We found that the provider had made the improvements we has asked for. Records showed that medication was being adminstered reliably. Medicines were stored and disposed of safely and there was information to explain how people's PRN (taken as required) medication was managed. The provider had ensured that there were detailed and up to date care records in place in relation to people who had recently begun to use the service.
During our inspection we spoke with eight people using the service at Nuffield House. They all told us that they were satisfied with the care and support they received there. One person summed this up when they told us, 'It's really very good here. I see what goes on, I notice how things are done, they are very good.'
People told us that their medication was given to them reliably. We found that some prescribed creams were not being stored safely and also the arrangements for medication taken when required (PRN) needed to be improved.
There was a reliable process in place for the recruitment of new staff and this helped to ensure that people had the relevant skills and experience for their new roles.
People using the service had opportunities to express their views about the quality of the service and to share any concerns they may have.
Records were kept securely and disposed of appropriately but we found that there was not always sufficiently detailed information available for staff to refer to.
A process for assessing people's nutritional needs had been introduced. This was being used in a reliable way to help identify any possible risks to people's health and wellbeing.
Agency staff were better supported and received training and support to help equip them in their roles. Recruitment was underway to appointment more staff to the home.
The former registered manager, Ms. Sandra Hamilton, was no longer employed by the provider. We asked the provider to contact the former manager as they were required to cancel their registration with the Care Quality Commission. A new manager was in post at the home and was due to submit their registered manager's application.
The people we spoke with were satisfied with the care and support they received. They told us that they were treated with respect and spoken to politely. One told us, 'The staff are very nice to me, they look after me well.' Another said, 'I have no complaints at all. It's all very good.'
People were very complimentary about the food at Nuffield House. One person told us, 'The food is very good, I look forward to my meals.'
Although we acknowledged people were made welcome at the home, CQC were concerned that staff did not always have the information they needed to keep people safe when they were first admitted (see Outcome 1).
People told us they liked living at Nuffield House and the care was good. One person said, 'The staff are always helping me. If I need anything they get it. If I want to go out I tell the staff and they sort it out.' Another commented, 'I'm well looked after here. I've got no complaints about the staff. They've been very good.
Two people told us their lives had improved since they came to Nuffield House. One person said, 'The staff here have got me back on my feet. When I came here I was in a state, but now I'm well and making lots of friends.' Another person told us, 'Thanks to this place I am so much better and hoping to move into my own house soon.'
We saw lunch being served in the mental health unit. There was a family atmosphere as people sat round the table, chatting with staff and eating. Staff assisted people with their food where necessary. After lunch people helped staff to clear up and wash the dishes.
People told us if they had any concerns they would tell the staff on duty. One person said, 'If I have a problem I go to the office ' there is someone there 24 hours a day.' Another told us the staff were always supportive if they had a problem. They said, 'If you get upset for any reason at any time, day or night, the staff will make you a cup of tea and have a chat with you.'
The people who use the service did not comment on the safety of the premises, however CQC had concerns about this (see Outcome 10).