Craigielea Nursing Home

Updated 3 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Act.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector 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.

Service and service type

Craigielea Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Dependent on their registration with us. Craigielea Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service, including notifications of incidents. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service, 7 relatives over the telephone, and 5 staff, including the registered manager, senior carers, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We observed interactions between staff and people. We contacted 6 external professionals via telephone and email, including safeguarding, commissioning and infection control teams. We contacted 8 further care staff via email.

We reviewed a range of records. This included 4 people's care records and medicines records. We reviewed a variety of records relating to the management of the service, including policies and procedures, training records and meeting minutes.

Updated 3 February 2023

About the service

Craigielea Nursing Home is a care home that provides accommodation, nursing and personal care for up to 60 people, some of whom are living with a dementia. At the time of the inspection there were 56 people living in the home.

People's experience of using this service and what we found

The premises were safe and a range of risks were well mitigated. The registered manager had introduced additional checks to ensure the premises were free from clutter, clean and appropriate doors were kept locked.

People felt safe and well supported by staff. Relatives raised no safety concerns and felt staff did a good job in reducing the risks people faced. External professionals shared similar feedback.

There were sufficient staff on duty, and planned in the rota, to ensure people received safe levels of care and the environment was clean and safe.

People’s care plans were up to date. Staff updated records electronically via handsets. At times information was added retrospectively due to the number of handsets available. The registered manager and provider assured us they would improve the contemporaneous nature of records.

Systems and processes for identifying patterns and trends were in place. Regular reviews of falls, safeguarding incidents and other incidents were analysed to try and reduce the risk of them repeating.

Medicines administration was safe. Records were clear and there were examples of good practice, for instance the recording of ‘when required’ medicines and topical medicines (creams). Regular auditing was in place and identified individual errors and areas for improvement, which were acted on. Where there was scope for improved working with the pharmacy, the provider pursued this.

People were kept safe from the risk of abuse. Relevant policies were up to date and information on how to report any concerns was readily available. When incidents occurred the provider acted promptly. The recording of some investigations could have been clearer and more open to scrutiny. The provider responded positively to this feedback and assured us they would review how investigations were documented and reported on.

Staff were recruited safely. Staff felt well supported and able to speak up if they had concerns.

The registered manager had made some positive changes and had more planned. The atmosphere during inspection was upbeat, with a school visit taking place and people relieved that staff were no longer required to wear masks at all times.

There were a range of champions in place for specific areas of practice, such as infection prevention and control, and end of life care.

The registered manager had surveyed people, relatives and visiting professionals regarding the standards of care.

External professionals felt communication from the registered manager was effective.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager demonstrated a good understanding of the service and people who used it.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 April 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.