19 and 20 November 2014
During a routine inspection
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.