Ledbury Nursing Home

Updated 11 January 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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we could 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

The inspection was carried out by two inspectors and a specialist advisor in nursing. One inspector and specialist advisor visited the home. One inspector gathered information from the management team via telephone conversations and email. Additionally, the inspector spoke with relatives over the telephone.

Service and service type Ledbury Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission (CQC). A manager had been appointed and their application to become registered with CQC was progressing. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The 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 who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During our on-site visit to the home, we spent time seeing how people were cared for. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the home manager, quality improvement manager, regional operations manager, housekeeping, facilities manager and both nursing and support staff members on shift.

We looked at four people’s care records including associated charts where these were required and multiple medicine records. We looked at a sample of records relating to the management of the service including accident and incident documentation, health and safety checks and fire safety policy and procedures.

After the inspection

We continued to seek clarification from the registered manager and provider to validate evidence found. This included looking at additional documentation including a sample of completed audits and checks and staff training planner. We also spoke with three relatives of two people living at the home.

Updated 11 January 2022

About the service

Ledbury Nursing Home is a residential care home providing personal and nursing care to 26 people at the time of the inspection. The service can support up to 36 people.

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

People were supported to stay as safe as possible by staff who understood what actions to take to reduce risks to their well-being. This included reducing risks to people's physical health and mental well-being. This was an area of improvement following our last inspection.

Staff used their skills and the equipment required to reduce the risk of people experiencing infections. Checks on the home environment were also undertaken and systems for identifying if there was any learning after safety incidents were in place.

Since our last inspection ongoing improvements had been made to the management and administration of people’s medicines. People were supported by staff to have the medicines they needed to remain well.

Staff recruitment procedures were in place and appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. There were enough staff to support people's care and safety needs. Staff induction and on-going training was provided to support staff in gaining the skills, knowledge and support they needed to undertake their roles.

The views of people, relatives, staff and health and social care professionals were considered when people’s needs were assessed, and their care plans developed and reviewed. People were supported to choose what they wanted to eat and to obtain care from health and social care professionals so they would remain well. The home environment was adapted in various ways to meet people’s diverse needs.

Wherever possible, people's consent was gained before any care was provided. People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The manager had come into post since our last inspection and was keen to promote a culture of support for staff where learning was promoted and improvements continued to flourish. The manager and staff team worked in partnership with other professionals and the local community to achieve good outcomes for people.

Following the last inspection, the management team had worked together to bring about continual improvements to ensure their quality checking and monitoring practices were more effective. The provider and management team had established a range of quality checks which were regularly completed to make sure people received quality care.

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 requires improvement published 20 January 2021.

Why we inspected

This was a planned inspection based on the previous rating.

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.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.