Archived: Middleton Grove Nursing Home

Middleton Grove Nursing Home provides personal care, accommodation and nursing care for up to 54 people. On the day of our inspection there were 51 older people at the service, some of whom were living with dementia and chronic health conditions. The service is spread over four floors with a passenger lift, communal lounges/dining rooms and a garden.

At the last inspection on 18 November 2014, the service was rated Good. At this inspection we found the service remained Good.

People and relatives told us they felt the service was safe. One person told us, “No you don’t have to worry about being here, they are all kind to us”. People remained protected from the risk of abuse because staff understood how to identify and report it.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People and their relatives felt staff were skilled to meet the needs of people and provide effective care. One person told us, “I don’t know what training they’ve had, but they seem well equipped to do the job as you’d expect”.

People remained encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People and relatives also said they felt listened to and any concerns or issues they raised were addressed.

Staff supported people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs were met and people reported that they had a good choice of food and drink. One person told us, “Oh I look forward to my food here, it’s very nice”.

Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. One member of staff told us, “[Registered manager] is always letting us know what training is on offer”. Another member of staff said, “Supervision is useful to find a balance on what we are doing”.

The service had a relaxed and homely feel. Everyone we spoke with spoke highly of the caring and respectful attitude of a consistent staff team which we observed throughout the inspection. One person told us, “They [staff] are all very kind here”. Another person said, “They are great, you can ask for anything and they don’t mind”.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

People, staff and relatives found the management team approachable and professional. One person told us, “The manager seems like a very nice lady”. Another person said, “Everything seems perfectly under control here and ticks over well”.

Further information is in the detailed findings below.

During this inspection we spoke with five people who used the service and one relative. We also spoke with 13 staff members; these were the registered manager, four registered nurses, six care workers and two activities co-ordinators.

The people we spoke with told us they were generally happy with the care they had received and with the staff team. One person told us "They're a nice bunch. I'm happy here". A member of staff told us "We always try to meet the residents' needs and give them what they want".

Staff we observed had an understanding of the support needs of people who use the service. We found that the documentation used for care planning had been reviewed recently, was detailed and person centred.

We looked at staffing rotas and during our inspection observed levels of staffing. We also spoke with staff members and people who used the service. We saw that the service had enough qualified, skilled and experienced staff to meet people's needs at all times.

We also saw that the service had quality assurance systems in place to monitor the quality of the service provided, and to gain the views of the people who used the service.

We arrived at the location at 6:10am. When we arrived we asked the registered nurse on duty how many of the people who used the service were out of bed and had been assisted to be ready for the day. The nurse told us that approximately 15 people who used the service were either out of bed and dressed, or in the process of being assisted to get ready for the day. The nurse gave us the names of these people. We were told by the registered nurse that staff had started to get people out of bed at approximately 5:30am. One care worker we spoke with told us that they had been instructed by the nurse to get people up at this time.

We looked at the care plans, risk assessments and daily records relating to 15 of the 42 people living at the service. We found that the documentation used for care planning lacked detail in respect to people's preferences, likes and dislikes. Information about people's preferred times to get up and eat and drink had not been recorded. The care plans that we viewed lacked consistency and detail in respect to people's assessed and on-going care and treatment. We also saw that the recording of daily care had not always been filled in or followed up correctly.

During our visit we spoke with three people who used the service and five relatives. We also spoke with eight staff members; these were the registered manager, two registered nurses, four care workers and the chef.

The people we spoke with told us they were generally happy with the care they had received and with the staff team. We saw that the service supported people to have adequate nutrition and hydration. Staff we spoke with said that they had undertaken safeguarding vulnerable adults training, and people we spoke with told us that they felt safe and knew who to talk to if they had any concerns.

Staff we observed had an understanding of the support needs of people who use the service, but we found that the documentation used for care planning lacked detail and consistency and was not always filled in or followed up correctly.

We looked at staffing rotas and observed levels of staffing. We saw that the service did not have enough qualified, skilled and experienced staff to meet people's needs at all times.

The service had quality assurance systems in place to monitor the quality of the service provided and to gain the views of the people who used the service, but at the time of our visit, some of these systems had not been fully implemented, or were not being utilised.