Westhampnett Nursing Home

Updated 14 August 2018

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 was 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 5 and 9 April 2018 and was unannounced. The inspection was carried out by two inspectors and an Expert 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.

Before the inspection we checked information that we held about the home and the service provider. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us.

During the inspection we spoke with 6 people and two visiting relatives or friends of people who lived at the home. We spoke with three care staff, a registered nurse, the chef, the manager, the provider’s group quality assurance and compliance manager, the auditor whom was responsible for some of the training and the provider’s group general manager.

We spent time observing the care and support people received in communal areas of the home. We used the Short Observational Framework for Inspection (SOFI) which is a way of observing care to help us understand the experiences of people who could not talk with us.

We looked at the care plans and associated records for seven people. We reviewed other records, including the provider’s internal checks and audits, staff training records, staff rotas, accidents, incidents, records of medicines administered to people and complaints. We looked at staff training records and staff supervision records. We also spoke with a Tissue Viability Nurse from the community nursing team and a visitor who provided religious services to people.

Updated 14 August 2018

The inspection took place on 5 and 9 April 2018 and was unannounced.

Westhampnett Nursing home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation, for up to 32 older people, who are living with dementia and who require support with their personal care or nursing care needs. On the day of our inspection there were 26 people living at the home. The home is a large property situated in Westhampnett, West Sussex. A combination of single or double bedrooms were available for people. Shared bedrooms were only used when two people, such as a married couple, or partners, chose to share. There was a communal lounge and dining room as well as a conservatory which people could use. The home had attractive gardens. There is a passenger lift so people can access the first and second floors and there is ramped access on the ground floor for those with mobility needs.

At the last inspection on 18 August 2015 we found the service was in breach of a regulation as the staff recruitment process did not ensure adequate checks were made that staff were suitable to work in a care setting. We made a requirement notice regarding this and the provider sent us an action plan of how they would be addressing this. At this inspection we found the provider carried out the required checks on newly appointed staff and this regulation was now met.

At this inspection we found risks to people were assessed and actions put in place to mitigate people coming to harm. These, however were not always consistently applied and we found sufficient action had not been taken regarding those people assessed of being at risk of developing pressure injuries to their skin. We have made a recommendation about this.

Where people did not have capacity to consent to their care and treatment this was assessed. Where these people had their liberty restricted an application for a Deprivation of Liberty Safeguards (DoLS) had been made to the local authority. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

There service did not have a registered manager in post but the current manager had submitted an application to register with the Commission. 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 and their relatives were satisfied with the standard and safety of the care provided. Staff had a good awareness of the principles and procedures for safeguarding people in their care.

Sufficient numbers of registered nurses (RGNs) and care staff were employed to ensure people were looked after well.

Medicines were safely managed.

The home was found to be clean and hygienic and there were no offensive odours.

The premises were safe and well maintained. Adaptations had been made so people with mobility needs could move around the home. People were able to personalise their rooms.

There were systems to review people’s care and when incidents or accidents had occurred.

People’s health and social care needs were assessed. There was evidence staff were trained in current guidance such as in palliative care and in supporting people who had needs regarding problems when swallowing food. Staff had access to a range of training courses including nationally recognised qualifications in care. Staff were also supported with supervision and their performance was monitored by regular appraisals.

People were provided with varied and nutritious meals. There was a choice of nutritious meals.

Staff supported people to access health care services such as their GP as well as when needing more specialist assessment and treatment for a dietician or the community nursing team.

People were observed to receive care from kind and caring staff. People’s rights to privacy and choice was promoted. People were consulted about their care and how they liked to be supported.

People received personalised care that was responsive to their needs. Care plans reflected people’s needs and preferences. Improvements had been made regarding the provision of activities and to engaging with people about this.

The provider had a complaints procedure and records were made of any complaint or concern raised. These records showed complaints were looked into and a response made to the complainant.

Whilst there were no people in receipt of palliative care staff were trained in this and there were plans to extend this to more staff. Advanced care plans had been devised with people regarding how they would like to be treated at the end of their life.

There were opportunities for people and their relatives to express their views which the provider responded to. The quality assurance and compliance manager had a clear plan of where improvements could be made and had put some of these into place. The staff and management worked well with other agencies such as the community nursing team.