Background to this inspection
Updated
10 June 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 between the 12 and 15 April 2016 and was unannounced. The inspection was undertaken by three inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
Prior to the inspection, we viewed all information we held about the service, including information of concern and statutory notifications. Statutory notifications are information about specific important events the service is legally required to send to us. We also viewed the Provider Information Return. 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 reviewed the information that we had about the service including statutory notifications. Notifications are information about specific important events the service is legally required to send to us.
We spoke with 33 people that used the service, 22 relatives and 18 members of staff. We also spoke with senior management staff including the area manager and registered manager.
We reviewed the care plans and associated records of 16 people who used the service. We also reviewed documents in relation to the quality and safety of the service, staff recruitment, training and supervision.
Updated
10 June 2016
We carried out a comprehensive inspection of Amerind Grove Nursing Home on 28, 29 July and 10 September 2015. Following this inspection, we served a Warning Notice for a breach of one regulation of the Health and Social Care Act 2008 relating to safe care and treatment. In addition to this, we also found an additional eight breaches of five other regulations of the Health and Social Care Act 2008 during that inspection.
Following the inspection the home was placed into special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements at its next comprehensive inspection and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Following the inspection the provider wrote to us to say what they would do to meet the legal requirements. We undertook a focused inspection on 3 February 2016 to check the provider was meeting the legal requirements for the regulation for which they had been served a Warning Notice; this related to safe care and treatment. At our focused inspection on 3 February 2016, we found that the provider had taken sufficient action to achieve compliance with the Warning Notice.
You can read the report for previous inspections, by selecting the 'All reports' link for ' Amerind Grove Nursing Home' on our website at www.cqc.org.uk
At this inspection the provider had made sufficient improvements to be removed from special measures.
Amerind Grove is a nursing home with a total of 171 beds. The home is split between five individual units. Kingsway provides nursing care, Picador is a residential unit for people with dementia and Embassy, Regal and Capstan units provide a mixture of residential and nursing care. Capstan unit in particular provides care for people with acute dementia. At the time of our inspection there were 96 people living in the home and Embassy unit was closed.
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.
People’s needs were regularly assessed and resulting care plans provided practical guidance to staff on how people were to be supported. Care plans however were not consistently person centred. Care plans were not personalised and did not contain individual information and references to people’s daily lives.
Procedures for the safe covert administration of medicines were not followed appropriately.
Training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) had been provided to staff. DoLS aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Staff were not knowledgeable about the protection of people’s rights. The service had also failed to ensure that best interest decisions were undertaken when people lacked the mental capacity to make decisions and give their consent.
Risk assessments did not always reflect necessary actions required to reduce risks to people. Some risk assessments were risk averse and placed unnecessary restrictions on people’s independence. Other risk assessments did not contain enough information to enable staff to prevent risk to people.
People were not supported to undertake person centred activities.
The provider had quality monitoring systems in place which were used to bring about improvements to the service. Some improvements had yet to be embedded by the service.
There were enough staff to meet people’s basic personal care needs.
There were mainly positive and caring relationships between staff and people at the service. We did see some instances of care which was uncompassionate. People praised the staff that provided their care. We received positive feedback from people’s relatives and visitors to the service. Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way when responding to their needs.
The staff had received training regarding how to keep people safe. They were aware of the service safeguarding and whistle-blowing policy and procedures.
There was a robust staff recruitment process in operation. The recruitment process was designed to employ staff that would have or be able to develop the skills to keep people safe and support their needs.
Staff demonstrated a detailed knowledge of people’s needs. They had received training to support people to be safe and respond to their care needs.
People had access to healthcare professionals when required, and records demonstrated the service had made referrals when there were concerns.
There was a complaints procedure for people, families and friends to use and compliments could also be recorded.
The provider had made appropriate notifications to the Commission; notifications tell us about significant events that happen in the service. We use this information to monitor the service and to check how events have been handled.
We found three breaches of regulations at this inspection. You can see what action we told the provider to take at the back of the full version of the report.