Nether Place Nursing Home

Updated 11 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Nether Place Nursing Home is a ‘care home’ with nursing care. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A manager was in post, we have referred to them as ‘the manager’ throughout this inspection report.

Notice of inspection

This inspection was unannounced on the first day and announced on the second day.

Inspection activity started on 25 January and ended on 23 February. We visited the service on 25 and 31 January.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

This inspection was carried out by conducting a site visit and speaking to relatives and staff remotely. We spoke with 3 people who used the service and 4 relatives about their experiences of the care provided. We spoke with 10 staff including the nominated individual, compliance manager, manager, deputy manager, nurses, care staff and a domestic. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 4 people’s care records. We looked at multiple medicines records. We reviewed 3 staff recruitment records. A range of records relating to the management of the service, including staff training records, accident and incident records, quality assurance checks, health and safety records and a sample of the provider’s policies and procedures were also reviewed. We received feedback from 2 health and social care professionals who work alongside the service.

Updated 11 May 2023

About the service

Nether Place Nursing Home is a care home providing personal care and nursing for up to 32 older people and people living with dementia. At the time of our inspection there were 22 people using the service.

Nether Place Nursing Home accommodates people across 2 separate wings, each of which has separate adapted facilities. One of the wings specialises in providing care to people living with dementia.

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

People were at risk due to shortfalls in safety across the service. Risks linked to nursing staff had not been robustly assessed to keep people safe. Staffing levels were not always sufficient to meet people’s needs or for the size of the service. Staff had not always received training to enable them to support people effectively and carry out their roles.

People were at risk as fire safety was not managed safely; staff did not always know how to respond in the event of a fire. The provider was working to make improvements to fire safety.

Systems were not always in place to ensure people received their medicines properly and safely. Medicines were not always being administered to people as directed, this was addressed during the inspection.

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 did not always support this practice. We have made a recommendation about the recording of Deprivation of Liberty Safeguards (DoLS) conditions.

People were at risk of harm because of a lack of oversight of the service by the provider. The service had been without a registered manager for over 6 months. The provider did not have effective systems in place to monitor quality and safety at the service and had not identified the issues we found during the inspection. The provider had started to make improvements following our inspection, these changes had yet to be embedded.

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

Rating at last inspection

The last rating for this service was good (published 13 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

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 COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing and good governance. We issued a warning notice for the breach of good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.