About the service St Margaret's Nursing Home is a nursing home providing personal and nursing care to 20 people aged 65 and over at the time of the inspection. Some people were living with dementia, some had mobility difficulties, sensory impairments and some were cared for in bed. Accommodation is
arranged over two floors. There was a passenger lift for access between floors. The service can support up to 25 people.
People’s experience of using this service and what we found
People told us they felt safe. Comments included, “They make sure everything is okay for you. They check you are alright, so I feel safe” and “They sort out my medication for me and they ask me if I want any pain killers. They always wait with you when you take your medicine.”
Relatives told us they were happy with the care their loved one’s received. Comments included, “The staff are brilliant, [loved one] is extremely well looked after” and “They know what to do, you couldn’t want for better staff.”
Staff had been recruited safely to ensure they were suitable to work with people. People had regular staff who they knew well. People were well supported by competent, knowledgeable and well-trained staff. Staff were well supported by the management team.
The premises were clean and free from odours. We were assured that the provider’s infection prevention and control policy was up to date. People and relatives told us, “I think the cleanliness is excellent”; “The room has been redecorated and new carpet and when I used to visit it was spotless. You never get any unpleasant smells”; “The staff always wear their PPE, so I am protected” and “Cleaning is fantastic, no smells ever.”
Risks to people’s safety had been well managed. Risks to the environment had been considered as well as risks associated with people's mobility and health needs. The provider continued to have systems in place to monitor accidents and incidents, learning lessons from these to reduce the risks of issues occurring again.
The design and layout of the service met people’s needs. Sign posts were in place which helped people living with dementia.
Prior to people moving in to the service their needs were assessed. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person.
Meals and drinks were prepared to meet people's preferences and dietary needs. Most people told us they liked to the food, some people told us the food was alright. We discussed this with the registered manager who arranged to do a meal survey with people.
The service was well-led. The management team carried out the appropriate checks to ensure that the quality of the service was continuously reviewed, improved and evolved to meet people’s changing needs. The registered manager promoted an open culture and was a visible presence in the service, staff felt listened to and valued.
People were protected from abuse and avoidable harm. People’s medicines were well managed. If people or their relatives wanted to complain they knew how to do so.
People were treated with dignity and respect. People’s views about how they preferred to receive their care were listened to and respected. People and relatives told us staff were kind and caring.
People had access to a range of different activities throughout the week. People told us that they took part in these. Activities were also provided for people who received their care and treatment in bed.
People received good quality care, support and treatment including when they reached the end of their lives. People had been involved in planning and discussions about their wishes and preferences in relation to their end of life care.
When people needed medical attention, this was quickly identified, and appropriate action was taken. For example, if people were losing weight referrals were made to dieticians, or if people fell regularly, they were referred to a fall’s clinic. Nursing staff worked closely with the GP and other health professionals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 May 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received about staff training, moving and handling practice and some risks not being effectively managed. This inspection was also carried out to follow up on action we told the provider to take at the last inspection.
We found no evidence during this inspection that people were at risk of harm from this concern.
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 coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.