Nyton House

Updated 20 April 2018

We carried out this comprehensive 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.

The inspection was undertaken by one adult social care inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the service. This included past reports and notifications. A notification is information about important events which the service is required to send us by law.

We spoke with a range of people about the service; this included eight people who lived at Nyton House, five staff members and the registered manager and care manager. Following the inspection we had responses from one health professional.

We looked at care records of three people who lived at the service, training and recruitment records of three staff members. We also looked at records relating to the management of the service. In addition we checked the building to ensure it was clean, hygienic and a safe place for people to live.

During our inspection, we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with people in their care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Updated 20 April 2018

This unannounced comprehensive inspection took place on the 7 February 2018. This was the first inspection since registration with the commission on 12 January 2017.

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

Nyton House is a large historic house in its own grounds situated on the outskirt of Chichester. The service provides single or double room accommodation for up to twenty five predominantly elderly people who need assistance with personal care, including those with a dementia related illness. There are also two houses in the grounds which provide accommodation to support people who are more independent. At the time of the inspection there were twenty-three people using the service.

The service is situated over three floors which are served by a passenger lift. A stair lift is located in one of the external buildings used for people with more independence. Fifteen rooms have en-suite toilets. Seven of those have baths or showers as well.

There were enough bathrooms including assisted baths on all floors. There is a large lounge on the ground floor with a conservatory also used as a dining area and general seating area overlooking the large gardens. There are a range of aids and adaptations to support people with limited mobility.

The atmosphere in the service on the day of the inspection was relaxing, friendly and calm. Staff responded promptly when people asked for help and support was provided at a relaxed pace. Throughout our inspection we observed staff providing support with respect and kindness. People told us they felt safe and comfortable living at Nyton House. Comments included, “It’s the best move I have made. Everything about living here makes me feel safe”; “All the staff have time for you. They are there whenever I need their help" and "Living here has certainly improved my quality of life and I do feel very safe living here."

People had access to an extremely diverse range of activities which were very meaningful to them. On the day of this inspection there was a choir practice which was well attended by people using the service. One person told us, “This is a wonderful idea. It is always well attended because everyone enjoys it so much. It brings back many happy memories of singing in a choir when I was younger.” People were supported to use a range of community activities either independently or with families and staff. This was to attend external events, have a coffee or visit local attractions. The service had also forged strong links with local schools who regularly visited the service to entertain people or just have a discussion with them. People also visited school events.

The service had recently introduced a new medicines system and was working through some of the changes which were designed to improve the safety and management of medicines. Medicines administration records had been completed and there were appropriate procedures in place for the ordering, storage and disposal of medicines.

Staff were sufficiently skilled to meet people’s needs. Necessary pre-employment checks had been completed and there were systems in place to provide new staff with appropriate induction training. Existing staff received regular training, supervision and annual performance appraisals.

People’s risks were being managed effectively to ensure they were safe. Records showed where changes in people’s level of risk were. Care plans had been updated so staff knew how to manage those risks.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse.

The manager used effective systems to record and report on, accidents and incidents and take action when required.

The service was suitably maintained. It was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

Staff wore protective clothing such as gloves and aprons when needed and there were appropriate procedure in place to manage infection control risks.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. Capacity assessments had been carried out however there were no restrictions authorised at the time of the inspection. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

There was a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff, resident meetings which could include families to seek their views about the service provided.