The inspection took place on 21 and 23 June 2016 and was an unannounced inspection.Petworth Cottage Nursing Home provides accommodation and nursing care for up to 32 older people. At the time of our visit there were 28 people living at the home.
The service has a registered manager. 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.
People, relatives, staff and healthcare professionals spoke very highly of the home. They told us that it had a strong reputation locally. We found that people received a high standard of care and that staff were continually striving to further improve the care and the service that people received.
People were actively involved in planning their care. Thorough pre-admissions assessments involving people, their families and community professionals ensured that effective care could be provided from the outset. Staff had taken time to get to know people and valued them as individuals. People were encouraged to pursue their independence and to participate in activities that interested them. We observed that people received sensitive, caring and prompt support from staff. On a monthly basis, each person met with their keyworker to discuss their care and make future plans. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).
Staff were proactive in monitoring people’s health and worked effectively with other services to ensure that people’s needs were met. Nurses met regularly with community professionals to ensure a coordinated approach in people’s care, to share best practice and to anticipate changes in people’s needs. A community matron told us, “They have good, knowledgeable nurses and they are very caring”.
Staff had expertise in palliative and end of life care. Relatives spoke highly of the care their loved ones had received and of the support staff offered to them. One relative wrote to the provider saying, ‘I would like to thank you all for the care, compassion and sensitivity you showed to my Father’. The service was working towards accreditation under the Gold Standards Framework (GSF) which aims to improve practice and reduce hospital admissions.
People had developed good relationships with staff and had confidence in their skills and abilities. They told us that staff were kind and that they treated them respectfully. Senior staff kept a focus on dignity through monitoring the delivery of care, trialling new initiatives and having regular discussions with staff. There was an established team of staff at the home, which offered continuity of care for people. Staff had received training and were supported by the management through supervision and appraisal. Staff were able to pursue additional training which helped them to improve the care they provided to people.
People felt safe at the home. Risks to people’s safety were assessed and reviewed. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. People received their medicines safely.
People enjoyed home-cooked food and were able to make suggestions for dishes they would enjoy. A team of volunteers worked on a rota to provide morning and afternoon drinks to people. Many people knew the volunteers from the local community and enjoyed their company. Staff were attentive to people’s needs and supported those who required assistance to eat or drink. People’s weight was monitored and prompt action taken if any concerns were identified.
There was strong leadership within the home. The registered manager and deputy monitored the delivery of care and had a system to monitor and review the quality of the service. Suggestions on improvements to the service were welcomed and people’s feedback encouraged.