Victoria House Nursing Home

Updated 23 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 15 March 2021 and was announced.

Updated 23 March 2021

This inspection took place on 5 September 2017. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

The service was last inspected in June 2016 and at that time required improvement. We found breaches of Regulations 17 good governance and regulation 18 staffing. This was because staff had not received supervision on a regular basis and best interest decisions were not recorded in care plans. Following our last inspection the provider sent us an action plan, which detailed the action they would take to make improvements at the home.

At this inspection we found that staff were now receiving regular supervision and best interest decisions were fully documented in care plans.

Victoria House Care Centre is a purpose built care home providing personal and nursing care to older people and older people living with a dementia. It is located close to the centre of Stockton-On-Tees, within easy reach of local amenities.

There was a registered manager in place who had been registered with the Care Quality Commission since 2015. 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.

Risks to people arising from their health and support needs and the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff were now given effective supervision and a yearly appraisal.

Staff understood safeguarding issues and were aware of the whistleblowing policy [telling someone] if they had concerns.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training and clearly understood the requirements of the Act. Best interest decisions were made appropriately with the person and family fully involved. This meant they were working within the law to support people who may have lacked capacity to make their own decisions. The manager understood their responsibilities in relation to DoLS.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they had a choice of food and everyone enjoyed what was on offer. Where people had a percutaneous endoscopic gastrostomy (PEG) in place and was nil by mouth. A PEG is a procedure to place a feeding tube through the skin and into the stomach to give the nutrients and fluids needed. Along with advice from the dietician and SALT team the service was offering taste spoons or oral food tasters. An oral food taster or taste spoon is where an empty spoon is dipped in custard or yogurt for example; all the excess is allowed to fall off the spoon leaving a very thin covering.

We saw evidence in care plans to show the service worked with external healthcare professionals to maintain people’s health.

We found the interactions between people and staff were kind and respectful and people were offered choice throughout the day.

Procedures were in place to support people to access advocacy services should the need arise. At the time of inspection no one was using an advocate.

Complaints were acted on using the guidance of the services complaints policy.

Staff had a clear understanding of people's needs and how they liked to be supported. People's independence was encouraged without unnecessary risks to their safety. Care plans were well written and specific to people's individual needs. However, people’s life history was missing from four of the six files we looked at.

The manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice. People, relatives and staff felt confident in the manager. Feedback was sought from people, and relatives to assist in this. The service had quality assurance systems in place.