Solent Cliffs Nursing Home Limited

Solent Cliff's is nursing home registered to provide personal and nursing care for up to 40 older people who may be living with dementia. At the time of our inspection 33 people were using the service.

People’s experience of using this service and what we found

We could not be assured people always received the correct dosage of medicine. Medicine was not always stored safely.

The provider had assessed people's needs; however, risk was not always explored sufficiently with regards to skin care and swallowing difficulties.

We could not be assured the culture within the home was always inclusive and dignified.

Staff were knowledgeable about abuse and were confident any concerns were investigated and dealt with properly.

Staff were sufficiently deployed to meet people's needs at all times and relatives and people told us staff were trained appropriately.

The provider had effective measures in place to reduce the possibility or spread of infection.

Relative's, people and staff were complimentary about the leadership in the home and told us any concerns were dealt with in good time.

The registered manager had implemented effective governance systems which highlighted areas of improvement that were required. Some of the issues we identified during our inspection were known and recorded by the registered manager. They had already started taking action to address the concerns.

The provider had effective systems in place for monitoring accidents and incidents and action was taken to drive improvement.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Why we inspected

We received concerns in relation to the management of medicines, leadership, culture of care and safety. We were also advised staff did not share important information with external organisations including relatives. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We carried out an unannounced comprehensive inspection of this service on 26 November 2018 and published the report on 22 January 2019.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed. We have identified a breach in relation to the management of medicines at this inspection. Please see the action we have told the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Solent Cliffs Nursing Home on our website at www.cqc.org.uk.

•At our last inspection in August 2016, the provider was found to be in breach of Regulation 18 (Failure to notify). At this inspection, we found improvements had been made and all notifiable events were being reported to the Care Quality Commission (CQC).

•The provider supported staff to provide effective care for people through person-centred care planning, training and supervision. They ensured the provision of best practice guidance and support met people's individual needs.

•People participated in a range of activities that met their individual choices and preferences. Staff understood the importance of this for people and provided the structured support people required. This enabled people to achieve positive outcomes and promoted a good quality of life.

•The service met the characteristics of Good in all areas.

•More information is in the full report.

Rating at last inspection: The service was last rated Good, last report published 19 August 2016.

About the service: Solent Cliffs is a care home that was providing personal and nursing care to 31 people at the time of the inspection.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found improvements had been made in Well Led since our last inspection and the service had met the characteristics of Good in all areas. The inspection was also prompted in part by notification an incident following which a person using the service sustained an injury. The information shared with CQC about the incident indicated potential concerns with moving and handling. We checked this in looking at the quality and safety of the service. Information of concern had also been shared with the Commission regarding the provision of end of life care and person-centred care. We looked into these concerns as part of the inspection process.

Solent Cliffs Nursing Home Limited is registered to provide accommodation, personal care and nursing care for up to 40 older people and people living with a physical disability. At the time of our inspection the home was fully occupied. People had a variety of nursing needs, including some with very complex needs, and some who were receiving end of life care.

Accommodation was on two floors. There were three shared rooms. One was occupied by a couple. Shared areas included a sensory room, dining room, conservatory and a quiet lounge. There were facilities for people and their visitors to make hot drinks in the sensory room.

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.

The provider had arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely. Recruitment processes were in place to make sure the provider only employed workers who were suitable to work in a care setting. There were arrangements in place to store medicines safely and administer them safely and in accordance with people’s preferences.

Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their needs. Staff were aware of and put into practice the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People were supported to eat and drink enough to maintain their health and welfare. People were supported to access healthcare services, such as GPs and specialist nurses.

Care workers had developed caring relationships with people they supported. People were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people’s independence, privacy and dignity.

Care and support were based on assessments and plans which took into account people’s abilities, needs and preferences. People were able to take part in leisure activities which reflected their interests. People were kept aware of the provider’s complaints procedure, and complaints were managed in a professional manner.

The home had a warm, welcoming atmosphere. Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided.

We have made a recommendation about making sure information in people’s care records is complete and consistent.

People who lived at Solent Cliffs Nursing Homes and their relatives told us that they were happy living at the home. They told us that staff always sought their agreement before providing care and support.

Individualised care plans detailed the support and care each person required. People confirmed they received the support and care they needed and liked. The home ensured relevant health care professionals were contacted when needed.

Medication practices at the home meant people were protected against the risks associated with medicines. People who lived at the home were protected from the risk of poor health because infection control practices were followed. The environment of the home was maintained to an adequate and safe standard.

The number and skill mix of staff employed at the home meant that people's needs were met.

The quality of the service provided was monitored by an effective quality assurance processes.