The Village Nursing Home

Updated 30 July 2022

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 Health and Social Care Act 2008.

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 undertaken by two inspectors, an assistant inspector, a specialist advisor 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. The specialist advisor was a nursing professional.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. The current manager has submitted their application to register with CQC.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 19 May 2022 and ended on 13 June 2022 when feedback was provided. We visited the service on 19 May 2022. Telephone calls were made to relatives by the Expert by Experience on 24 May 2022

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection. 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.

During the inspection

We spoke with nine people and 13 relatives about their experience of the care provided. We spoke with 19 staff which included permanent and agency nursing, and care staff, team leader, medicine technician, activities co-ordinator, chef, housekeeper, deputy manager, quality manager and manager.

We reviewed a range of documents and records including the care records for 13 people, 50 medicine records, and three staff recruitment files. We also looked at records that related to the management and quality assurance of the service. 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.

Updated 30 July 2022

About the service

The Village Nursing Home is a residential care home providing personal and nursing care and accommodation for up to 90 people across three floors. Each floor is separated into two units each with its own communal areas. The service supports people with complex needs including dementia and people with nursing needs. At the time of our inspection there were 68 people using the service.

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

We were not always assured people received their medicines as prescribed due to the lack of information in their records for time sensitive medicines. We were not assured risks to people were effectively monitored due to the lack of records to support the management of these and discrepancy in records. The provider’s internal checks had not identified the shortfalls we found during our inspection.

We have recommended for the provider to seek external advice and guidance on providing an environment that will meet the needs of people with dementia. With observed some practices which compromised people’s dignity.

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; however, the policies and systems in the service did not always support this practice. We found Deprivation of Liberty Safeguards (DoLS) authorisations had expired and the provider had not sent requests for renewals in a timely manner. The new registered manager has implemented a new system to address this.

Safeguarding procedures were in place, and staff had received training to protect people from abuse. Action had been taken to learn from incidents that had occurred to reduce the risks of the same incident reoccurring. Staff were recruited safely. The provider was actively recruiting to reduce the number of agency staff used to support people. We were assured with the measures in place to prevent the spread of infection.

People were supported to access routine healthcare appointments. People told us they enjoyed the food provided and were supported to eat and drink enough to maintain their health. Staff had received additional training in relation to peoples medical needs to increase their knowledge and understanding. The provider had implemented additional training to agency staff to ensure they had the skills to support people who lived at this service.

Staff felt supported in their role. Systems were in place to support people to maintain contact with their loved ones. The manager was described as approachable, open and transparent. The service was taking part in research studies for people who live with dementia to aid the development of the research in this area.

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

Rating at last inspection. The last rating for the service under the previous provider was requires improvement published on 20 August 2021.

Why we inspected

The inspection was prompted in part by a notification of a specific incident. Following which a person using the service sustained potentially avoidable harm resulting in a hospital admission. This incident has been subject to a safeguarding investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of medicines and the training of staff including agency staff. This inspection examined those risks.

We have found evidence that the provider needs to make improvements.

Please see the safe section of this full report.

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.