The Shrubbery Nursing Home

Updated 10 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector and an assistant inspector.

Service and service type: The Shrubbery 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on 31 July 2019. We announced our intention to return to the home to complete our inspection on 01 August 2019.

What we did

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We looked at information we held about the service, including notifications they had made to us about important events. We also reviewed other information sent to us from other organisations, for example, the local authority.

During the inspection

During the inspection, we spoke with seven people who lived at the home and two relatives to ask about their experience of care. We spoke with the provider’s representative, the registered manager, one senior care staff, six care staff, a member of catering staff, a cleaner and a member of the maintenance staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at five people’s care records and multiple medication records. We saw records relating to the management of the home. These included minutes of meetings with people, their relatives and staff, systems used to manage complaints and any accidents and incidents which may occur. We looked at records of compliments received, and checks made on the safety of care and the environment. We also checked records relating to people’s rights.

Updated 10 January 2020

About the service:

The Shrubbery Nursing Home is a care home providing care and nursing for up to 38 older people, some of whom live with dementia or physical disabilities. There were 27 at the time of the inspection. The Shrubbery Nursing Home accommodates people in one adapted building.

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

Services that provide health and social care to people are required to inform the Care Quality Commission (CQC), of important events that happen in the service. Provider checks had not ensured this consistently happened, and this had led to delays in CQC being advised of some important events.

People and their relatives were positive about the way the home was managed. People told us the home was a good place to live because of this. The registered manager had driven through improvements in the way people’s care was planned and the quality of care provided, with support from the provider.

Caring relationships had developed with people and staff supporting them, and people were involved in decisions about their care. People told us their rights to dignity, privacy and independence were promoted.

People were supported to have the medicines they needed to remain well, and staff understood the risk to people’s safety and acted to reduce these. There were enough staff to care for people when people wanted support.

People told us staff understood how to look after them and staff assisted people to achieve the best well-being and health possible. This included people who were supported at the end of their lives. People were supported to have enough to drink and eat and to see other health and social care professionals. 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.

People, relatives and staff were consulted when people’s care was assessed, planned and reviewed, so people’s needs continued to be met. People had opportunities to do things which they enjoyed, and their communication needs were considered when their care was planned.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 03 August 2018). Since this rating was awarded the registered provider of the service has changed. Chandos Lodge Limited became the provider of The Shrubbery Nursing Home on 23 October 2018. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the health care and support provided. A decision was made for us to inspect and examine those risks. We found systems were in place to monitor and to respond to people’s health needs.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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