Archived: Netherton Green Care Home

Netherton Green Residential and Nursing Home is registered to provide accommodation and support for 120 people. The home is a purpose built building and consists of four separate single storey buildings each accommodating up to 30 older people. The four units are called Saltwell, Darby House, Windmill House and Primrose. On Windmill House, nursing care was provided to people who lived with dementia and 28 people were in occupancy. Primrose provided care for people who lived with dementia and 29 people were in occupancy. On Darby House palliative nursing care was provided and 25 people were in occupancy. Saltwell provided intermediate/rehabilitation nursing care and 30 people were in occupancy. This is a step down support unit for people discharged from hospital who were not ready to return to their own homes.

At our last inspection of July 2014 the provider was not meeting two regulations that we assessed relating infection control standards and staffing levels within Primrose unit. Improvements were also required regarding the caring approach towards people and the level of interaction from staff with people who lived with dementia, on Primrose. Following our inspection the provider sent us an action plan which highlighted the action they would take to improve. Our inspection findings confirmed that improvements had been made. However we found other areas of practice that required improvement at this inspection.

There was a registered manager in post 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.

People were kept safe from harm or potential abuse by staff who had been trained and knew how to recognise and report concerns. Information about the risks to people’s safety were communicated and equipment was in place to meet their needs safely.

There were enough staff across the different units but staff were not always effectively deployed to consistently meet people's needs.

People were cared for by staff who had been recruited safely and who had received induction and training. Additional training was needed and had been planned to ensure they met people's needs

and kept them safe. Staff felt that they were well supported.

People's rights were met under the Mental Capacity Act 2005 (MCA), and the Deprivation of

Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty, these have been authorised by the local authority. Assessments of people’s capacity and advanced decisions made by them were known.

Most people enjoyed the meals offered. Some people were not proactively given a choice because information about meals was not provided in a way they could understand. Some people did not receive the support they needed to eat and drink sufficient amounts.

People were complimentary about the staff and described them as kind and patient. However some people’s support was not sufficiently personalised to meet their needs and preferences. People’s dignity was at times compromised because staff did not always promote choice or anticipate the needs of people whose communication was limited.

People told us that they felt that activities at the service were limited. We saw the provider was taking action to improve this.

People were given information on how to make a complaint and systems were in place to manage complaints. People felt the home was well led. There was a new management structure in place. We saw quality assurance systems had improved and had picked up a number of shortfalls which the registered manager had plans to address. However we found additional areas that required improvement which demonstrate care practices and processes are not consistently embedded to ensure people receive person-centred, quality care.

Records showed that people's consent was not being recorded consistently, but people told us their verbal consent was sought before any care or treatment. One person said, "Staff do ask for my consent".

We found that the provider had a system in place to ensure people needs were identified and staff knew what people's needs were and how to support them. One relative said, "I am very happy with this home, staff and management. My relative has all the care that is needed".

The provider had system in place to ensure the home was clean and tidy, and that cross infection was managed appropriately.

The provider had a quality assurance system in place to ensure the quality of the service people received.

People told us the staff were respectful and caring towards them. People told us their privacy and dignity was maintained. Staff shared positive examples of how they provided people with choice and promoted their independence.

People said their needs were assessed and regularly reviewed with them. People told us they felt safe in the presence of the staff. One person commented, 'I feel safe with them, they are very good'. Staff had received training on protecting vulnerable adults. They were able to describe abuse and knew how to respond to ensure people were protected from the risk of harm.

People were complimentary about the staff. Staff told us they enjoyed their work and said they were, 'very' well supported. They said they had received training to keep people safe and to meet their individual needs.

People and their representatives were made aware of the complaints process. People said they felt confident in raising concerns and considered that they would be listened to.

Complaints made had been appropriately addressed.