Background to this inspection
Updated
9 July 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 took place on 31 May and 1 June 2016 and was unannounced.
An inspector, nurse specialist and an expert by experience undertook this inspection. 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 expert by experience at this inspection had expertise in older people and dementia care.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.
We observed care and spoke with people and staff. We spent time looking at records including seven care records, three staff files, medication administration record (MAR) sheets, staff rotas, the staff training plan, complaints and other records relating to the management of the service.
On the day of our inspection, we met with six people living at the service and spoke with three relatives. We chatted with people and observed them as they engaged with their day-to-day tasks and activities. We spoke with the registered manager, the deputy manager, two registered nurses, four care staff, a volunteer who spent time at the home and the chef.
The service was last inspected on 18 June 2014 and there were no concerns.
Updated
9 July 2016
The inspection took place on 31 May and 1 June 2016 and was unannounced.
Irene House is registered to provide nursing care and accommodation for up to 40 people with a range of needs, including people living with dementia. At the time of our inspection, 39 people were living at the home. Irene House is a large, older-style detached property with the addition of annexed accommodation surrounding an enclosed garden/courtyard area. Communal areas include a large dining room, sitting room and conservatory. Some rooms have en-suite facilities and all are of single occupancy. Irene House is situated close to Worthing town centre and seafront.
A registered manager was 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.
Not all staff had received regular supervision meetings or annual appraisals to assist them to carry out their role effectively. This had been already been identified as an area for improvement by the provider. Following the inspection, the registered manager had put a plan in place to ensure that outstanding staff supervisions were organised and completed in line with the provider’s policy.
The home was uniformly decorated throughout and had not been specifically adapted to meet the needs of people living with dementia. This was discussed with the registered manager as an area for improvement.
Staff had completed all essential training and staff meetings were organised, although these were not always well attended by staff. New staff completed an induction programme and studied for the Care Certificate, a universally recognised qualification. Staff understood the requirements relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and put this into practice.
People had sufficient to eat and drink and were supported to maintain a balanced diet. They had access to a range of healthcare professionals and services.
People told us they felt safe living at Irene House. Staff had been trained to recognise the signs of potential abuse and knew what action to take. People’s risks were identified, assessed and managed appropriately by staff. Accidents and incidents were reported and prompt action taken to prevent the risk of reoccurrence. Weekly checks were undertaken of equipment used to support people. Staffing levels were sufficient and robust recruitment systems were in place. Medicines were managed safely. Staff had a good understanding of their role in the prevention and control of infection.
People were looked after by kind and caring staff who knew them well. They were supported to express their views and to be involved in all aspects of their care. People were treated with dignity and respect. At the end of their lives, people were supported to have a private, comfortable, dignified and pain-free death by staff who were sensitive to their needs. Records relating to people’s end of life care had been completed appropriately.
People received personalised care that was responsive to their needs. Care plans included detailed, comprehensive information about people’s care needs, their likes, dislikes and preferences. A range of activities was organised for people. Complaints were managed promptly in line with the provider’s policy.
People were involved in developing the service and they were encouraged to be involved in meetings with their relatives to feedback their views about the service. The provider sent out annual surveys to people and their relatives. Staff felt supported by the management team at Irene House and that any concerns they had would be listened to. People and staff said the home was well managed and well led. A system of audits monitored the quality of the service overall and identified areas for improvement.
We found one breach of regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.