people using the service, because most of the people using the service had complex needs which meant they were not able to tell us their experiences.

We found that the management of medicines by the service needed to improve in order to ensure that people using the service received their medicines safely.

26 June 2012

During a routine inspection

When we visited Victoria Nursing Home we met with each person using the service and spoke briefly with one of the people who was able to tell us a little about their care. We met and spoke with one relative, two members of staff, the person managing the day to day delivery of care and the provider.

Most people using the service were not able to talk to us about their care because of their dementia, however when we asked them if they were comfortable they smiled and nodded. One person told us that staff were caring for them well and were kind. They told us, 'Staff have taken me outside into the garden ' it was so nice.' and 'I go downstairs for my bath, it's a nice clean bath.'

We spoke with one relative who was visiting at the time about the care provided to their family member. They told us, 'Yes I am happy with the care delivery. It is very good. Staff are very focused.' They told us they felt they would be able to talk to the manager and staff about any concern and were confident it would be looked into.

We saw people's bedrooms were clean, warm and well furnished. People had brought some personal items with them into the care home and this made their rooms "homely".

We found that staff knew people as individuals and understood their personal needs and ways of communicating those needs. We saw that people were relaxed and at ease with staff and within the home environment.

We looked at the care planning documentation for five of the people using the service to see how their care was provided and managed. We found care plan development since our inspection in March 2012 now included more information about the person. The information centred on the person's individuality, their previous lifestyle, likes and dislikes. This information was easily accessible for any new staff member and would ensure they could quickly understand the individual needs of the people they would be providing care to. We talked with staff who demonstrated they were aware of people's care and support needs.

We looked at how medication was managed for people using the service and found that improvements were needed.

22 March 2012

During a routine inspection

We visited Victoria Nursing Home on 21 and 22 March 2012 and we spoke with 10 people using the service, two relatives and six staff members.

Mostly people using the service told us they liked living at the care home and felt well cared for. One person told us, "I am very happy with the staff, they are good. I only have to ask if I want anything." Another person told us, "Staff are very caring; I can share a sense of humour with them.' Some people were not able to talk to us about their care because of their dementia, however when we asked them if they were comfortable they smiled and nodded.

Three people we spoke with told us they were not always happy with some aspects of their care, which was mainly around their not being supported to be independent with their personal care and not having much to do during the day.

We saw that people were smart in their appearance and people told us their clothing was well laundered. We saw people's bedrooms were clean and some people had brought some personal items with them into the care home and this made their rooms "homely".

We asked people about the food being served to them and did they have a choice each day. People we spoke with told us the food was good, that they enjoyed their meals, one person said, 'My salad was lovely.' The people we spoke with however told us they did not always have a choice at mealtimes, although they said that meals were always well cooked.

On the days we visited Victoria Nursing Home we saw that most people spent the day in their bedroom. Some people were to frail to come down to the lounge and three people we spoke with told us they chose not to mix with other people using the service. Some people, because of the dementia, found it difficult to communicate with others and therefore conversation between people in the lounge was limited. For those people who chose to come down to the lounge during the day we noted there was no planned activities for them to participate in on either of the days we visited and staff interaction with people was mainly at mealtimes or when providing personal care.

We asked relatives about the care provided to their family and mostly they were happy with the care their family member received. One relative told us, 'XX is well cared for and the food is good.' Another relative told us, 'Staff are welcoming, they treat people with dignity and I have not seen any poor practice.' Another relative expressed some concern however about the lack of activities for people. They said, 'Staff are never in the lounge, residents just sat in a circle and the television is too loud.'

During our visit we heard staff speaking kindly to people using the service and we observed that people appeared comfortable and at ease with staff.

Information we had received from other agencies such as the local authority raised concerns about the care people may be receiving and health and safety practices at the home. We checked out these concerns during our review and reported our findings to the agencies. We told them that although we found people's nursing care and personal care needs were being met by the home there remained some concerns regarding the provision of care for people with a diagnosis of dementia. We also reported a safeguarding concern to the local safeguarding authority for further investigation.