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Inspection Summary


Overall summary & rating

Good

Updated 14 August 2018

The inspection took place on 5 and 9 April 2018 and was unannounced.

Westhampnett Nursing home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation, for up to 32 older people, who are living with dementia and who require support with their personal care or nursing care needs. On the day of our inspection there were 26 people living at the home. The home is a large property situated in Westhampnett, West Sussex. A combination of single or double bedrooms were available for people. Shared bedrooms were only used when two people, such as a married couple, or partners, chose to share. There was a communal lounge and dining room as well as a conservatory which people could use. The home had attractive gardens. There is a passenger lift so people can access the first and second floors and there is ramped access on the ground floor for those with mobility needs.

At the last inspection on 18 August 2015 we found the service was in breach of a regulation as the staff recruitment process did not ensure adequate checks were made that staff were suitable to work in a care setting. We made a requirement notice regarding this and the provider sent us an action plan of how they would be addressing this. At this inspection we found the provider carried out the required checks on newly appointed staff and this regulation was now met.

At this inspection we found risks to people were assessed and actions put in place to mitigate people coming to harm. These, however were not always consistently applied and we found sufficient action had not been taken regarding those people assessed of being at risk of developing pressure injuries to their skin. We have made a recommendation about this.

Where people did not have capacity to consent to their care and treatment this was assessed. Where these people had their liberty restricted an application for a Deprivation of Liberty Safeguards (DoLS) had been made to the local authority. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

There service did not have a registered manager in post but the current manager had submitted an application to register with the Commission. 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.

People and their relatives were satisfied with the standard and safety of the care provided. Staff had a good awareness of the principles and procedures for safeguarding people in their care.

Sufficient numbers of registered nurses (RGNs) and care staff were employed to ensure people were looked after well.

Medicines were safely managed.

The home was found to be clean and hygienic and there were no offensive odours.

The premises were safe and well maintained. Adaptations had been made so people with mobility needs could move around the home. People were able to personalise their rooms.

There were systems to review people’s care and when incidents or accidents had occurred.

People’s health and social care needs were assessed. There was evidence staff were trained in current guidance such as in palliative care and in supporting people who had needs regarding problems when swallowing food. Staff had access to a range of training courses including nationally recognised qualifications in care. Staff were also supported with supervision and their performance was monitored by regular appraisals.

People were provided with varied and nutritious meals. There was a choice of nutritious meals.

Staff supported people to access health care services such as their GP as well as when needing more specialist assessment and treatment for a dietician or the community nursing team.

People were observed to receive care from kind and caring staff. People’s rights to privacy and choice was promoted. People were consulted about their care and how they liked to be supported.

People received personalised care that was responsive to their needs. Care plans reflected people’s needs and preferences. Improvements had been made regarding the provision of activities and to engaging with people about this.

The provider had a complaints procedure and records were made of any complaint or concern raised. These records showed complaints were looked into and a response made to the complainant.

Whilst there were no people in receipt of palliative care staff were trained in this and there were plans to extend this to more staff. Advanced care plans had been devised with people regarding how they would like to be treated at the end of their life.

There were opportunities for people and their relatives to express their views which the provider responded to. The quality assurance and compliance manager had a clear plan of where improvements could be made and had put some of these into place. The staff and management worked well with other agencies such as the community nursing team.

Inspection areas

Safe

Requires improvement

Updated 14 August 2018

The service was not always safe.

Risks to people were assessed but action had not always been taken to mitigate these.

The service had policies and procedures on safeguarding people from possible abuse. Staff knew what to do if they suspected any abuse had occurred.

Sufficient numbers of staff were provided to meet people’s needs. Checks were made that newly appointed staff were suitable to work in care.

Medicines were safely managed.

The home was found to be clean, hygienic and free from any offensive odours.

People’s care was reviewed and incidents were monitored and action taken to make improvements.

Effective

Good

Updated 14 August 2018

The service was not always effective.

The service adhered to the requirements of the Mental Capacity Act 2005 Code of Practice by carrying out capacity assessments and making applications to the local authority where people's liberty was restricted for their own safety.

People’s physical health and social care needs were assessed and staff were supported to complete training in care and nursing practices.

People had varied and nutritious meals.

People had access to health care services.

Adaptations had been made to the environment and people were able to personalise their rooms.

Caring

Good

Updated 14 August 2018

The service was caring.

People received care from staff who were kind and caring. Staff promoted people’s rights to choice, privacy and independence.

People were consulted and involved in decisions about their care.

Responsive

Good

Updated 14 August 2018

The service was responsive.

People received personalised care which was responsive to their needs. Activities were provided and people had opportunities to make suggestions about this.

People’s views and concerns were listened to and acted on. The service had a complaints procedure and complaints were acted on and complainants responded to.

Whilst there were no people in receipt of end of life care staff training and care records showed the service had policies for palliative care.

Well-led

Good

Updated 14 August 2018

The service was well-led.

The provider’s management team had introduced improvements and had plans for the future direction of the service.

A number of audits and checks were carried out regarding the quality of the service.

People and staff had opportunities to express their views about the service and these were acted on.

Staff worked well with other agencies to meet people’s needs.