Archived: The Village Nursing & Care Home @ Murton

The Village Nursing & Care Home @ Murton provides personal and nursing care to a maximum of 40 people some of whom are living with a dementia. At the time of the inspection there were 37 people who used the service.

This inspection took place on 9 November 2017. The inspection was unannounced, which meant that the staff and provider did not know we would be visiting. At the last inspection of the service on 30 September 2015, we rated the service as Good. At this inspection the service remained Good.

The service had 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place.

Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. In general medicines were managed safely with an effective system in place. However, we did note some areas in need of improvement and the registered manager wrote to us after the inspection confirming these improvements had been made.

Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

People and relatives told us there were suitable numbers of staff on duty to ensure people’s needs were met.

Pre-employment checks were made to reduce the likelihood of employing people who were unsuitable to work with people.

The registered manager had systems in place for reporting, recording, and monitoring significant events, incidents and accidents. The registered manager told us that lessons were learnt when they reviewed all accidents and incidents to determine any themes or trends.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.

People were supported with eating and drinking and feedback about the quality of meals was positive. Special diets were catered for, and alternative choices were offered to people if they did not like any of the menu choices. Nutritional assessments were carried out and action was taken if people were at risk of malnutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, further work was needed to ensure decision specific Mental Capacity Assessments and best interest’s decisions were in place when people lacked capacity.

The premises were clean and tidy and people and their relatives told us they liked the homely atmosphere. The service was well maintained with appropriate furniture throughout. The registered manager had carried out research, attended workshops and training to ensure there were some dementia-friendly aspects to the environment in the ‘memory loss’ area of the service.

We observed numerous examples when staff were kind, caring and courteous. Privacy and dignity of people was promoted and maintained by staff. Explanations and reassurance was provided to people throughout the day.

Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care need. Staff encouraged people to actively participate in meaningful leisure and recreational activities that reflected their social interests and wishes and maintain relationships with people that mattered to them. The service had a clear process for handling complaints.

The registered manager was aware of the Accessible Information Standard that was introduced in 2016. The Accessible Information Standard is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need.They told us they provided and accessed information for people that was understandable to them. They told us their service users guide and other information was available in different formats and fonts.

Staff told us they enjoyed working at the service and felt supported by the registered manager and senior staff. Quality assurance processes were in place and regularly carried out to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Before anyone received care from the service, pre-admission information was obtained and assessments of people's individual needs took place. This meant the staff knew how to care for the people who used the service.

Staff had completed their mandatory training, which included health and safety, moving and handling, infection control, first aid, food hygiene, safeguarding and first aid.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We discussed DoLS with the manager, who told us that applications had been submitted and that she had considered the impact of the recent supreme court decision about how to judge whether a person might be deprived of their liberty. We saw records of these applications in people's care records and also saw that notifications of the applications had been submitted to CQC. We also saw records of mental capacity assessments and best interest decisions.

Is the service effective?

Each person had an individual support plan which set out their specific care needs and people and their representatives had been involved in the assessment and planning of their care.

We found that there were clear processes for obtaining people's consent and ensuring people could make informed decisions where appropriate.

We saw that support plans and risk assessments were up to date and reflected people's individual needs.

Is the service caring?

We found that people received the care and support they needed. People were supported by suitably trained staff and the staff we spoke with had a good understanding of people's care needs.

People's needs were assessed and care and treatment was planned and delivered in line with their individual support plan. People told us they were happy with their care. They told us, 'I like it', 'it's like home from home', 'very happy' and 'I'm well looked after'.

Is the service responsive?

People were asked for their views on a regular basis and were asked to complete annual residents' questionnaires. Residents' meetings were held on a regular basis.

Records showed that people's needs had been taken into account and care and support had been provided in accordance with people's wishes.

We saw that the provider and manager had been responsive in increasing staffing levels to care for people with higher dependency needs.

Is the service well-led?

The home had a manager who was registered with CQC and there were effective quality assurance systems in place.

Audits were carried out to check people were cared for appropriately, for instance, to make sure there were effective infection control measures in place.

Staff we spoke with during our visit confirmed that they had regular supervisions and appraisals and felt that they had received enough training to carry out their role.

We observed staff providing care and support to people throughout the inspection. There was a calm, friendly atmosphere around the home and people were seen to respond positively to the staff throughout.

People described how their care and welfare needs were met. One person said 'It's very good in here. The staff treat me well. My legs have improved since I have been in here.' A visiting relative described their experience of the service. They said 'It's the best thing that has happened to me and my family.' Another relative said 'The staff are brilliant. You couldn't fault them.'

We saw people were fully involved in decisions about their care. A visiting relative said 'They (the staff) keep me informed and involved with everything.'

People's nutritional needs were met. Comments from people included "The food is good. We get lots of choices and things I like. I love the vegetable soup.'

We found the building to be clean and well maintained. One person said 'It's spotlessly clean in here. It gets done everyday'.

We found staff received appropriate support professional development. One member of staff told us 'We get loads of training.'

We saw the manager had a good system to regularly assess and monitor the quality of the service people received.