Background to this inspection
Updated
25 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 08 and 09 December 2015 and was unannounced.
The inspection team comprised of four inspectors and one expert by experience that had experience with dementia. An expert-by-experience is a person who has personal experience of using or caring for someone who uses a dementia care service.
We looked at and reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We contacted commissioners for social care, responsible for funding some of the people living at the service. We also reviewed the information we held about the service which included notifications of significant events that affect the health and safety of people living at the service. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with eight people living at the service and nine relatives. We spoke with eight members of care staff, three unit managers, the registered manager, area manager and the regional support manager. We also spoke with three health and social care professionals. We reviewed the records of eight people, which included plans of care, risk assessments and medicine plans. We also looked at recruitment files of four members of staff, a range of policies and procedures, maintenance records of equipment and the building, quality assurance audits, feedback forms and minutes of meetings.
Updated
25 February 2016
The inspection took place on 8 and 9 December 2015 and was unannounced.
Grey Ferrers Nursing Home has four separate units. Brandon Unit provides low level dementia/mental health care and care for those with a physical disability. Stewards Hay which provides medium level dementia/mental health care and care for those with medium physical disabilities, Woodville provides high level dementia/ mental health care, and Bradgate Unit which provides end of life care. All four units provide both residential and nursing care. The location is registered to provide care for up to 120 people with dementia and physical disability. At the time of our inspection there were 83 people using the service.
Grey Ferrers Nursing Home has 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.
People told us that they felt safe at the service, and were happy living there. Staff had a good understanding of how to safeguard people and protect them from abuse. Staff were confident about what action they would take if they had any concerns, this would include reporting concerns to the unit manager or the registered manager. Staff were aware of the whistleblowing policy and felt confident to use it.
People were protected by safe staff recruitment procedures. Staff had received training which reflected the needs of the people living at the service and enabled them to provide support in a safe manner. This included supporting people with specific health related conditions and the appropriate use of equipment to move people safely.
We saw that people received their medication in a timely and safe manner, administered by staff who were trained in the administration of medication. People’s needs had been risk assessed to promote their safety. We saw there were sufficient staff to support people’s individual needs.
People told us that the food had recently improved as there was a new chef. People were offered choices with food and drinks and appropriate support was given when needed. There were drinks and snacks available between meals. We were informed that the nutritional risk screening tool and food record charts were not being completed correctly. This meant that people living at the service who are at risk of poor nutrition may not be being supported appropriately in order to meet their nutritional needs.
People were protected under the Deprivation of Liberty Safeguards (DoLS). We found that appropriate referrals had been made where people were thought to not have capacity to make certain decisions and had restrictions placed upon them.
We found conflicting information in people’s mental capacity assessments. We saw that in some instances documentation stated that a person living at the service lacked capacity but further documentation stated the same person had capacity. There were no decision specific mental capacity assessments in people’s plans of care. This meant there was a possible risk that people’s human and legal rights were not being respected.
People’s health and welfare was promoted and they were referred to relevant healthcare professionals in a timely manner to meet their health needs.
People’s plans of care were personalised and accurately reflected people’s care and support needs, the plans of care included information about people’s life histories, interests and likes and dislikes which provided staff with sufficient information to enable them to provide care effectively.
People told us they were happy with the care they received and were complimentary about the staff. The service had an atmosphere which was warm, friendly and supportive. We saw staff positively engaging with people living at the service and treating people with dignity and respect.
Audits and checks were effectively used to ensure people’s safety and the building and equipment were well maintained.
The provider’s management team and registered manager provided effective leadership to the service and sought regular feedback from people living at the service, and their relatives. They encouraged staff to attend meetings to share their views in order for them to review and develop the service.