Bethshan Nursing Home Limited

We found the following examples of good practice.

Staff had received infection prevention and control training (IPC) and were regularly supported to update their knowledge and skills in relation to best practice standards. Staff wore personal protective equipment (PPE) and were knowledgeable about what standard of PPE was needed and when. Staff were supplied with scrubs or extra uniforms so that they could wash them after each shift, and had designated areas for changing and hand washing when they entered and left the home.

People were provided stimulation and supported to maintain contact with their friends and family when shielding or isolating. The home's maintenance man had built a visiting pod in the garden for the winter months. The pod resembled a summer house, had insulation, safe means of heating (cool touch panels), a nurse call bell for assistance, phone and internet connection. There was also a Perspex divider in the middle to ensure the pod was Covid-19 secure with separate entrances.

The environment was clean and domestic workers demonstrated good understanding of best practice standards for cleaning and decontamination. An extra domestic had been employed so that each unit had a designated cleaner.When recruiting new staff the provider had hired a local community centre for final face to face interviews. All IPC measures were in place for these interviews.

The home carried out a virtual tour for relatives and people prior to admission to the home. The staff did a virtual walk around and showed relatives and people their new bedrooms and facilities via WhatsApp and video links.

People were tested for Covid-19 before admission and asked to isolate for a period of 14 days, even if the test result was negative. The service had put electronic key pads on the two zoned areas used for isolation as an additional measure to prevent staff and resident movement when in isolation. Staff entered the home directly onto a designated unit and extra electronic staff clocking in systems had been put at each entrance way. A spare bedroom on each unit had been assigned as a staff break room.

The provider had risk assessed and implemented contingency plans to ensure any outbreak of Covid-19 was effectively managed.

Further information is in the detailed findings below.

At our last inspection, 14 September 2015, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

Why the service is rated Good:

People continued to be safe living in the home. Hazards to people’s safety had been identify and managed. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

Robust systems were used when new staff were employed to ensure they were suitable to work in the home.

The staff received training and support to ensure they had the skills to provide people’s support in a safe way. The staff knew how to identify and report abuse.

Care was assessed, planned and delivered to meet people’s needs. People who lived in the home, and others who knew them well, were included in planning their support.

People continued to receive the support they required to maintain good health. They had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received their medicines in a safe and timely way.

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.

We saw a positive dining experience was provided to people who used the service. Meals were of a good quality, varied and people were given choices. The staff were knowledgeable about the support people required to enjoy their meals and drinks safely and this was provided.

People and relatives said staff were kind and caring. Staff had time to interact and engage with people and not just when they carried out tasks. The staff promptly identified if people were unwell or anxious and provided assistance as individuals required.

People were provided with activities and entertainment of their choosing and regularly accessed activities within the community. Technology was used to enhance people's lives such as access to the internet for leisure and for keeping people safe by means of sensor mats and beams.

People had the opportunity to give their views about the service and feedback was acted upon in order to ensure improvements were made to the service when required. A complaints procedure was available.

The provider had systems in place to ensure the delivery of good quality care. The home was well maintained and had an on-going programme of improvements for the benefit of people living in the home.

"I'm quite happy here… We all have a laugh together!"

"I like living here as you get a bit of fun in this house."

A visitor told us:

"My relative has settled well here and we enjoy still being part of their life. We can't praise the staff highly enough. Where they sometimes fall down is in relation to activities. I think they could do more."

We observed the way care was given to people who lived in the home and we looked at individual files. We judged that people were getting suitable levels of personal care and support. We had evidence to show that people were given help to get the right kind of health care.

We checked on the management of medicines in the home and found that this was being done appropriately. People received suitable medication to deal with their health needs.

The home was fresh and clean on the day of our visit. We had evidence to show that maintenance, upkeep and replacement of furniture, fittings and equipment was ongoing.

We met all of the staff on duty and we heard from them that they were suitably recruited, inducted, supervised and trained. We also had evidence to show that any poor performance in the team was dealt with appropriately.

We looked at a wide range of records including those related to monitoring quality and we found these to be easily accessed and appropriate.

We found the home to be appropriately staffed for the needs of the people living in the home. The staff team were experienced and well trained with specialist skills in caring for people with dementia.

One person living in the home said, “The staff are all brilliant, we are spoilt here. The food is very good.” And another said, “We are always asked about what we would like to do, you can please yourself about joining in the activities that’s on offer.”

A relative told us, “We spent a long time in choosing this home and have been very pleased with the level of care, support and consideration my relative receives. We are kept up to date and included in any important decisions.”

We saw that the provider had an effective system in place to identify, assess and manage the quality of the care and the environment. This meant the home was clean, tidy and well maintained. It also meant people’s care was regularly checked to make sure the support offered was still meeting their needs.