Resthaven Nursing Home

Resthaven Nursing Home is a residential care home providing personal and nursing care to 31 people aged 65 and over at the time of the inspection. The service can support up to 42 people.

People were accommodated in one building made up of two wings. Each provided adapted facilities, ensuite bedrooms and communal rooms to relax and eat in. The service has its own secure outside space which adjoins surrounding countryside as well as ample car parking.

People’s experience of using this service and what we found

People told us they felt safe and able to talk with staff about anything that worried them and referred to the staff as being kind, friendly and helpful. A person’s representative told us they felt well informed, both about their relative’s health and the arrangements in place to protect their relative during the Coronavirus pandemic.

Two healthcare professionals told us they had felt reassured that people continued to receive appropriate care and treatment during the pandemic

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively. We identified no concerns in relation to the cleanliness of the service or the actions being taken to protect people from Coronavirus or other potential infections.

A winter support plan was in place and people and staff were encouraged and supported to access the Flu vaccine.

People’s medicines were managed safely. There were processes in place to help managers monitor the safety of medicines and to identify areas which required improvement. People spoken with told us they received their medicines on time.

People were aware that a new home manager had been identified and that they were due to start in the new year. In the meantime, arrangements were in place to provide staff with leadership and support.

The provider’s quality monitoring systems had been effective in identifying areas of shortfall. Actions had been introduced to address these and drive improvement. Staff had been supported to understand their roles and responsibilities in this process. There was strong evidence to show that the provider was fully involved in supporting staff, improving team working and morale and monitoring progress against the improvement actions. Feedback was sought from people, relatives, professionals’ and staff and acted on to help improve the running of the service and people’s overall experience. One member of staff said, “We are all part of one team” and a senior manager said, ““The staff have been coming on the journey.”

Managers were proactive in introducing new and existing learning and were open to ideas which supported ongoing improvement of the service and which improved people’s experiences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 27 November 2018).

Why we inspected

This was a planned focussed inspection looking only at the key questions, Safe and Well-led. This report only reports on the findings under those key questions. We reviewed the information we held about the service and no areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Resthaven Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit again. If we receive any concerning information we may inspect sooner.

Resthaven Nursing Home (known as Resthaven) 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.

Resthaven can accommodate 42 people in one adapted building. It predominantly cares for older people. At the time of the inspection 33 people lived there and required support with their physical needs whilst some also lived with dementia. People lived on two floors, each floor having single occupancy bedrooms with washing facilities, lounge and dining areas, communal bathrooms and toilets. Outside there was an enclosed garden as well as an open front garden with ample car parking. Attached to the home was a small chapel which people and visitors could use.

The service is required to have a registered manager and one was in post. 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.

The provider had identified areas that required improvement when they took over the home in March 2017and had since made significant improvements to the service.

There were many positive comments from people and relatives about how caring and kind the staff were and we observed many kind and caring interactions from the staff. The provider had forwarded specific examples of where staffs’ patience and kindness had improved people’s quality of life and wellbeing.

Personal care was delivered in private but staff sometimes forgot to respect people’s private spaces, for example, we observed staff entering people’s bedrooms without first knocking on the door and being invited in. Although the provider subsequently told us staff were trained to do this we have recommended that the training around this be reviewed so that practice can alter.

People’s preferences and their likes were explored with them and met. People’s diverse preferences were included in people’s care plans for staff information and to help staff meet these.

People had opportunities to take part in social activities which they enjoyed. On one of the days of this inspection the weather was unusually hot and this had an impact on what we observed in relation to activities on that day. People were sleepy and this had an impact on their ability to be engaged. On the second day of the inspection we observed people to be more involved and enjoying themselves. The registered manager told us this was far more representative of the activities at Resthaven. We were given examples of how support with meaningful activities had improved people’s self-worth, their confidence and quality of life. On-going improvements were being made to further support people’s overall wellbeing.

People were supported to take their medicines and medicines were stored securely; records were well maintained. During the warm weather staff had found it difficult to meet the medicine manufactures’ recommendations in relation to the temperatures medicines should be stored at. Action was being taken in response to this and the provider told us they planned to take further action to address this.

The provider continued to keep staffing levels and the deployment of staff under review. There were enough staff to keep people safe. Where needed agency staff were used to support this and successful staff recruitment had seen this usage reduced. Robust recruitment procedures were followed and helped to protect people from those who may not be suitable to care for them.

Systems and processes were in place to keep people safe and to ensure their health needs were met. Risks to people were identified and managed resulting in these being reduced or removed altogether. People told us they felt safe and well cared for and relatives told us they considered their relative to be well cared for. People had access to health care professionals to support their health needs. Some adaptions to the building and its grounds had been made to meet people’s needs.

A complaints process was in place and records showed that complaints were fully investigated and where necessary action had been taken to address these. Managers aimed to resolve complaints to the satisfaction of the complainant but in some cases, this had not been possible, despite great lengths having been taken to try and achieve this. There was evidence to show that the provider’s complaints procedures were adhered to and complaints were managed in a transparent manner. Where appropriate people were offered and explanation and an apology given. The registered manager used all complaints and other feedback as points for learning.

People’s relatives were made welcome and they were consulted with, where appropriate, about people’s health and care. People were afforded the right to have visitors in private if this was their wish.

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 support this practice. People’s independent decisions were respected by the staff. The principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards were adhered to in order to protect those who were unable to consent to live at Resthaven and received the care and treatment they required. Where people were unable to make independent decisions and where it had been necessary to make decisions on their behalf, these had been made in the person’s best interests.

People’s end of life wishes were explored with them. People were supported to remain comfortable at the end of their life. Those who mattered to people and who were important to them could stay with them at this time. Staff provided support to relatives and friends as and when they wanted this.

There were processes in place to monitor the quality of care provided to people and monitor the home’s overall performance. Where required actions were identified and completed which led to continuous improvement being made. The home’s continuous improvement plan showed what actions had already been completed and what further action was planned. For example, actions completed included the recruitment of further staff to support activities for people. On-going actions included those relating to people’s care records; staff were getting used to the provider’s new documents.

A change in the staff culture and how staff were expected to work had led to people receiving safer and more personalised care overall. Managers were managing these changes well. They were continuing to make improvements to the home’s senior staff structure, so that best practice could be fully promoted moving forward. These changes were also providing staff with the support and direction they needed. The provider had supported the registered manager to make these changes and they continued to provide additional support and guidance where needed.