Archived: Newstead Nursing Home

Updated 31 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 inspection took place on 19 and 20 November 2014. The inspection team included two inspectors, two specialist professional advisors (one nurse and one speech and language therapist) and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This person’s expertise was in the care of people who have dementia.

We took into account the service’s inspection history, which included three inspections in the previous 12 months. We took enforcement action against the registered provider, GCH (Newstead) Ltd, as a result of our inspections. This took the form of four warning notices in August 2014, due to breaches of regulations about staffing, support for staff, record keeping and quality assurance (the provider’s responsibility for assessing the risks to people in the home and the quality of the care provided). We then served another warning notice in October 2014 due to a failure to comply with the regulation about the care and welfare of people in the home, including a substantiated case of neglect of a person living in the home. The local authority had also made the decision to restrict further admissions of people into the service.

Before this inspection we reviewed all the information we held about this service, including the notifications sent in by the provider over the past six months, complaints, safeguarding alerts, inspection reports from July and September 2014, enforcement action taken against the provider, the provider’s action plan for improving the service and information provided by the local authority and the local Clinical Commissioning Group.

We used a number of different methods to help us understand the experiences of people living in the service. We spent time observing care and how staff interacted with people in the communal areas such as the lounge and dining area and spent time with some people in their rooms. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. There were 21 people using the service at the time of our inspection. We met 20 of the 21 people who were using the service and spoke with nine of them about their experience living in the home and views on the home. We also spoke with four relatives. We spoke with the temporary manager, one of the provider’s directors, a quality assurance manager for the company, and eleven staff members, including kitchen and domestic staff, care assistants and nurses. We also spoke with four health and social care professionals during and after the inspection.

We looked at ten people’s care and treatment records in detail. We also checked menus, risk assessments, six staff files, staff duty rosters, staff training, supervision and meeting records, accident and incident records, selected policies and procedures, quality checking records and medicine administration record charts.

Updated 31 March 2015

This unannounced inspection took place on 19 and 20 November 2014.

Newstead Nursing Home provides nursing and personal care to older people who have nursing needs. The home can accommodate 36 people in single bedrooms. At the time of this inspection there were 21 people living in the home.

There was no registered manager in the home. 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. The home has had a number of different managers in recent years which meant there has been a lack of continuity of management which had an impact on staff morale and on quality of care provided. There had been concerns about the standard of care and treatment provided to people at the service over the last six months. We took enforcement action against the provider in August 2014 and again in October 2014. At the last inspection in October 2014, we took enforcement action because some people in the home were not receiving safe and good care. We told the provider to take action to improve the care provided and we found this action was completed.

The provider had increased staffing levels so that there were enough staff to keep people safe, meet their care needs and spend time with them talking and providing comfort and reassurance. People said they felt well looked after and that staff were quick to help them whenever they needed support.

Nineteen people were getting good support to eat and drink enough. Two people were not getting the right support to meet their individual eating needs.

This was a breach of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. This regulation requires care providers to provide suitable food to meet individual needs. You can see what action we told the provider to take at the back of the full version of the report.

Staff were not trained in end of life care. Community specialist nurses provided this support to people in the home. The provider had ensured staff had more training and supervision which helped them to provide a safer standard of care. However staff did not have enough training in communicating with people who have dementia or other difficulties with communication.

This was a breach of Regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. This regulation requires care providers to ensure staff have appropriate training to provide safe and appropriate care and treatment. You can see what action we told the provider to take at the back of the full version of the report.

The organisation of the environment was not based on best practice for people living with dementia to help people have a more homely experience. Some people sat all day in the same chair and furniture was not placed in the best way to give people a choice of where to sit and whether to talk to others or watch television.

This was a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. This regulation requires care providers to ensure the building is of a suitable design and layout . You can see what action we told the provider to take at the back of the full version of the report.

We found that staff formed good relationships with people in the home and got to know them well. There was a friendly atmosphere and staff and residents were talking and laughing together.

People living in the home and their representatives were satisfied with the care and thought their individual needs were met.

The temporary manager who began managing the home in July 2014 made significant improvements in the quality of care provided at this home. Staff, relatives and people living in the home told us they were all happy with the positive changes this manager had made.

The provider was regularly monitoring the standard of care and making continuous improvements.

We have made a recommendation about improving the quality of care records.