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Nazareth House - Cheltenham Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 January 2020

About the service

Nazareth House - Cheltenham is a residential home which provides personal care to 63 older people and people living with dementia. The home consists of a home contains, a range of communal areas, including lounges, dining rooms and a café and reception area. At the time of our inspection 40 people were living in Nazareth House - Cheltenham.

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

Since our last inspection the management of the service had changed. The interim manager, head of care and provider had identified a number of the concerns we had found prior to our inspection. However, actions at the time of our inspection were still ongoing and had not been fully implemented and evaluated to ensure people would always receive safe and effective personalised care. We continued to identified breaches of regulations at this inspection. The provider had not demonstrated that they were able to consistently meet the requirements of their registration and operate effective systems to ensure that Nazareth House – Cheltenham met the requirements of the Health and Social Care Regulations. Therefore, we have rated the key question ‘Is the service Well-led?’ as ‘Inadequate’.

People and their relatives told us their views had not always been sought and listened to. They told us that due to the changes in the management of the home they were not confident the service was managed well. Healthcare professionals, senior care staff and agency staff told us that communication was not always effective, which impacted on people’s wellbeing when requests had not been acted upon.

People did not always receive care which was personalised to their needs. People told us they did not always receive care which made them comfortable or maintained their wellbeing. Staff told us they did not have the time to spend with people and promote their wellbeing. Staff did not always take opportunities to engage with people and ensure care was tailored to their needs.

People did not always receive their medicines as prescribed. Senior care staff did not always follow recognised good practice to ensure people received their medicines as prescribed. Staff did not have effective systems to ensure people’s prescribed medicines were in stock and effectively replenished. People could not be assured that they would be safe if an emergency evacuation was required. Fire evacuation practices had not taken place regularly and people’s personal evacuation plans were out of date.

People were not always protected from the risks associated with their care as staff did not always follow their assessed plan of care.

There were enough staff deployed to keep people safe. People, their relatives and staff told us that staffing was an issue and impacted the quality of care people received. The provider was heavily reliant on agency care staff to ensure safe staffing levels. People told us how this impacted on the care they received.

Care staff followed recognised infection control procedures. We observed, and people and their relatives told us that the home had not always been cleaned. The interim manager was aware of these concerns and was taking actions to improve this. People were protected from the risk of malnutrition or choking. The interim manager was taking action to improve the quality and variety of food people received.

Care staff required further support to enable them to meet people’s day to day needs. Not all staff had received effective supervision and staff told us they would benefit from more training in relation to dementia care. People spoke positively about the caring nature of permanent staff.

People told us they generally enjoyed their time at Nazareth House – Cheltenham. A new activity co-ordinator had started to work at the home, and previously the Sisters of Nazareth had provided a range of activities whilst the service were recruiting. People were supported to maintain their personal relationships. However, there w

Inspection areas

Safe

Requires improvement

Updated 10 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 10 January 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 10 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 10 January 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 10 January 2020

The service was not well-led.

Details are in our well-Led findings below.