Background to this inspection
Updated
13 January 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 was 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.
This inspection took place on 23 November 2015 and was unannounced. The inspection team consisted of one adult social care inspector, a specialist advisor with a background in nursing and an expert by experience with experience in mental health. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 improvements they plan to make. We also reviewed all the information we held about the service. This included any statutory notifications that had been sent to us. We contacted health professionals and the local authority.
During our visit we spoke with eight people who lived at Nesfield Lodge, nine visiting relatives, a district nurse, eight members of staff, two deputy managers and the registered manager. We observed how people were being cared for. We looked at areas of the home including some people’s bedrooms and communal rooms. We spent time looking at documents and records that related to people’s care and to the management of the home. We looked at five people’s care plans.
Updated
13 January 2016
This inspection took place on 23 November 2015 and was unannounced.
Our last inspection took place on 6 October 2014, at that time we found the service was not meeting the regulations relating to consent. The registered person did not have suitable arrangements in place to show they were acting in accordance with the Mental Capacity Act (MCA) 2005. On this visit we checked and found that the home was meeting the required standard.
Nesfield Lodge provides care for up to 44 people. There were 39 people living at the home at the time of the inspection. At the time of the inspection, the service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 we spoke with told us they enjoyed living at Nesfield Lodge and were very complimentary about the staff who supported them. They told us they felt safe, enjoyed the food and received good support with their health needs. The home had recently introduced a new device called ODE. (This is an innovative new product for use around the home, using fragrances to promote appetite to offer discreet reminder of mealtimes throughout the day this has been created for people living with dementia, including alzheimer’s.) The home had been using this with two people in order to help them put on weight. Through the provider’s auditing systems we saw both people had an increase in appetite which subsequently meant they had both put on weight.
People consented to care and had the freedom to make their own choices. People were relaxed in the company of staff. Staff interactions were friendly, respectful and caring. Visiting relatives were happy with the standard of care and told us the service was well led.
People’s individual care plans included information about who was important to them, such as family and friends. We saw people had varied individual interests they engaged in and were supported to be involved in a lot of activities in the home.
Staffing levels were sufficient to ensure people were supported with all their care needs and activities. The home had a variety of activities within the home and in the community to ensure that people were stimulated throughout their day. This included a five pet ‘hen coop’ area directly outside the ground floor lounge. This provided a source of enjoyment for several of the people living at the home, especially one person who spent a significant amount of time outside when previously they had been reluctant to do so. This meant that the home was providing a stimulating and meaningful activity to people in the home.
Staff understood how to safeguard people and knew the people they were supporting very well. Medicines were managed consistently and safely through an online system.
People lived in a safe environment. Rooms were decorated to individual taste and people could choose what items to keep there. The homes décor was vibrant, light and had meaningful pictures, many with textured finishes. People used the textures and hand rails to help find their way around the home.
Information for people was displayed in the home, this included leaflets about people’s rights, standards people should expect and customer surveys results.
Staff we spoke with told us they were well supported by their colleagues and management. The staff received appropriate training, supervision, appraisal and observations around their practice which meant that staff had the right skills and knowledge for their role.
Everyone we spoke with was complimentary about the registered manager. Staff told us the home had made positive changes over the last year. People had the opportunity to comment on the service and influence service delivery.