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Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about Regency Nursing Home on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Regency Nursing Home, you can give feedback on this service.

Inspection carried out on 2 April 2019

During a routine inspection

About the service: Regency Nursing Home is a ‘care home’. The home accommodates up to 30 people who have nursing needs. At the time of our inspection 30 people were living in the home. The home provides accommodation over five floors with passenger lifts to all floors, stair lift access to some floors and external wheelchair access to the grounds. The lower floor of the home provides areas for staff, kitchen area and laundry facilities.

What life is like for people using this service:

• People were kept safe from avoidable harm. Staff recognised the risks to people’s health, safety and well-being and knew how to support them safely. People received their medicines as prescribed.

• Healthcare professionals told us the staff at the service worked well with them to provide good outcomes for people.

• People were cared for by staff who were kind and caring and people’s privacy, independence and dignity were promoted.

• People received personalised care that met their needs and preferences. People chose how to spend their day and were engaged in activities that they enjoyed.

• Staff were supported in their roles. They took part in regular training and supervision. Staff told us they enjoyed working at the service and felt well supported by the registered manager and the management team.

• People knew how to raise concerns. They had confidence in the registered manager and told us they would recommend the home to others.

• A quality assurance system was in place to continually assess, monitor and improve the service.

• We found the service met the characteristics of a “Good” rating in all areas. More information is available in the full report.

Rating at last inspection: Requires Improvement (report published 14 June 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: There is no required follow up to this inspection, however we will continue to monitor the service through information we receive.

Inspection carried out on 13 March 2018

During a routine inspection

This inspection took place on 13 and 20 March 2018 and was unannounced. Regency Nursing Home provides accommodation and nursing care for up to 30 people. The home provides accommodation over five floors with passenger lifts to all floors, stair lift access to some floors and external wheelchair access to the grounds. The lower floor of the home provides areas for staff, kitchen area and laundry facilities.

There was a registered manager 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.

At our last inspection in June and July 2015 we found that there were not always enough staff to meet people’s needs. We made a recommendation about this. At this inspection we found there were enough staff on duty. We have, however, made a recommendation to the provider with regards to the ongoing monitoring of staffing levels.

During this inspection we found some shortfalls at the service with regard to record keeping. The provider used a range of quality assurance systems including audits; however these were not robust and did not pick up on some of the issues we found with records. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.

Staff told us they felt well supported by the senior team, the registered manager and the provider, however there was not a regular programme of supervision or appraisal for staff which was recorded.

People and visitors felt the service was safe. People looked comfortable, relaxed and happy and were supported by staff that knew them well. The registered manager and staff had a good understanding of how to keep people safe. All staff displayed good knowledge on how to report any concerns and were able to describe what action they would take to protect people from harm. Risks were well managed. Accidents and incidents were recorded but were not monitored to determine if any trends were occurring. Safe recruitment processes, including pre-employment checks, had been followed. Health and safety checks on the building and equipment were regularly carried out.

Medicines were administered by trained staff. Lack of clear direction regarding as required (PRN) and topical medicines were addressed to ensure they were administered in line with people’s needs.

Staff received training that enabled them to meet the needs of people they supported and deliver effective care. Staff worked well as a team and people were supported to maintain good health and had access to appropriate healthcare services.

Feedback about the food on offer was positive. Where people needed support to eat, this was given in a dignified way. Food consistencies were not in line with national guidance and people did not have daily fluid intake targets recorded. The registered manager told us they had put this place following the inspection.

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 supported this practice. Applications had been made for Deprivation of Liberty Safeguard (DoLS) authorisations, where it was considered that people would be unable to keep themselves safe if they were to leave the home unaccompanied.

Care plans in place were person-centred and included details about people's life histories and what was important to them. People’s individual needs were assessed and most people had an up to date plan of care in place.

People told us staff were friendly and caring. They told us they were treated with dignity and respect. We saw that staff knew people well, and observed positive interactions between people and staff. Visitors told us they were

Inspection carried out on 15 June 2015 and 29 July 2015

During a routine inspection

We carried out an unannounced inspection of this home on 15 June 2015 and 29 July 2015. Regency Nursing Home provides accommodation and nursing care for up to 30 people over the age of 18. The home provides accommodation over five floors with passenger lifts to all floors, stair lift access to some floors and external wheelchair access to the grounds. The lower floor of the home provides areas for staff, kitchen area and laundry facilities.

The service had a registered manager. 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 felt safe at the home. Staff knew them well and people felt confident any concerns they raised with staff would be addressed. The registered provider and staff had a good awareness of how to safeguard people from abuse. Policies and procedures were in place to support staff in the management of safeguarding issues. Staff were confident to raise any issues with the management team and said these would be addressed promptly and efficiently. Safe recruitment practices in place meant staff were suitable to work with people in a care setting.

Whilst there were sufficient staff available on the day of our visits, we have made a recommendation to the provider with regards to the monitoring of staffing levels within the home and the dependency of people who live there.

Risk assessments in place informed care plans and records, to ensure people received individualised, safe and specific care based on their needs. Incidents and accidents were recorded, monitored and reported in a way which ensured the safety and welfare of people. Medicines were stored securely and people received their medicines in a safe and effective way.

Staff at the home were guided by the principles of the Mental Capacity Act 2005 MCA when working with people who lacked capacity to make decisions. The Care Quality Commission monitors the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The DoLS requires providers to submit applications to the local authority where people may need to be legally deprived of their liberty in some circumstances in order to receive safe care and treatment. These had been implemented appropriately to ensure the safety and welfare of people.

Staff knew people very well and interacted with them in calm, encouraging and positive manner at all times. They ensured people were offered choice and demonstrated good communication skills. Staff received training to support them in their role and received supervision in line with the registered provider’s policy.

Nutritious food was provided for people and dietary requirements were recognised and recorded. People had access to external health and social care professionals for support and treatment as was required.

People felt valued, happy and content in their home. They enjoyed living at the home and found staff very caring and compassionate. Their privacy and dignity was respected at all times and they felt able to express their views and have them respected and acted upon.

Assessments of people’s needs had been completed on admission to the home. Care plans were developed, reviewed and updated in accordance with people’s needs.

Relatives and health and social care professionals found the management team to be responsive to and effective in meeting the needs of people.

An activities coordinator was available to support people with a wide range of activities which encouraged people’s independence and reflected their choices.

People and their relatives felt the managers of the service were visible and available to speak with them when required. They said the manager and senior staff were easy to talk to, open to suggestions for improvements or new ways of supporting people, and always responded to them positively and with encouragement.

The registered provider had an effective system of quality audit in place to monitor the health and safety of people who used and visited the home. This included audits on incidents and accidents, complaints, infection control, equipment used in the home and the environment.

Inspection carried out on 19 December 2013

During an inspection looking at part of the service

This inspection looked at the two compliance actions made as a result of the last inspection of 22 October 2013. The provider sent us an action plan to say the service was compliant in these by 15 December 2013. This inspection also looked at concerns raised with us about the ongoing building work and some of the home�s equipment not working properly.

We found the home had taken action to address the two compliance actions made at the last inspection.

We spoke to three people who lived at the home and to a relative of someone living at the home. We also spoke to the local authority safeguarding team about concerns raised with them. We also spoke to one of the providers and to the home�s head of nursing care as well as the chef and a staff member who monitored the environment. We also spoke to the local authority fire and rescue service.

One person said they liked living at the home describing the staff as kind and helpful. Both people we spoke to said staff responded when they asked for assistance when using the call point in their rooms. However, both people said there were sometimes delays in the time it took for staff to get to them. During the inspection visit we tested the call point in one room and found staff responded promptly.

A relative we spoke to said the home�s environment had improved considerably adding, �It looks good now.�

The staff we spoke to said any disruptions caused by building works were kept to a minimum and were safely managed.

Inspection carried out on 22 October 2013

During a routine inspection

This was a scheduled inspection but we also looked at outcome areas where concerns had been raised with the Commisison.

We spoke to five people who lived at the home and to two relatives of people who lived at the home. We also spoke to three staff and the manager as well as one of the providers. We also spoke to a health and social care professional about the service provided by the home.

People told us they were treated well by the home�s staff and that the standard of care was good. One person said they sometimes had to wait a long time for staff to respond when they asked to be taken to the toilet. A health and social professional told us the home provided appropriate standards of nursing care.

People were supported to have a nutritious diet and to have adequate fluid intake.

At the time of the inspection building work was taking place. The home had taken steps to minimise any disruption to people and the running of the home. A number of people and staff raised issues about noise from the building works.

We found that one staff member was working in the home without adequate recruitment checks.

The home had adequate numbers of staff.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff. We saw people had positive experiences. The mealtime was well organised. Meals were brought promptly and staff helped people if they needed it.

Inspection carried out on 19 December 2012

During a routine inspection

We spoke to four people living at the home and to one relative of someone living at the home.

We also spoke to three staff, the manager and the provider.

People told us they were treated with respect and that staff were kind. People and their relative said the home met people�s care needs.

We saw each person had comprehensive assessments of need along with care plans. These showed people�s views were taken account of in how they liked to be helped.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection)

tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us

to spend time watching what is going on in a service and helps us to record how people

spend their time and whether they have positive experiences. This includes looking at the

support that is given to them by the staff. We spent 40 minutes observing at lunchtime and

found that people had positive experiences. Staff were observed assisting people in a calm, friendly and polite manner. People were treated with respect and there was warmth and humour in staff interactions with people. We did note two isolated occasions where the dignity of people was not upheld.

People and staff gave mixed views regarding the staffing levels. One person and two staff felt there were not enough staff. Staff said this had not affected the care people received. Staff told us people were well cared for.