Ingleborough Nursing Home

Updated 14 October 2022

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

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ingleborough Nursing Home is a ‘care home’. 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. Ingleborough Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

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

We spoke with seven people who used the service and two relatives about their experience of the care provided. We spoke with five members of staff including the nominated individual, manager, clinical lead, a nurse and a domestic worker.

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 three people’s care records and seven people’s medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 October 2022

About the service

Ingleborough Nursing Home is a care home providing personal and nursing care to up to 55 people. The service provides support to older people, some of these people are living with dementia. At the time of our inspection there were 22 people using the service. Ingleborough Nursing Home is a large adapted building supporting people across three floors, serviced by a lift.

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

There were two different systems in place for the management of medicines, paper and electronic. Paper medicines administration records for creams and ointments were not completed or used effectively to record the administration of these medicines. We found electronic records to be robust and effective.

Audits in place were not effective in identifying and monitoring issues found on inspection and issues known to the manager. Action had not been taken in a timely manner to address concerns identified in a fire risk assessment and during a fire drill.

Care records and risk assessments did not always contain the most up to date relevant information available. It was not always clear if people were receiving the support they needed to prevent harm. We made a recommendation about this.

There was a good variety of training available to staff but systems to monitor training compliance was confusing and inaccurate. Staff were safely recruited and received a thorough induction and support before working with people. People told us they felt safe and staff were competent in their roles.

People told us they enjoyed the meals provided and were offered choice of food. People were supported to eat and encouraged to maintain their independence at mealtimes.

The home was clean and homely but required maintenance work and redecoration throughout. The provider had a refurbishment plan in place which was due to start in September.

A new manager is in position who has plans to implement new processes and systems to improve the service. These were not in place at the time of the inspection, but we saw examples of the new audits and surveys to be used.

People were happy with the care they received and there was a clear direction and ambition to improve the service.

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 supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 11 March 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

The provider took immediate action to address the risk found during the inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

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. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines, safety and good governance at this inspection.

Please see the action we have told the provider to take at the end of this 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.