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Archived: Abbey Court Nursing Home - West Kingsdown Inadequate

Reports


Inspection carried out on 17 December 2019

During a routine inspection

About the service

We inspected the service on 17 December 2019 and 19 December 2019.

Abbey Court Nursing Home – West Kingsdown is registered to provide accommodation, nursing and personal care for 22 older people and people who have physical adaptive needs. There were 10 people living in the service at the time of our inspection visit. Most people lived with dementia and had special communication needs.

The service was run by Abbey Health Care Limited. The company was operated by two directors one of whom was also the registered manager.

People's experience of using the service and what we found

People said they did not consistently receive care meeting their needs and expectations. A person said, “The best you can say is the staff do try hard but it’s just not organised right. It’s hit and miss if you get the help you need. I’m not happy here and I want to move.”

We found there were continuing, multiple and serious shortfalls significantly increasing the risk people would not receive safe care and treatment. Safeguarding incidents were not reported or investigated appropriately. The registered provider and staff did not recognise or respond to safeguarding incidents or follow established local procedures for reporting and investigating them.

People were not adequately protected from the risk of harm in the event of a fire due as staff did not know what they should do in the event of an emergency. Known risks to people in relation to skin integrity, how people were moved safely and choking risks were not managed well which placed people at an increased risk of harm. Poor medicines practice and recording was identified as well as a lack of robust oversight of what actions should be taken to reduce the risk of incidents and accidents re-occurring.

There was a lack of staff which impacted on the care people received and recruitment practices were poor with little or no action taken by the registered provider when concerns about staff conduct were raised. Staff did not have the appropriate knowledge, competency or skills they needed to consistently provide people with the right care. This should have been identified by the registered manager and provider.

There were continuing, multiple and serious failings in the systems and processes used to monitor the safety and quality of the service. Quality assurance systems were ineffective and had not identified the serious concerns we found. The registered provider did not fully understand the duty of candour and had not always been open and honest when things had gone wrong. Important incidents that required CQC to be notified were not completed meaning we could not be assured we could effectively monitor the service.

People had not been fully consulted about the development of the service and good team work was not promoted. These shortfalls had resulted in people not consistently receiving the high-quality care they needed and had the right to expect. There were defects in the accommodation. The provision and recording of care did not enable people to be fully supported to receive coordinated care when they moved between or used different services. The registered manager had not worked effectively with other agencies to develop the service. Suitable provision had not been made to comply with the duty of candour.

Care was not always provided in ways promoting people’s dignity and respecting their right to privacy. Staff did not always consider or uphold peoples dignity. The culture in the service was one of being ‘done to’ rather than people having genuine choice and freedom to live as individuals.

People were not always supported to safely eat and drink enough to have a balanced diet and food choices were not always available to people. People were not supported to have maximum choice and control of their lives and they were not always supported in the least restrictive way possible and in their best interests.

People did not always receive responsive, person-centred

Inspection carried out on 17 December 2018

During a routine inspection

We inspected the service on 17 December 2018. The inspection was unannounced. Abbey Court Nursing Home – West Kingsdown is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Abbey Court Nursing Home – West Kingsdown is registered to provide accommodation, nursing and personal care for 22 older people and people who have physical adaptive needs. There were 13 people living in the service at the time of our inspection visit. The service was run by a company who was the registered provider. The company was owned and operated by two directors one of whom was also the 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.

At the last comprehensive inspection on 7 November 2017 the overall rating of the service was, ‘Requires Improvement’. This was because our domains ‘responsive’ and ‘well led’ were rated as ‘Requires Improvement’. In relation to our domain ‘responsive’, nurses and care staff had not been fully supported to consistently provide people with person-centred and responsive care. This was because care plans that were intended to describe the assistance people had agreed to receive were not sufficiently detailed to guide nurses and care staff to provide care in the way people preferred. In relation to our domain ‘well led’, we found that sufficient provision had not been made to ensure that people who lived with dementia were suitably supported to pursue their hobbies and interests.

At the present inspection we found that although progress had been made more still needed to be done to address both these shortfalls.

In addition to this we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there were shortfalls in the provision made to ensure people consistently received safe care and treatment. These included oversights in the support people received to manage healthcare conditions, fire safety, the management of medicines and the prevention and control of infection. There were also shortfalls in the systems and processes used to monitor, assess and improve the quality of the service. You can see what action we have told the registered provider to take at the end of the full version of this report.

We also raised other concerns with the registered manager in relation to which we have made recommendations. These recommendations were because of shortfalls in the deployment of staff and the provision of reassurance to people who lived with dementia. They also referred to the provision of care that promoted people’s dignity and the arrangements made to support people to make and review decisions about their care.

Due to these shortfalls we have again rated the service as, 'Requires Improvement. This is the third consecutive occasion when we have rated the service as, 'Requires Improvement'.

Our other findings are as follows: Recruitment checks for two care staff had not been completed in the right way. People were safeguarded from situations in which they may experience abuse. Lessons were learned when things had gone wrong.

The accommodation was not designed, adapted and decorated to meet people’s needs and expectations. People had been supported to eat enough to have a balanced diet. Suitable arrangements were in place to obtain consent so that people only received lawful care. People receive coordinated care when they moved between different services and they had been helped to obtain any healthcare they needed.

People’s right to privac

Inspection carried out on 7 November 2017

During a routine inspection

This inspection took place on the 7 and 8 November 2017 and was unannounced.

Abbey Court Nursing Home is a large detached building with large gardens. It provides nursing care for up to 22 older people some of whom are living with dementia. At the time of the inspection there were 15 people living at the service.

The provider was also the registered manager of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the agency. 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 agency is run. The provider was supported in the day to day running of the service by a matron who had worked at the service for many years.

We last inspected the service in March 2017 and found a number of breaches of regulation. These related to management of medicines, not involving people and their loved ones in planning their care and a lack of meaningful activities. There were also concerns relating to the number of staff on duty and the safety of the premises. The provider had failed to establish effective systems to manage complaints and audit the quality of the service. They had also failed to inform the Care Quality Commission (CQC) of incidents which they were required to report. The provider sent the Care Quality Commission an action plan to address the shortfalls, with a timescale to become complaint with the regulations. At this inspection improvements had been made.

People told us they felt safe at the service. They were supported by staff who had been trained in safeguarding and who understood their responsibilities in relation to reporting any concerns. Staff had guidance about how to support people in order to keep them and others safe. Risks to people and the environment had been assessed and the plans in place to minimise risks gave staff the guidance required to keep people safe. We previously made a recommendation about the contents of risk assessments related to the management of diabetes, this had been followed and the risk assessments contained all the required information. At the last inspection people were at risk due to maintenance issues and a lack of cleanliness in the service. A programme of works was underway at the service and progress had been made. People were no longer at risk and the refurbishments had made it possible for staff to maintain cleanliness and minimise infection control risks. The refurbishment plans took into account the needs of the people at the service and making the service as accessible and comfortable as possible for them.

People’s needs were assessed prior to moving to the service and this information was used to form the basis of their care plan. People’s care plans showed what support they required and how they liked staff to meet their needs. People’s care plans included information about their wishes for end of life care. However, care plans would benefit from more detail and step by step guidance for staff to ensure care was provided consistently. At the last inspection there was a lack of meaningful activities for people, some improvements had been made. There was a part time activities co-ordinator in post; they spent time with people in the communal areas and in people’s own rooms. The provider told us there was a plan in place to continue to expand the activities on offer to people.

People were supported by staff who told us they had the training and support they needed to carry out their roles. There were enough staff on duty to keep people safe and meet their needs. Staff had been recruited safely and appropriate checks had been completed to ensure they were suitable to work with people. Staff and the provider used handovers to ensure effective communication about people’s needs and any changes staff needed to be aware of.

People’s medicines were managed safely by qua

Inspection carried out on 16 March 2017

During a routine inspection

We inspected Abbey Court Nursing Home on 16 and 17 March 2017. The inspection was unannounced. Abbey Court Nursing Home is a nursing home providing support and accommodation for up to 22 people. At the time of our inspection there were 20 people living at the service. Abbey Court is one large converted building with a purpose built extension. Support was provided over two floors.

There was a registered manager in post who was registered with the CQC. 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 our last inspection on 7 and 8 April 2016, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach was in relations to people’s records not being effectively updated to accurately reflect their current need. At this inspection, we found that the provider had not acted on this previous breach of regulation and this was a continuing breach of the Regulations.

There were not enough competently trained staff to fully support people at the service. People, relatives and staff told us there was not enough staff at the service.

The registered provider had not ensured effective medicine management systems were in place at the service. There were no protocols in place for medicines that are prescribed as and when needed. We found discrepancies in stock levels of medicines and staff were not double signing for medicines where needed.

The registered manager had not done all that was required to reduce risk. Cleaning equipment was left unattended and staff were not recording all accidents and incidents appropriately. Moving and handling risk assessments were not being updated when required.

The registered manager had not ensured that the building was well maintained. We found that an exit door required an emergency repair to make it safe and the carpets in communal areas were, in places, ripped and lifting from the floor.

The registered manager had not ensured the cleanliness of the service. There were bad odours in areas of the home, pieces of food left on the floor and the carpets required a deep clean.

The registered manager had ensured that people were safe to work with vulnerable adults. Staff files showed that people had relevant safety checks along with two references and photographic identification.

Staff could identify the forms of abuse and how they should report any suspected abuse. Staff could identify that they could contact the local authority or Care Quality Commission with any concerns.

The principles of the Mental Capacity Act 2005 (MCA) were adhered to. People were being assessed appropriately and best interests meetings took place to identify the least restrictive methods of keeping people safe. Staff had training on MCA and had good knowledge.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005.

The training provided was not completely robust as staff received moving and handling training, but we saw poor moving and handling techniques during inspection.

The registered provider took into account people’s nutritional and hydration needs. However, the registered manager had not identified all risk regarding those living with diabetes. We have made a recommendation about this in our report.

People’s records showed that there were appropriate referrals being made to health professionals. Staff were effectively managing people’s wound and pressure areas.

People and their relatives were not being consulted with the reviews of their care. People a

Inspection carried out on 7 April 2016

During a routine inspection

The inspection was carried out on 07 and 08 April 2016 by two inspectors and a specialist advisor. It was an unannounced inspection. The service provides personal and nursing care and accommodation for a maximum of 22 older people and people living with dementia. There were 19 people living there at the time of our inspection. One person was on respite for a short stay. Some people were able to communicate with us directly. Some people were not able to express themselves verbally due to their health needs.

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.

At our last inspection on 29 June 2015 the service was placed in special measures. The purpose of special measures is to ensure that providers found to be providing inadequate care significantly improve. This also provides a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

At this inspection we found the registered manager had made significant improvements to the service. They had worked with the local authority to improve standards of care and practice. We have judged the service is no longer in special measures. Whilst significant improvements have been made, there are further areas identified for improvement. We will inspect the service again within 12 months to ensure the provider has made the required improvements.

People had care plans to record the care and treatment needs. Although staff had updated evaluation records every month, people’s care plans did not always reflect people’s most current needs.

People received prescribed medicines from staff who had been trained in medicines management. However, guidelines were not in place for staff to administer people’s PRN (as required medicines) and topical medicines safely. Although we did not identify poor outcomes for people, the lack of guidelines could increase the risk of people not receiving PRN medicines in line with people’s individual guidelines. We have made recommendations about medicines management. The registered manager was responsive to making the necessary improvements.

Where the responsibility for people’s care and treatment was shared with other people to include health care professionals, one person’s review of care had not taken place in a timely way. Whilst improvements had recently been noted, we have made recommendations about improving joint working protocols.

We have made a recommendation that ‘All About Me’ documents are completed to support effective handover with external health professionals in the event people are admitted to hospital.

Staff training was renewed annually, was up to date and staff had the opportunity to receive further training specific to the needs of the people they supported. Staff completed training in dementia awareness. The registered manager had plans to develop staff knowledge and competence in dementia care practice. We have made a recommendation about dementia practice.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the last inspection in June 2015 improvements were needed to ensure people were not unlawfully deprived of their liberty and had their right to make decisions upheld. At this inspection we found improvements had been made. The registered manager understood when an application should be made and how to submit one. We have made a recommendation to further develop this practice.

At the last inspection we made a recommendation that suitable signage and environmental items of benefit for peo

Inspection carried out on 29 June 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 05 and 09 March 2015. At which four breaches of legal requirements were found. There were breaches for consent, governance, records and medicines management. We issued requirement actions in respect of these breaches. After the comprehensive inspection, the registered manager completed an action plan to meet legal requirements in relation to the breaches.

We undertook a focused inspection on the 29 June 2015 to check that the registered manager had followed their action plan and to confirm that legal requirements had been met.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Abbey Court Nursing Home – West-Kingsdown’ on our website at www.cqc.org.uk’

There were 22 people living at the service. People received nursing and personal care. Older people with physical, mental health and sensory loss needs and people living with dementia received care and treatment at the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At our focused inspection on the 29 June 2015, we found that the registered manager was following an action plan which recorded some of the actions to address shortfalls from the last inspection. Some improvements had been made since the last inspection, however not all legal requirements had been met. Breaches of regulation with regard to consent, governance and records identified at the inspection in March 2015 had not been adequately addressed. We identified two additional breaches of regulation with regard to premises and person-centred care.

Staff had received training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out processes to follow when people do not have capacity to make their own decisions and what guidelines must be followed to ensure people’s freedoms are not unlawfully restricted. However people could not be assured they were provided with care and treatment they had legally consented to. The registered manager and senior staff had not followed correct guidelines to assess people’s mental capacity. This could mean that people were unlawfully deprived of their liberty.

This is a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Some improvements had been made to the quality assurance systems, however further improvements were needed as there were still some shortfalls as identified at the previous inspection. The registered manager had not systematically reviewed and implemented the necessary improvements to the quality assurance systems. The registered manager had not acted on all breaches of regulation and recommendations made at the last inspection. The registered manager had not systematically monitored progress against their action plan to improve the quality of the service or taken appropriate action where progress was not achieved as expected.

This is a breach of regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014.

The registered manager had not made improvements to ensure environmental adjustments had been made for people living with dementia.

This is a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Premises and equipment.

The registered manager had not made improvements to provide activities suitable for people living with dementia and confusion related to other health conditions.

This is a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Person-centred care.

The registered manager failed to produce full records of personal emergency evacuation plans (PEEPs) to show how people would be supported to vacate the premises in the event of a fire. They did not send us all information as requested after the inspection and could not produce all records in a timely manner on the day of the inspection.

This is a breach of Regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014.

Improvements had been made to the management of medicines. This met the legal requirements. This ensured that people received their medicines safely and in line with their prescriptions.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special Measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.

Inspection carried out on 5 and 9 March 2015

During a routine inspection

This inspection took place on 5 and 9 March 2015. Both days of the inspection were unannounced, which meant that the provider did not know that we were coming.

Abbey Court Nursing home provides nursing care and accommodation for up to 22 people. It is a large detached building, situated in West Kingsdown. The service is provided over two floors, there are two passenger lifts. Shared areas are the lounge and dining room. 20 people were living at the service at the time of the inspection.

When we last inspected the service on 5 March 2014, we found that the service was meeting the Health and Social Care Act (Regulated Activities) Regulations 2010.

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which correspond to breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.

The provider did not have effective systems in place to regularly assess and monitor the quality of the service and identify and manage risks to the health, safety and welfare of people. People’s medicines were not always managed safely. People’s consent had not always been sought or recorded. Records were not always up to date or accurate.

The provider was the registered manager of the service. 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 was run.

People and relatives were complimentary about the service. Health and social care professionals told us staff met people’s needs well and followed through the advice they gave to them correctly. People and relatives told us people were well cared for and relatives gave us examples of people’s health and independence improving at the service. However, our own observations and the records we looked at did not always match the positive descriptions people and relatives had given us.

People were not always protected against the risks associated with the unsafe use and management of medicines.

Some people living at the service had dementia but there were no specific adaptations to the premises to meet their needs or signage to help them identify what certain rooms were for, or items to use or look at to stimulate their interest. We have made a recommendation related to activities for people living with dementia.

The provider had not made sure that people’s records maintained an accurate record of the care and treatment provided to them. Records were not always kept up to date to reflect people’s current needs. We have made a recommendation that accurate and up to date records related to risk assessments are maintained.

People had limited choice of activities and these did not meet the need for meaningful activity and stimulation for people living with dementia. We have recommended that appropriate activities are put into place.

The service was clean and staff understood how to prevent the risk of cross infection. However, wheelchairs were not cleaned frequently enough. We have recommended that a cleaning schedule is used effectively.

Some guidance was in place for staff to follow about how to support each person in the event of an emergency at the service but it was brief and required review to make sure it reflected in detail the support people would need. We have made a recommendation that this guidance is put into place and used in practice.

Staff were respectful, kind and caring and protected people’s dignity and privacy. Staff and had mostly completed all the training needed for their roles. Some staff had not completed dementia care training but this had been planned.

Staff understood how to recognise the signs of abuse and how to report suspected abuse. There were safeguarding and whistleblowing policies and procedures in place.

The provider had assessed the needs of the people living at the service and made sure there were enough staff on duty to meet them. Staff understood the ways in which people communicated. Staff had time to spend with people individually during their day.

Safe recruitment procedures made sure that staff were suitable to work with people. Staff received regular supervision and told us senior staff and the provider were supportive and approachable.

People told us they liked the meals provided and there was choice of what to eat. Meals were freshly cooked and staff supported people who needed assistance with eating at people’s own pace.

People were supported to maintain their independence. This included independence with moving around and personal care.

Inspection carried out on 5 March 2014

During an inspection looking at part of the service

Our inspection of 4 October 2013 found that there were gaps in the recording of information about people�s needs and that these included gaps in information about people�s health needs. Our inspection found that the provider did not have systems in place to make sure that staff received all their essential training or regular supervision. Our inspection also found that care and staffing records were not always being held confidentially. People�s records were not always being properly completed by staff in order to reflect their current needs.

The provider wrote to us on 15 November 2013 and told us about the action they were taking to address the non- compliance.

At this inspection we found that people�s care records had been reviewed and were up to date. We found that where people needed additional checks to be made on their health and welfare by staff these had been completed.

We found that staff were receiving the support and training that they needed for their role. However, the systems for tracking and planning training needed improvement as they did not provide up to date information to help the provider monitor and plan training.

We found that people�s records were stored securely and confidentially.

We observed that staff supported people safely and that staff were kind and caring.

Most of the people living at the service had complex needs which meant they were not able to tell us about their experiences. We spoke with two people who told us they liked the home and their rooms. We also spoke with three members of staff.

Inspection carried out on 4 October 2013

During an inspection in response to concerns

We used a number of different methods to help us understand the experiences of people using the service, because some of the people who lived there had complex needs which meant they were not able to tell us about their experiences. We spoke with five people who were living at the service and with seven members of staff.

We saw that people had care plans that reflected their individual needs. People told us they were well cared for. However, people's care records were not always kept up to date to reflect changes to their needs. One person told us they were �very comfortable here� and another that �we get looked after and there are enough staff�.

There were enough staff to provide people with the support they needed and staff told us they felt well supported. However, systems for tracking and recording training were not always effective.

People told us they liked the staff and we saw that staff were kind, patient and respectful towards people. People told us �the staff and carers are good �, �they are very patient with me� and that "there is nothing I would want to improve".

We found that care and staff records were not always kept up to date to reflect current information and that confidential information was not always stored in a way that protected people�s personal information.

Inspection carried out on 7 August 2013

During an inspection looking at part of the service

Our inspection of 7 May 2013 found that the provider had not always made sure that people were protected from the risk of infection or protected from risks due to areas of the premises being unsafe for them to use. The provider wrote to us on 7 June 2013 and told us that they had replaced old and unsafe commodes, they were in the process of obtaining quotes for the replacement of some shower room flooring and carpeting that was unsafe, and laundry cupboards were being kept locked so that people were not exposed to hot pipe work.

At this inspection we found most of the required improvements had been put into place. Written quotes had been obtained for the carpeting and flooring and the work was due to start later the same week.

We spoke with three people who used the service. They told us they were satisfied with the cleanliness of their rooms and the building in general. One person said that �the cleaning has got better, it is more thorough� and another person told us that �the bedroom is lovely and clean�.

Inspection carried out on 7 May 2013

During a routine inspection

At the time of the inspection 20 people were using the service. Some people were unable to talk to us directly due to their complex needs, so we used a number of different methods to help us understand their experiences. We spoke with five people who used the service and three relatives.

People told us they received the care and support they needed and made choices about how their care was provided. People and relatives confirmed that their needs had been assessed before they moved to the service. Some people said they were aware of their care plans and that their needs were regularly reviewed.

People and relatives said staff were kind, caring and respectful. They said �The staff are all so nice�, �They work hard� and �Some are nice and jovial�. People said staff came quickly if they used their buzzers and understood how they liked to be supported.

People said they liked the meals provided, there was choice and plenty to eat and drink. They said �Food is pretty good and �I have plenty of choices�.

People liked their rooms and said they were kept clean and tidy, if possible when they moved in they had been offered a choice of room. People in shared rooms had given their consent to sharing.

Whilst overall the service was clean, safe and hygienic. We found that people would benefit from the provision of new commodes and some improvement to the environment.

Inspection carried out on 13 April 2012

During an inspection looking at part of the service

The visit was carried out by two inspectors over two hours. During this time we talked with seven people living in the home, two relatives, and two staff. The matron and the registered manager were present for most of the visit.

We talked with people in the lounge and in their own rooms. The conversations included the following comments:

�I like it here, and feel quite settled. I enjoy the bingo, and I did some painting last weekend."

�The staff are pleasant, and it is very homely here.�

�The staff are kind and work very hard.�

�The girls are helpful and look after me well.�

�The food is always good; and they always make sure that I have the choices that I want.�

Inspection carried out on 24 November 2011

During a routine inspection

During the course of our visit we talked with nine people living in the home, and six staff.

People living in the home said that they were generally well cared for, and that staff were kind and caring.

Comments included:

�The staff are very good, very kind.�

�All the staff are very approachable, we can talk to them any time, especially Matron.�

�I�m happy here. I like to join in with things.�

Most people said that the staff attended to them in a reasonable amount of time, and one said that �the bells are answered quickly night and day.� Two others said that the bells were not always answered quickly and one said �we sometimes feel neglected.� It became apparent during our conversation with these people that they had a level of confusion, and so we were unable to know if this reflected their true feelings or not.

We viewed some recent comments on survey forms, from people living in the home and from relatives.

These comments included:

�The staff are extremely caring and gentle.�

�I am very satisfied with the care provided.�

�Any questions are responded to quickly; Matron is always available.�

�I feel a staff member should be in the lounge area most of the time.�

�I feel safe and comfortable living here.�

Reports under our old system of regulation (including those from before CQC was created)