13 September 2023
During an inspection looking at part of the service
Conifers Nursing Home is a residential care home providing personal and nursing care to up to 40 people. The service provides support to older people, some who may be living with a diagnosis of dementia. At the time of our inspection there were 32 people using the service.
People’s experience of using this service and what we found
People’s risks were not always managed safely, and care plans did not always reflect people’s needs. Medicines were not always managed safely. Lessons were not always learned when things went wrong.
Some areas of the home required refurbishment and there were plans in place for this to be completed. However, there were areas of the home where infection prevention control practices needed to be more robust. Safeguarding processes needed strengthening to ensure people were protected from harm.
Governance systems needed improving. There was no registered manager in place and therefore the service had received limited managerial oversight. There were some mechanisms in place for staff to feedback and share thoughts and views about the service although these had not always been effective.
There were enough staff to support people. The management team had received recent contact with other professionals and organisations and were taking learning to improve. People were mostly supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Where people were being supported with needs relating to a learning disability, we expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
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 good (published 24 September 2019).
Why we inspected
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.
We received concerns in relation to the general management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Conifers Nursing Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to regulation 12 (safe care and treatment), regulation 15 (equipment and premises) and regulation 17 (governance) at this inspection.
Please see the action we have told the provider to take at the end of this report. We have issued the provider with a warning notice. We will check the provider is taking action to comply with the legal requirements set out in the warning notice.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.