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Inspection Summary


Overall summary & rating

Good

Updated 22 December 2016

The unannounced inspection took place on 10 and 11 November 2016. A previous inspection, on 22 May 2014 found that the standards we looked at were met.

Nashley House Retirement Home provides accommodation and personal care for up to 52 older people.

There was a registered manager. 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 treated with kindness and respect by staff that had made caring relationships with them. People’s views and opinions were sought toward improving the service and making their lives better. Privacy and dignity were upheld.

There was a strong emphasis on risk management and there was a low incidence of accidents as a consequence. The premises and equipment was maintained in a safe state.

Robust recruitment practice protected people from staff who might be unsafe or unsuitable to work with older people. People were protected from abuse because the staff had a good understanding of how to respond if they had any concerns and the registered manager met their responsibilities.

There were sufficient staff to meet the needs of the people using the service and some flexibility should those needs change.

Medicines were handled for people by staff that were trained and supervised to do this safely. There were measures in place to maintain those safe standards.

Staff were very happy with the level of training they received, which they said had improved. Staff received supervision of their work, a yearly appraisal and felt able to take any questions to senior staff or the management.

Staff responded quickly to any change in people’s health and involved external health care professionals where advice or treatment was required. The standard of care provided was very high. One person said, “I feel confident in the care I receive from the staff and the staff are very supportive and they take care of me“.

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions, and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. The service was upholding people’s legal rights.

People’s needs and wishes were assessed and each person had a detailed plan to inform staff how the care they required was to be delivered. People were involved in regular reviews of their care plan.

There was a broad programme of activities available for people but some people said these did not suit their interests. Activities included arts and crafts, a pantomime, quizzes and visits to local attractions. People who preferred to stay in their room were provided with one to one attention. One person said they go to the lounge where there is “company if you need it”. One male resident said they wanted more activities of interest to men. There were examples of where personal interests had been supported, including visits to a ‘do-it-yourself’ store.

People’s dietary needs were met, there were several choices of meal, but there were some negative comments about the food provided. The registered manager had regularly consulted people about the menu and the activities on offer.

People and their family members felt confident that they could take any concern or complaint to the registered manager and it would be dealt with appropriately. The registered manager said, “A complaint is an opportunity for us to learn.”

The registered manager had been in post for one year. They said the culture of the home since their arrival was “moving forwards”. In that time they had formed a strong, happy team of staff who felt the home was well-led. Many changes had been implemented, for residents, the business and premises and for supporting and valuing staff.

Inspection areas

Safe

Good

Updated 22 December 2016

The service was safe.

People were protected through safe recruitment of staff, adequate staffing levels and attention to managing individual and generic risks.

People’s medicines were handled in a safe way for them.

The premises and equipment were regularly serviced and were maintained to a safe standard.

People were safeguarded from abuse because staff know how to respond to any concerns to protect people.

There were arrangements in place should there be an unforeseen emergency.

Effective

Good

Updated 22 December 2016

The service was effective.

People received a nutritious diet, specialist dietary needs were met and there was a choice of menu but some people did not like all the food on offer.

People’s consent was sought at all times and people legal rights were upheld.

People benefitted from a staff team which was trained, supervised and well supported.

People’s health care needs were very well met because the staff were quick to identify problems and contact appropriate health care professionals.

Caring

Good

Updated 22 December 2016

The service was caring.

People’s views were sought and responded to.

A caring attitude was led from the top. People were treated with kindness, compassion and respect and their privacy was upheld.

Staff had made meaningful relationships with people.

People received a high standard of end of life care, with compassion and kindness.

Responsive

Good

Updated 22 December 2016

The service was responsive.

People’s care was planned with them in detail and delivered to a high standard.

There were many activities available for people to engage in, based on information from people using the service, but some people found these did not suit their particular interests.

People felt confident in taking any concern or complaint to the registered manager and that it would be dealt with appropriately.

Well-led

Good

Updated 22 December 2016

The service was well-led.

A culture of working to a high standard, and team work were led from the top by competent management.

People, staff and health care professionals complemented the standard of management.

There were comprehensive systems in place to monitor the standard of service and safety at the home.

A lot of improvements had been made and there were plans for continuing improvement, taking into account people’s views.

Regulatory requirements were being met.