8 May 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was carried out by two inspectors and a specialist advisor. A specialist advisor is a qualified health professional.
Service and service type: Royal Leamington Spa Nursing Home is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: The inspection visit took place on 10 April and continued on 11 April 2019. The first day of the inspection was unannounced.
What we did: Before the inspection we reviewed the information we held about the service. This included notifications the provider is required by law to send us about events that happen within the service such as serious injuries. The registered manager had completed a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
We sought feedback from the local authority and other professionals who work with the service such as Healthwatch. Healthwatch is an independent organisation which collects people's views about health and social care services. The feedback from these organisations was used in planning for the inspection and helped identify some key lines of enquiry.
We used all this information to plan our inspection.
During our inspection visit we spoke with:
• Six people who lived at the home
• Eight relatives of people who lived at the home
• Two members of care staff
• One senior member of care staff
• A registered nurse
• The head chef
• A housekeeper
• The activities co-ordinator
• The deputy manager
• The registered manager
• Two healthcare professionals
We looked at:
• Four people’s care records in full and specific aspects in other people’s care records
• Three people’s medicine records
• Three staff personnel files, recruitment, induction and training records
• Meeting minutes
• Records of complaints and compliments
• Management quality audits and checks
We also completed checks of the premises and observed how staff cared for and supported people.
8 May 2019
About the service: Royal Leamington Spa Nursing Home is a care home consisting of two buildings identified as house number '14' and '16' with care provided across three floors. The houses are connected by a corridor known as 'the link'.
Royal Leamington Spa Nursing Home is a care home with nursing that provides accommodation and personal care for up to 43 older and younger people living with dementia and physical disabilities. At the time of our visit, 38 people lived at the home.
People’s experience of using this service:
• People felt safe and were protected from avoidable harm. Staff understood how to keep people safe and how to report any concerns they may have.
• Staff knew about the risks associated with people’s care and understood how to minimise risks to them. Further information was available in care plans for staff to refer to.
• Staff supported people to take their medicines as prescribed.
• Staff understood how to prevent the spread of infection.
• People received care from a consistent team of staff who understood their needs.
• Staff were recruited safely and processes checked the background of potential new staff.
• People’s needs were assessed to ensure they could be met by the service.
• Staff received the training and guidance they needed to complete their role well. The registered manager encouraged staff to expand their knowledge through specialised training.
• People made their own decisions about their care and were supported by staff who understood the principles of the Mental Capacity Act 2005.
• People were offered choices. For example, in the meals and drinks they were offered.
• Staff respected people’s rights to privacy and dignity.
• People received information about the service in a way that was appropriate to their needs.
• People were involved in planning their care.
• Care plans contained the information and guidance staff needed to support people.
• The service used innovative ways to achieve meaningful outcomes for people
• Systems were in place to manage and respond to any complaints or concerns raised.
• The registered manager had robust systems and processes to monitor quality within the home.
• The registered manager understood their regulatory responsibilities and shared information with stakeholders in a timely way.
Rating at last inspection: At the last inspection the service was rated as good overall with one area of requires improvement within the responsive domain (The last report was published on 14 October 2016).
At this inspection we found improvements had been made and the service is now rated good in all areas.
Why we inspected: This was a planned inspection based on the date and the rating of the previous inspection.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk