The inspection took place on 31 March 2015. The Adelaide Nursing Home was last inspected on 6 June 2013 and no concerns were identified.
The Adelaide Nursing Home is located in Hove. It is registered to support a maximum of 35 people. The service provides personal care and support to people with nursing needs, some of whom were living with dementia. The home is two converted houses set over two floors. On the day of our inspection, there were 31 people living at the home.
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.
The home had some arrangements in place to meet people’s social and recreational needs. However, we could not see that activities were routinely organised in line with people’s personal preferences. Feedback from people clearly indicated this need was not being addressed, in particular for people who remained in their rooms and wished to have one to one interaction. We have identified this as an area of practice that requires improvement.
People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.
Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately, including the administration of controlled drugs.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.
Accidents and incidents were recorded appropriately and steps taken by the service to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.
People were encouraged and supported to eat and drink well. One person said, “The food is quite good, not like school dinners”. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were advised on healthy eating and special dietary requirements were met. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service. Staff had received regular supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.
People felt well looked after and supported and we observed friendly and genuine relationships had developed between people and staff. One person told us, “I feel very well cared for here. No problems at all”. One staff member told us, “It’s our priority to see that the residents are happy. We need to make sure they get what they want”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible.
People were encouraged to express their views and completed surveys showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “I do feel listened to yes, and I know the sister would sort anything out for me”.
Care plans gave detailed information on how people wished to be supported and were reviewed and updated regularly.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where management were always available to discuss suggestions and address problems or concerns. The provider undertook quality assurance reviews to measure and monitor the standard of the service.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.