10 November 2015
During a routine inspection
This inspection was undertaken on 10 December 2015, and was unannounced. The service was last inspected on 23 September 2013, at that inspection the service was compliant with all of the regulations that we assessed.
Nicholson House is situated in the east of Hull close to local shops and amenities and access to public transport. Nicholson House is registered to provide care and accommodation for a maximum of 29 older people who may have dementia.
At the time of our inspection there were twelve people living at the service and two people receiving respite care.
At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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 was purpose built to support people who were living with a physical disability, with wide doorways and corridors, overhead tracking in bedrooms and bathrooms, specialist baths and a lift to the first floor. Accommodation was provided over two floors and comprised of twenty nine single bedrooms, three bathrooms, three shower rooms, seven lounges and two dining rooms.
People who used the service had their assessed needs met by attentive and caring staff who had a good understanding of their individual requirements. We observed staff during interactions with people who used the service and found them to treat people with dignity and respect.
People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.
The CQC monitors the operation of the Deprivation of Liberty Safeguards [DoLS] which applies to care homes. The registered provider had followed the correct process to submit an application to the local authority for a DoLS where it was identified this was required to keep people safe. At the time of the inspection there had been four applications submitted and the service was waiting for assessment and approval of these.
Staff had completed a range of training pertinent to their role which enabled them to effectively meet the needs of the people who used the service. Staff told us they received regular supervision, support and professional development.
Systems were in place to manage medicines effectively. Staff who administered medicines had completed relevant training to enable them to do so safely.
We found people’s health and nutritional needs were met and saw professional advice and treatment from community services was accessed when required. People who used the service received support in a person-centred way with care plans describing their preferences for care and staff following this guidance.
Staff were recruited, trained and supported to meet people’s needs appropriately. We found there was enough staff on each shift to meet people’s needs. Staff told us they felt well supported, they could raise any concerns with the registered manager and that they were listened to. Support systems were found to be in place for staff and an open-door policy adopted by the registered manager which enabled them to raise concerns.
There was a complaints policy and procedure and people felt able to raise concerns and they would be taken seriously.
There was a quality monitoring system that consisted of audits, spot checks and surveys. When shortfalls were identified, these were addressed and people were notified of the action that had been taken.
The registered manager and registered provider were aware of their responsibilities in notifying the Care Quality Commission of incidents that affected the safety and welfare of people who used the service.
A pre admission assessment was completed, prior to anyone being offered a placement at the service. The assessment along with relevant information from the placing authority was used to develop a number of personalised support plans. Risk assessments were in place to reduce the known risks to the people who used the service.