Archived: Needwood House Nursing Home

Updated 30 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. The inspection took place on the 05 March 2019 and was unannounced.

Inspection team:

The inspection team included 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 care service.

Service and service type:

Needwood House Nursing Home is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, both were looked at during this inspection. The service had a registered manager who was in post at our last inspection.

What we did:

Before the inspection we reviewed the information we held about the service and the provider. 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 looked at the notifications we had received for the service. Notifications are information about important events the service is required to send us by law. We also reviewed information we had received from the general public and professionals visiting the service.

We spoke with four people who used the service and four visitors to gather their views about the care they received. We looked at five people's care records. We checked recruitment, training and supervision records for staff and looked at a range of records about how the service was managed. We also spoke with the registered manager, the general manager, the provider and six staff in a range of roles in the service. After the inspection we received feedback from a professional who had visited the home.

Following the inspection we requested the registered manager send us their safeguarding policy, fluid audit charts and an updated choking risk assessment for a person using the service. The registered manager sent us this information within 24 hours of the inspection as requested.

Updated 30 April 2019

About the service:

Needwood House 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. Needwood House provides accommodation, personal and nursing care for up to 33 people some of whom are living with advanced dementia. At the time of the inspection, 32 people were using the service.

People’s experience of using this service:

We completed an unannounced inspection at Needwood House on the 05 March 2019. There was a registered manager in place who was present at the time of the inspection. 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.’

During our inspection we found, whilst people told us they felt safe we found people were not always protected from the risk of harm.

People were not always supported in a consistently effective way. We found people at high risk of choking and dehydration were not receiving timely review and risk assessments were not reflective of their needs. There were not effective systems in place to safely review the quality of the care being provided and highlight areas of risk.

Whistleblowers were not always supported to confidentially raise concerns regarding the service and the service did not always promote a culture of openness. Whistleblowing is the term used when someone who works for an employer raises a concern about risk or wrongdoing which creates a potential for harm to people who use the service, colleagues or the wider public.

People were treated in a caring way and staff had a good knowledge of the people they supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to be involved in decisions regarding their care where possible.

There were sufficient staff to support people. People did not have to wait for care to be delivered and when needed, people were supported on a one to one basis in accordance with their needs.

Staff were provided with training and supervision. Training was reviewed and additional training offered based on the needs of people living at Needwood House.

People were supported to receive their medicines in a safe and timely way by trained staff.

People were supported in a clean environment where good infection control practices were consistently applied.

People had access to adaptive equipment to maximise their independence and promote their dignity.

People were encouraged and supported to engage in social activities of their choosing both inside and outside of Needwood House.

Rating at last inspection:

At our last inspection on the 24 March 2016 we rated the service “Good”. At this inspection we found continued improvements were needed to ensure a consistent quality of care and the rating has declined to “Requires Improvement”. The service met the characteristics of “Requires Improvement” in the key questions of “Effective” and “Well led” and “Good” in "Safe", “Caring” and “Responsive”. This is the first time the service has been rated ‘Requires Improvement’ overall.

More information is available in the full report below.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk