Archived: Palm Court Nursing Home

Updated 12 February 2016

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to look at the quality of the service.

We undertook a focused inspection of Palm Court Nursing Home on the morning of 22 December 2015. This inspection was carried out by two inspectors. Before our inspection we reviewed the information we held about the home, including the recent concerns raised with the Care Quality Commission and the improvements the provider told us they were going to make after the last inspection.

During the inspection we spoke with three people who lived at the home, three visitors and five members of care staff. We also spoke with two health and social care professionals who visited the home and looked at three people’s care records

Updated 12 February 2016

We carried out an unannounced comprehensive inspection of this service on 17 and 20 March 2015. In December 2015 we received concerns in relation to the care provided to one person. We also received additional information that staff did not have time to meet people’s personal care needs. As a result we undertook a focused inspection to look into these concerns. We inspected the service against one of the five questions we ask about services: is the service safe? This is because the concerns raised were in relation to this question and we needed to check whether the service was meeting legal requirements. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Palm Court Nursing Home on our website at www.cqc.org.uk.

Palm Court provides personal and nursing care and accommodation for up to 36 older people. At the time of our inspection, there were 33 people living at the service. People had complex care needs, including advanced dementia and some who were completely dependent on staff to meet their physical care needs.

The service had a registered manager in post. 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.

We visited in the morning on 22 December 2015. We found staffing levels had been increased since the last inspection in March 2015 and staff had been deployed differently in order to work more effectively. We found no evidence to show people were receiving unsafe care. However, staff told us there were times when they were not able to meet people’s care needs as effectively as they would wish.

Staff told us there were not always enough staff to meet the care needs of everyone living in the home, particularly in the afternoons. This was due to the level and complexity of needs of the people they were supporting; often requiring two staff to assist with personal care or moving. Staff told us they did not have concerns about people’s safety, but they could not always spend as much time as they would like trying to persuade and encourage people to accept care. This meant there was a risk that people’s care needs may not always be met.

We found that records for the application of prescribed creams were not always being kept, or were not accurate This meant that the manager or nurses could not tell if people were receiving all of their prescribed medication correctly and people could be placed at risk of skin damage. However, we saw no evidence of this during the inspection and the deputy manager made immediate changes to improve recording systems in this area.

There was a range of risk assessments in place including pressure area care, falls, and nutrition. The assessments were comprehensive and clearly written. Where risks had been identified, appropriate action had been taken to minimise the risk. For example, where people had been identified as being at risk from pressure sores, pressure relieving equipment was being used.

Despite the staff being busy, the home felt calm and we heard lots of laughter between people and staff. People responded warmly to staff and told us they were happy with their care. Where they could not tell us, we saw that people responded positively to staff; smiling and holding hands. This indicated that they felt safe. Relatives told us that staff were patient and kind and their relative was happy. They felt confident that their loved one was being well looked after.

We recommend that the service considers using a tool to determine suitable staffing levels and reviews staffing levels regularly to ensure people receive safe care and support at all times.