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The Old Rectory Nunney Limited Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 May 2018

We undertook an unannounced inspection of The Old Rectory on 17January 2018 and 24 January 2018. When the service was last inspected in August 2016 there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements were needed in the environment of the home and in the recruitment of staff.

The Old Rectory provides care and accommodation for up to 24 people in one adapted building. At the time of our inspection there were 12 people living in the home.

The Old Rectory is a “care home”. People living 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.

Currently there is no registered manager for the service this is a legal requirement. However, a manager has recently been appointed and is planning to make an application to be the registered manager of this service. 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.

At the last inspection a breach of Regulation15 was found in relation to the environment of the home. At this inspection improvements had been made in the environment which had been appreciated by people living in the home, particularly making outside space more accessible and pleasant to use. One person said, "The garden is lovely now they have done it and we used it a lot in the summer it is much better now we can get out."

At the last inspection we had found concerns about recruitment practices of the service. On this inspection we looked at recruitment records and were satisfied the correct procedures had been followed.

There was a failure to ensure all staff had completed necessary training in order for them to demonstrate their knowledge and help in meeting people's care needs in a safe and effective manner.

There was a lack of governance of the service around the provider having oversight of the quality of care being provided specifically having robust and effective audits of the care arrangements so they could identify and drive improvements.

Staff had a good knowledge of people as individuals but this was not always reflected in care plans to ensure care was consistently being provided in a person centred way.

Medicines were administered at the time required and we found no concerns around storage and administration, other than where given covertly. We have made a recommendation in relation to some aspects of the current medicines management.

The service had been subject to an inspection by the fire service. They had found that the service was not fully complying with fire safety legislation and had made some conditions. We asked the provider to provide us with full information as to how they had and were planning to meet the conditions. They had failed to provide us with this information. We have contacted the fire service to advise them of this failure.

People described the service as caring and a number of people spoke positively about the relationships they had with staff and how they were treated with respect. One person said, "I’m happy and get on well with all the staff, they’re very kind, it’s such a nice atmosphere and you can ask them anything." Another said, "I get treated how I like to be treated with respect."

People told us they felt safe and staff recognised and were confident about reporting any concerns about the safety and welfare of people.

The service was responsive to people's changing care needs and had good arrangements for getting support from outside professionals such as community nurses. People received good support from health professionals.

Activities provided by the service were varied and people said how they enjoyed the, "Opportunity to do something." The home had made real efforts to improve the opportunity for people to use the village facilities and be part of the local community.

People enjoyed a varied and nutritious menu and said how much they enjoyed the food. One person said, "The food is lovely and I always get a choice."

People and staff spoke of an open and approachable management and provider.

We have identified two breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 4 May 2018

The service was not always safe

People did not benefit from a robust system to protect their rights when medicines were administered without their knowledge.

The provider failed to provide assurances they had, or were, in the process of meeting shortfalls in complying with fire safety legislation.

People were supported by staff who had received pre-employment

checks to ensure they were suitable for the role.

People benefitted from staff who understood their responsibility to report any concerns about possible abuse.

Effective

Requires improvement

Updated 4 May 2018

The service was not always effective

All staff had not received training and demonstrated they had the knowledge they required to meet people's needs effectively.

A condition required of a DoLS authorisation had not been met.

People had benefitted from improvements to the environment.

People benefitted from receiving meal which were nutritious and met their needs.

Caring

Good

Updated 4 May 2018

The service was not consistently caring

People did not always benefit from staff having an understanding of their needs with regards to equality and diversity.

People had established warm and supportive relationships with staff.

People were able to maintain relationships with family and friends which were important to them.

People were treated with kindness and there was respect for people's dignity and privacy.

Responsive

Good

Updated 4 May 2018

The service was not always responsive

People's end of life or palliative care needs were not recorded as part of the person's care plan.

People's care plans did not always reflect a person centred approach to the providing of care.

People benefitted from improvement in the activities provided by the provider.

Well-led

Requires improvement

Updated 4 May 2018

The service was not consistently well led

There was a lack of formal provider oversite and governance of the service.

People benefitted from an open and approachable manager and provider.