Witnesham Nursing Home

Updated 3 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 checked whether the provider is 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 unannounced comprehensive inspection visit took place on 13 June 2018.

The inspection team consisted of an inspector manager and one inspector. Before our inspection we looked at information that had been sent to us by the registered manager. We also reviewed our previous inspection report, and the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make.

We spoke with six people who used the service and five relatives. We also spoke with the director, manager, one qualified nurse, chef, house keeper, three members of care staff, one member of the activities staff and two visiting professionals. We observed staff interactions with the people in their care.

We looked at the care records of five people who lived at the service. We also reviewed three staff recruitment files, the service training records. We also viewed staffing rotas with regard to people’s assessed needs, the recorded complaints and compliments, medicine records, audits of care and arrangements for meal provision.

Updated 3 August 2018

This comprehensive inspection took place on 13 June 2018 and was unannounced.

Witnesham nursing home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection of 13 March 2017, we rated the service as ‘Requires improvement’ because the environment did not always meet people’s needs and people were not always offered choices in all aspects of how they lived their daily lives. People’s care plans recorded their preferences but did not always detail how these would be met. The service did provide a variety of activities but these were not always directed towards people’s preferences. Audits to check the quality of the service provided were carried out but had not been in place long enough for to determine if they were effective.

At this inspection of 13 June 2018, we found the service had taken action on the above and we have rated the service as ‘Good’.

At the time of our inspection there were 18 people living at the service. There was a lounge, dining room, conservatory and secluded gardens for people to use and enjoy. The service had changed the service layout since our last inspection so that people could easily view televisions and the garden as they wished. People were supported to make choices of when they got up and when they retired for the day. Activities were focussed upon the interests of the people using the service we saw people making fudge and the day before our inspection people had visited a garden centre and bird sanctuary. The service had audits in place which were acted upon for the smooth running and development of the service.

At the time of this inspection, the service had not had a registered manager in post since April 2018. The service was now being managed by a previous registered manager of the service and they had re-applied to become the registered manager. 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.

There were arrangements in place to protect people from risks to their safety. Staff had received training regarding the safeguarding of people. Staffing levels of nursing and care staff were appropriate to support people to meet their assessed needs. There was a robust recruitment process in place for employing staff to support the people living at the service. Processes and procedures were in place to receive, record, store and administer medicines safely. Infection control training had been provided for the staff and procedures in operation were designed to keep people safe.

People were cared for by staff who received supervision and on-going training to develop their skills to support people with their assessed needs. Staff encouraged people to eat sufficiently and have drinks of their choice. People were supported promptly as required to see a range of healthcare professionals in order to maintain good health. 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 support this practice.

Care was delivered in an understanding and empathic way to meet people’s needs. People were supported by staff to make day to day decisions about their care. This included what they chose to eat and the times they got up and went to bed. The staff respected people’s dignity and privacy.

Each person had a care plan which was based on an individual needs assessment and took into account people’s preferences. The care plans were reviewed monthly and more regularly if so required to remain up to date. People were aware of how to make a complaint and spoke positively about the staff and managers.

People and relatives told us the service was run by knowledgeable and responsive staff with an open culture to listen to their views. There were systems in place to ensure the service was managed effectively and to monitor the quality of the service provided.