The Old Rectory Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems were in place to protect people from the risk of abuse. Staff told us they received training in safeguarding and knew what actions to take if they suspected abuse. The service worked within the principles of the Mental Capacity Act 2005 (MCA) and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. Any conditions related to Deprivation of Liberty Safeguards (DoLS) authorisations were being met. We found there were sufficient staff on duty to meet people’s needs in a timely way. Staff showed compassion and were caring in their interactions with people. The environment was clean and infection prevention and control measures promoted people's safety.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives felt the home was safe and staff provided appropriate care and support. People felt comfortable talking with staff about any concerns and felt listened to.

The registered manager told us they used incidents as learning and discussed them in staff meetings. The registered manager was aware of their responsibilities in line with the duty of candour and said families were notified and support was offered to them. Staff told us they were involved in discussions about incidents and spoke about actions taken to improve the service.

The registered manager took a proactive response to concerns and used incidents to learn lessons and develop the service. An accident and incident analysis was in place and reviewed monthly so trends and patterns could be identified and action taken to reduce risk. The registered manager was keen to look for ways to develop the service and used the audit system to identify concerns, learn lessons and take action to improve the service. Staff were also on board with the learning and wanted the home to succeed. All staff were made aware of any actions required from complaint and concern investigations and how to change service delivery to improve the standards of care and service that people receive.

People had no concerns about the home or care they received. However, people felt they were not always involved in decisions about their care and support.

Staff were aware of procedures in place to support safe transitions. One staff member said, “When someone goes into hospital, we send an hospital pack containing all relevant information, including past medical history, diet and supporting information.”

Visiting professionals were complimentary about the home and told us care plan documentation had improved and were very informative and reflective of people’s current needs.

Hospital packs were in place to ease transfers to hospital. Also, electronic medication administration records were also sent with people. This ensure information was passed effectively. Care plans showed evidence that people were referred to healthcare professionals as required, so they received the most appropriate care and support.

People were protected from the risk of abuse. People told us they felt safe living at the home. One person said, “I feel well looked after and not frightened of anything, I sleep better at night now.”

Staff and leaders were knowledgeable about safeguarding and knew how to recognise and report abuse. Staff were confident the management team would take appropriate actions. One staff member said, “[Manager] would definitely take appropriate actions to keep people safe.”

We observed staff to be kind and caring. Staff assisted people in a safe way, for example, when using hoists to transfer people from wheelchair to armchair. One person expressed discomfort when using the hoist sling, staff informed the person of the need for the sling and tried to make the person more comfortable.

Systems and processes were in place to safeguard people from the risk of abuse. The registered manager kept a record of safeguarding concerns and alerted the safeguarding authority about any concerns. The registered manager and staff understood their responsibilities and were working within the principles of the Mental Health Act 2005 (MCA). Where people lacked capacity to consent to care, decisions were made in their best interests. Deprivation of Liberty Safeguards were also applied for when required. This ensured the most appropriate support was being delivered in the least restrictive way.

People and relatives felt staff knew them well and carried out care and support safely and in line with their needs and preferences. One person said, “If I want to go walk about with my frame someone is always there to support me.” Another person said, “I feel well looked after and not frightened of anything, I sleep better at night now.”

Staff and leaders knew people well and were able to describe how they managed risks. Staff also told us they attended handovers to ensure any changes to people’s care and support were communicated.

Care and support we observed was delivered in line with people’s current needs and in line with their care plans. We observed staff assisting people to transfer using hoists and found this was carried out safely and in line with people’s assessed needs.

Risks associated with people’s care were identified and managed to keep people safe. Care plans and risk assessments clearly showed how people’s care should be delivered.

People told us they lived in a safe environment. One relative said, “When my [relative] was discharged from hospital they needed a special bed and there was one waiting for them.”

Staff told us they ensured the environment was safe especially when preparing to transfer people using the hoist. They told us they ensured areas were kept free from clutter so no unnecessary obstacles were in the way.

We carried out a tour of the service and found the environment was predominantly safe. However, we raised concerns with the registered manager regarding 2 easily accessible stairwells and many radiators without radiator covers. Following our site visit the registered managers took appropriate steps to ensure these areas were safe.

Systems were in place to ensure building and equipment safety, and servicing took place routinely. However, internal audits had not identified and addressed the concerns in relation to the accessible stairwells and radiator covers.

People and their relatives were positive about the staff and did not raise any concerns regarding their knowledge, availability or care.

Staff told us there were enough staff available to meet people’s needs. Staff informed us there had recently been an increase in staffing levels and this had been welcomed. One staff member said, “I think staffing is under constant review as well. We have some occasions when we are really busy but was can meet people's needs.”

We observed staff interacting with people and found there were sufficient staff to respond to people in a timely way. However, there were some occasions where people had to wait for staff to support them. We found staff deployment could be improved.

The registered manager completed a dependency tool to identify how many staff were required each day and night to meet people’s needs. This was reviewed regularly, and staffing levels were adjusted accordingly. The provider had an effective recruitment procedure which helped them recruit suitable staff. Staff received an induction when they commenced employment at the home. A comprehensive training programme was in place to provide staff with the knowledge and skills required to carry out their role well.

People and relatives said the home was clean and well maintained. One person said, “They [staff] are always cleaning and changing beds it is so clean and tidy.”

Staff were knowledgeable about infection prevention and control and ensured they carried out their tasks safely. Staff confirmed they had access to personal protective equipment and washed their hands in between tasks.

The home was clean, tidy and well presented. Ancillary staff were available to support cleaning and laundry within the home.

The provider had infection control policies in place and staff received training in infection prevention and control. An infection control audit was carried out routinely by the registered manager to ensure cleanliness was maintained.

People received their medicines as prescribed. We did not receive any negative feedback regarding medicine administration.

Staff informed us they received training in the safe handling of medicines and had their competencies checked on a regular basis. Staff could explain what action would be taken if an error was made. This showed concerns were acted upon.

Safe systems were in place to ensure people received their medicines as prescribed. Staff were knowledgeable about medicine management and their competencies were checked regularly to ensure their knowledge was maintained.