1 August 2023
During an inspection looking at part of the service
Retired Nurses National Home is a residential care home providing personal care and support for up to 52 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 32 people using the service.
People’s experience of using this service and what we found
People were not always protected from harm and abuse as safeguarding concerns had not been identified by staff and referrals were not always made to the local authority. Staff had received safeguarding training but had not always reported concerns. Some records completed by staff, did not demonstrate dignity and respect were given to people living at the home. Risks people faced were not always assessed robustly enough to support their safety. Risks regarding people’s health conditions were not always mitigated, especially where they could develop into a medical emergency.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. The service had not notified the CQC of all incidents that took place within the service as legally required. The provider wrote to us following the last comprehensive inspection to tell us how they would ensure they would meet the regulations. We found that some of these actions and improvements had not been sustained.
Management oversight within the home and at provider level was not robust. This was because their systems had not identified the shortfalls found within the inspection. During and after the inspection the provider had been responsive to address the issues identified and took action to make improvements.
People and their relatives told us they were happy with the care they received from the Retired Nurses National Home. Recruitment processes were in place to ensure staff had the right skills to work with people and various checks were carried out. People were protected from avoidable infections as safe procedures were in place which promoted a safe, hygienic environment. People were able to move safely around the home including to outside spaces.
People had access to healthcare and the home worked well with health and social care professionals. Staff had training for them to carry out their role. People received their medicines as prescribed. People had enough to eat and drink. The home sought feedback on the care it provided, people were consulted through meetings. Staff received training to support them in their role.
Staff felt appreciated and were complimentary about their colleagues. We received positive feedback about the management of the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 26 January 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last two rated consecutive inspections.
Why we inspected
We received concerns in relation to safeguarding people from harm and abuse, safety of medicines and the management of the home. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, and well led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Retired Nurses National Home on our website at www.cqc.org.uk
Enforcement
We have identified breaches in relation to safeguarding people from harm and abuse, consent, safe care and treatment and the management of the home.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.