The inspection took place on 23 and 24 May 2016 and was unannounced. The service was last inspected in December 2013. There were no breaches of the legal requirements at that time. Larkhall Springs Nursing Home is registered to provide nursing care for up to 36 people. On the day of the visit, there were 36 people at the home.
There was a registered manager for the service. 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.
Some staff assisted people who needed extra help with their meals by standing next to where the person they were assisting was seated. This practise was not dignified for the people who were being supported. This was because the mealtime experience for those people was not being treated as an interactive and person centred event.
Everyone we spoke with told us they always felt safe and secure at the home. They said that staff were kind and always respectful towards them. When risks to people were identified suitable actions were put in place to minimise the risk of people being harmed when receiving care. The risks of abuse to people were minimised, as staff were competent in their understanding of abuse. The team were trained to know how to report concerns correctly.
People had their needs met by enough suitably qualified staff. Staff provided people with care that was safe. The numbers and skill mix of staff deployed at any time of the day or night meant peoples’ needs were met in a timely manner.
People told us how much they liked the programme of regular one to one and group activities taking place in the home. People told us they liked the entertainers who performed at the home on a regular basis.
People said that they liked the food and told us they were offered choices at each mealtime. People were provided with a varied diet that suited their needs.
People who lived at the home and the staff had built up positive and caring relationships. This also extended to include relatives and friends.
Care plans were informative and guided staff so that they knew what actions to follow to meet people’s range of care and nursing needs. Staff knew what was written in each person’s care records. They knew how to provide care that was flexible to each individual and met their needs.
People were supported by a team of well trained staff. The staff had attended regular training and were developed and supported in their work. This helped them to improve and develop their skills and competencies. Nurses were able to go on regular training and updating of their skills. This was to help them know how to provide nursing care based on up to date practice.
When people had the capacity to, they were encouraged to be included in making deciding how they wanted to being cared for. There were effective systems in place that helped ensure staff obtained consent to care and treatment in line with legislation and guidance. When people did not have capacity to consent, their care needs were assessed in line with The Mental Capacity Act 2005. Staff had completed Mental Capacity Act training. They knew about consent, people’s rights to take risks and the how to act in someone’s best interests.
People knew how to complaint and make their views known .The provider actively sought the views of people and their families. Suggestions were acted upon and changes were made to the services when needed.
Staff spoke positively of the management structure of the organisation they worked for. They said that senior managers and the registered manager provided strong and effective leadership. The staff team told us they were well supported by the registered manager who spoke positively about their role, Staff said they saw them every day and they were always there for them when they needed support and guidance.
There were systems in place to monitor the service to ensure people always received care that was personalised to their needs. Quality audits identified where improvements were needed and actions were in then put in place to address these areas.
We have made a recommendation about staff training on the subject of assisting people in a way that maintains dignity.