The service provides care and support for up to 49 people. When we undertook our inspection there were 46 people living at the service.
The people who were using the services had diverse needs. Most were older people, but there were some younger adults’ present. Some used wheelchairs to move about and some walked with the assistance of staff. Several people had nursing needs and were predominately nursed in bed and some had dementia and were nursed across the units, but their behaviour observed.
We inspected St Edmund’s Nursing Home on 16 March 2015. This was an unannounced inspection. Our last inspection took place on 11 June 2013 during when we found the service was meeting all the standards we assessed.
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.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. There were no people living at the home that were subject to any such restrictions. However, the recording of people’s best interests was poor.
We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.
The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives. However, the deployment of staff throughout the day and the high sickness levels meant there was the potential for care and treatment to be delayed.
Medicines were kept in a safe environment. However insufficient quantities of medicines were being kept to ensure people could receive their medicines as prescribed. Staff did not always ensure the medicines were locked away.
People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home.
People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. People could join in group activities, but their individual interests and hobbies were not being developed.
The provider used safe systems when new staff were recruited. All new staff completed thorough training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual. There were sufficient staff to meet people’s needs.
A complaints process was in place. However, this was only available in written English. No other formats were in use. This could mean that people were unaware of how to make concerns known.
People had been consulted about the development of the home. The provider had completed all the checks to ensure the quality of the service met peoples’ needs. However, there had been no analysis of the audits to show whether improvements were required and lessons learnt passed on to staff. There was a plan in place to ensure the environment and equipment was updated.