The inspection visits took place on 14 and 17 April 2015 and were unannounced. The home was last inspected on 14 October 2013 and was meeting all the required standards we checked at that time.
Halwill Manor Nursing Home provides personal and nursing care to a maximum of 25 people. Most live with the condition of dementia. There were 25 people using the service at the time of the inspection.
The home has a registered manager. 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.
Medicine management was not robust. Although medicine management had been reviewed a discrepancy was found in the number of tablets recorded to what was actually in stock. Staff were also putting medicines into pots and carrying them on a tray and so increasing the potential for mistakes. Some medicines had been recorded into the home, not needed, but were still in stock over three months later. Changes to people’s medicine records had not been dated or signed which increased the risk of medicine errors.
Staff numbers and deployment met people’s needs in a safe way and were under regular review, taking into account people’s needs and staff opinion.
People were protected by the arrangement for prevention of abuse. This included staff training, robust recruitment and an openness to notify external agencies of any concern.
The home environment and equipment was well maintained and kept in a safe state. Improvements to the environment were planned and in progress.
There was a strong emphasis on staff training. Staff were encouraged and supported to undertake qualifications in care and they benefitted from a broad range of training opportunities. Staff received supervision and support to succeed in their role.
The provider had acted in accordance the Mental Capacity Act (2005) and Deprivation of Liberty safeguards to promote decision making and protect people's rights.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). People at the home were not being deprived of their liberty unlawfully.
People received a diet which promoted their health and welfare. Dietary concerns were identified and action taken as necessary. There was on-going nutritional assessment and management.
One staff member said, “People are loved here not just cared for.” People, their families and health care professionals reported staff to be kind, friendly and caring. Staff understood how to engage with people as individuals and in a person centred way. People’s dignity and privacy were promoted.
End of life care was provided in accordance with people’s wishes and with regard to their dignity and comfort.
People’s needs were assessed and their care was planned with them or with people who knew them best on their behalf. People’s hygiene and personal care needs were well met and their health was promoted. Staff could describe people’s needs and how to meet them, in detail.
People said they had no reason to complain but felt any complaint would be dealt with effectively.
The service was well led by a registered manager and provider working together to manage any risks and looking at how to continually improving the service.
We found one breach of Regulations in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The action we have asked the provider to take can be found at the back of this report.