Background to this inspection
Updated
2 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by one inspector.
Service and service type
North Shore is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we held about the service. We sought feedback from the local authority commissioning team. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected North Shore and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke about North Shore with three relatives, four staff and the registered manager. We walked around the building to carry out a visual check. We did this to ensure North Shore was clean, hygienic and a safe place for people to live.
We looked at records related to the management of the service. We did this to ensure the provider had oversight of the home, responded to any concerns and led North Shore in ongoing improvements. We checked care records and looked at infection control protocols, leadership and quality oversight.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed the home’s auditing records.
Updated
2 June 2021
North Shore provides nursing care and support for a maximum of 25 people who live with dementia and/or a physical disability. At the time of our inspection there were 25 people living at the home. North Shore is situated in a residential area of Blackpool close to the promenade. There are three floors with 23 single rooms and a double room, of which sixteen are en-suite. There are on-site gardens and several communal areas for the use of people who live at the home.
North Shore is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.
A registered manager was 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.
At the last inspection on 20 October 2015, the service was rated Good. At this inspection, we found the service had improved to Outstanding.
During this inspection, a relative told us, “The place is perfect. It demonstrates high quality care and should be used as an example to other homes.” We found the provider accessed systems, tools and partnerships known to benefit the person’s welfare and treatment. Care delivery centred on excellent communication systems and highly detailed records about each person. A wide range of models were utilised and reviewed to ensure people received the best possible support. We saw multiple examples where this enhanced their lives and optimised their welfare.
The registered manager was proactive in ensuring people accessed healthcare services quickly. Their pioneering techniques greatly improved people’s lives because they assisted staff to implement treatment before problems deteriorated.
The management team had exceptional procedures for the preparation of meals, delivery of nutritional support and monitoring of associated needs. For example, food moulds and observational review of staff support greatly improved people’s nutrition intake and enjoyment of their meals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. We found for each area of people’s support staff completed additional decision-specific, individual deprivation of liberty care plans. Staff maintained up-to-the-minute documentation to assure they continuously met the person’s changing capacity and support requirements.
The registered manager had an exceptional initiative for training and to assist staff to apply their learning in practice. They used team meetings, handovers, supervision and group discussions to follow training up with observation, question and answer sessions, competency testing and role-play. The review of staff skills assisted them to provide remarkable support for people who lived with dementia. A relative told us they were highly reassured by this and said, “I know the staff are well trained because there’s a list up on the wall of the courses they have to attend.”
We observed the provider deployed very high staffing levels and skill mixes at the home to deliver care that flowed smoothly and effortlessly. People and their relatives said this was very reassuring because it meant staff had time to provide compassionate, dignified care. The registered manager had implemented a ‘Dignity Challenge Initiative.’ The project focused on how staff should provide dignified support that improved people’s self-confidence and independence.
Staff had a very good grasp of the Human Rights Act 1998 and implemented this in their work. They had relevant training and demonstrated an in-depth awareness of inclusion, discrimination, diversity and prejudice. We found staff continuously kept people and their representatives fully informed and involved, which helped them to take ownership of their treatment. One relative said, “Every time I come in [the management team] give me an update and talk with me about my [relative’s] care plan.”
End of life care ethos at the home was one of exceptional dedication, compassion and empathy, reinforced with technical expertise. Staff frequently evaluated care documents to ensure they were updated to people’s changing wishes and health to optimise their end of life experiences.
The provider’s high staffing levels enabled staff to provide activities for long periods throughout the day. Staff had training and role-play to assist them to better understand people’s interests. Relatives we spoke with said they felt this was an outstanding part of care delivery.
The registered manager had staff, people and visitors at the heart of their continuous improvement drive. This meant developments were quickly embedded and more successful because everyone was involved. People and their relatives told us North Shore had strong leadership.
The management team promoted an authentic culture of transparency at North Shore through extensive quality assurance audits and feedback systems. We found multiple examples where people’s lives had drastically improved because the home’s management focused heavily on their welfare and safety.
We noted the registered manager followed safe recruitment procedures to ensure suitable staff were employed to work with vulnerable adults. A relative commented, “The manager seems to recruit staff based on how compassionate they are.”
Each person had a detailed medication care plan to guide staff to their associated support requirements. We observed medicines were administered safely, patiently and with a very caring approach.
When we discussed safeguarding with staff, we found they understood their responsibility to protect vulnerable adults from abuse and poor practice. Care records we looked at held detailed risk assessments to support staff to maintain their safety. People, staff and visitors experienced a clean and tidy environment.