Inglewood Nursing Home

Inglewood Nursing Home is a residential care home providing regulated activities personal and nursing care up to 60 people. The service provides support to people who were living with a range of health care needs. Some people had memory loss associated with their age and physical health conditions. At the time of our inspection there were 50 people using the service.

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

Improvements were needed for some aspects of record keeping. We discussed this with the registered manager and senior managers from the provider and they told us what actions they would take to address this.

There were systems in place to keep people safe and protected from the risk of harm and abuse. Staff were aware of the risks associated with people they supported. There were risk assessments to guide staff. Medicines were managed safely by staff who had received the appropriate training. There were enough staff, who had been recruited appropriately to support people. The home was clean and tidy throughout.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a positive culture at the home. People, relatives and staff spoke well of the home. They were regularly asked for feedback to improve and develop the home for the benefit of people living there. The registered manager had good oversight of the home and knew people and staff well. There was a quality assurance system which helped identify areas to improve and develop.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 13 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There were systems in place to ensure people received safe care and support during a Covid-19 outbreak. These were in line with government guidance. People who had tested positive to Covid-19 were supported to remain in their rooms. They were cared for by a dedicated team of staff. This helped to reduce the risk of the spread of infection.

Due to frailty associated with their age and health some people chose to remain in their bedrooms. A number of people spent time in the lounge. They were socially distanced but remained close enough to engage with each other as a group.

The home was clean and tidy throughout. There were cleaning schedules and this included high touch point cleaning. There were adequate supplies of Personal Protective Equipment (PPE) and staff were seen to use this appropriately.

Visitors were welcomed to the home; they were able to meet with loved ones in their bedrooms or in a lounge area. This allowed them time together in private. There was an appointment system to ensure visits could be managed safely. People were also supported to maintain contact with family and friends through regular phone and video calls.

There was a registered manager at the home. 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.’

Improvements were needed to ensure the service was consistently meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Quality assurance systems were in place but these had not identified some areas that needed to be improved in relation to people’s records, and documentation in relation to people’s mental capacity. We made a recommendation about this. Other areas for improvement had been identified and work was taking place to address these.

Staff knew people really well. They had a good understanding of each person’s needs and choices. They could tell us about people’s personal histories including their spiritual and cultural wishes. Each person was treated as an individual and their choices and rights were respected and upheld. People were supported to make their own choices about what they did throughout the day.

People were supported by staff who were kind and caring. Staff knew people well and had good relationships with them. Staff maintained people's privacy and dignity. They understood the importance of confidentiality. Relatives were able to visit at any time, and were made to feel welcome.

There were enough staff, who had been safely recruited, working to ensure people’s needs and preferences could be met. Staff had received the training they needed to support people and deliver care in a way that responded to people's changing needs.

People were looked after safely. Staff had a good understanding of the risks associated with the people they looked after. Staff understood the procedures in place to safeguard people from the risk of abuse and discrimination.

People were supported to eat and drink a variety of food. They were provided with a choice of freshly cooked meals and drinks each day. People’s health was monitored and staff responded when health needs changed. People were supported to attend healthcare appointments and were referred to external healthcare professionals when needed.

There were systems in place to ensure medicines were ordered, stored administered and disposed of safely. There was a complaints policy and people told us they were able to discuss any concerns with the registered manager or staff.

There was an open and friendly culture at the home. The registered manager was well thought of by people, visitors and staff. She worked hard to include people and staff in decisions about the home, and was committed to improving and developing the service.

This unannounced focused inspection on the 21 March 2017 was to look specifically at the ‘Responsive’ question and we found that that they had now met the breach of regulation previously found.

At the last inspection in August 2015 we found the ‘responsive’ question required improvement. This was because documentation was not always appropriately completed. There was minimal evidence in people’s care plans of their views on how they would like to receive their care and support. Preferences and choices were not well recorded.

We received an action plan from the provider that told us how they were to meet the breach of regulation by November 2015.

At this inspection we found that improvements had been made to all areas of documentation to ensure they were person centred, accurate and up to date and the provider was now meeting the regulation. Care documentation was stored on a computerised system with summaries printed off and kept in care folders in people’s rooms. Information was documented clearly with reference to people’s preferences included throughout.

People had been involved in the assessment and review of their care. This had been done in conjunction with families or Next of Kin if appropriate. Changes to care documentation were printed off and people were given the opportunity to read and sign changes if they chose.

Inglewood had designated activity coordinators. People had access to regular activities provided in house or by visiting entertainers. We received positive feedback regarding the activities. People told us they enjoyed attending and also liked the interaction with other people.

People were given a copy of the complaints procedure and this was also displayed around the home. The registered manager had a robust system in place to demonstrate that any issues including minor concerns had been documented and addressed in a timely manner. Records were kept of email and letters sent and information recorded to show how a complaint had been resolved.

We used a number of different methods to help us understand the experiences of people using the service. Not everyone who lived in the home was able to tell us about their experiences. Those who could told us, 'I am involved in all decisions. It is a good place, it's clean and the staff are good.' We were also told 'activities are good and varied, there's always something to do.'

We spoke to relatives and visitors. One relative who visited the home regularly told us 'I am happy with the care provided here, they keep me informed when something changes.'

During our inspection we found that people had been involved in decisions about their care, and chose how they spent their time.

Care plans were personalised, and documented the needs of people living in the home. We saw that risk assessments had been completed when required.

Staff had attended safeguarding training and were able to demonstrate a good understanding around recognising and reporting concerns.

Staff received regular supervision, and annual appraisals. We spoke with staff who told us they felt supported by their colleagues and appointee manager.

Inglewood Nursing Home had a complaints policy and procedure in place. Copies of this were available in the main reception. We spoke to a relative who told us they felt able to raise concerns with the appointee manager when they needed to.

One person spoken with was at Inglewood for a period of respite, they told us 'Staff are polite and seem nice, if you ring the bell it gets answered quite quickly.' A relative spoken with told us they had no concerns and were very happy with the care provided.

During our inspection we found that care and treatment was being provided to meet people's needs. The design and layout of the home was suitable for carrying out the regulated activities, and systems were in place to maintain appropriate standards of cleanliness and maintenance. The provider had effective measures in place to regularly assess and monitor the quality of service provided.