Archived: Resthaven Nursing Home

Updated 25 June 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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was unannounced and was undertaken by a single adult social care inspector. At the last inspection in July 2013 we found no breaches in regulations.

Prior to the inspection we looked at information about the service including notifications and any other information received by other agencies. Notifications are information about specific important events the service is legally required to report to us. We reviewed the Provider Information Record (PIR). The PIR was information given to us by the provider. This is a form that asks the provider to give some key information about the service, tells us what the service does well and the improvements they plan to make.

During our inspection we spoke with 13 people living in Resthaven Nursing Home and six relatives. We were able to speak with two healthcare professionals who were visiting the service the same time as us and have included their feedback in the body of the report. We spoke with the registered manager and 13 other members of staff. This included members of the care team, the compliance manager, the administrator, catering staff and the activity coordinator. Two of the trustees were available for the feedback session at the end of the inspection.

We looked at five people’s care documentation and other records relating to their care. We looked at three staff files, training records, policies and procedures, audits, quality assurance reports and minutes of various meetings.

Updated 25 June 2016

This inspection took place on 10 and 12 May 2016. Resthaven Nursing Home is located on the outskirts of Stroud with commanding views over the valley of Painswick. The home is registered to accommodate up to 42 people, who are predominantly older people. At the time of our inspection there were 34 people in residence. A recent extension to the premises had been completed providing additional en-suite bedrooms and communal facilities. The home is fully accessible to those people with mobility impairments.

There was 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.

Since the last inspection a new registered manager was appointed in October 2015. The previous manager had worked at the home for a 15 year period. The trustees engaged a consultant to review how the service was performing along with the new registered manager and a robust action plan had been put in place to address those areas where improvements were needed. Throughout the report we have identified those areas where the registered manager had already instigated changes and the plans for the immediate future.

Improvements were required ‘as soon as possible’ with care planning documentation and other care records related to how the staff monitored people’s food and fluid intake and summaries of the full care plan. Completion of the charts was not being monitored by the qualified nurses at the end of their shifts and had not been picked up by the head of care nurse. Care planning documents did not provide a clear picture of people’s needs and were not person centred. The service had already taken some steps to make improvements and planned to revert to a paper based care planning process. Despite this, people’s care and support needs were being met.

All staff received safeguarding adults training as part of the mandatory training programme. They knew what to do if bad practice was witnessed, alleged or suspected and would take the appropriate actions. The registered manager was aware of the need to report events promptly to the local authority and CQC. There were safe recruitment procedures in place to ensure unsuitable staff were not employed. The appropriate steps were in place to protect people from being harmed.

Risk assessments were completed for each person as part of the care planning process and where risks were identified appropriate management plans were in place. The premises were well maintained and all maintenance checks were completed to ensure the home and equipment was safe.

The registered manager regularly checked that the staffing levels were reviewed and the care and support needs of each person could be met because there was sufficient staff. Staffing numbers had been increased following feedback from people and their families. People were not put at risk because staffing levels were not low.

New staff completed an induction training programme and there was a programme of mandatory refresher training for the rest of the staff team. The registered manager had implemented a programme of face to face training on a monthly basis. Care staff were generally only employed if they achieved a nationally recognised qualification in health and social care.

People were supported to make their own choices and decisions. Staff were aware of the need to ensure people consented to their care and support. The registered manager was aware when people lacked the capacity to make decisions, best interest decisions were made involving healthcare professionals. Staff were aware of the Deprivation of Liberty Safeguards and able to act accordingly when there was a need.

People were provided with sufficient food and drink. Their specific dietary requirements were catered for. A GP visited the service regularly on a planned basis and at other times whenever necessary. Arrangements were made for people to see other healthcare professionals as and when they needed to do so.

People were able to participate in a range of different activities and external entertainers visited the home. There were plans to increase the number of activity organisers and to involve the care staff in meeting people’s social needs.

There was a staffing structure in place. Regular staff meetings were held in order to keep them up to date with any changes and developments in the service. There were also ‘resident and relative’ meetings and people were encouraged to express their views about things they wanted to happen. This feedback was listened to and acted upon.

There was a programme of audits and checks in place in order to ensure the quality and safety of the service was maintained. Some of the checks were completed on a daily basis, others on a weekly or monthly basis. The information collected from these audits was used to drive improvements. The trustees had an active role in monitoring the service, visited regularly and spoke to people and the staff team.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.