Cheviot Nursing Home

Updated 21 December 2018

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.

This inspection took place on the 30 October 2018 and was unannounced. The inspection team consisted of two inspectors, a specialist professional 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. They had cared for a family member living with dementia.

Prior to our inspection, we reviewed the information we held about the service. This included safeguarding information, information from members of the public and notifications. Notifications are the events happening in the service that the provider is required in law to tell us about. We used this information to plan what areas we were going to focus on.

During the inspection, we observed the interaction between staff and people who used the service especially those who could not tell us their experiences verbally.

We spoke with 11 people who used the service, five relatives and friends. We spoke with 11 nursing, care and kitchen staff, the registered manager, deputy manager, director and deputy director of the company. Information was provided to us by two healthcare professionals.

We looked at a range of records relating to people's care and support. This included six people's care plans, four staff personnel files, training and supervision records and information on how the safety and quality of the service was being monitored and managed.

Updated 21 December 2018

At the last inspection on 5 May 2015, the service was rated as Outstanding. This comprehensive unannounced inspection was carried out on 30 October 2018. At this inspection, the overall rating is Good.

The service is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

There was a registered manager in place. 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.

Cheviot Nursing Home is registered to support 33 older people, some of whom may be living with dementia. On the date of our inspection, 28 people were being supported by the service.

People and their relatives were very complimentary about the service. They told us it was a safe place to live. Staff understood their responsibilities and knew how to safeguard and protect people from harm.

There was a system in place to assess risks to people’s health and wellbeing, however, these were not always appropriately recorded and reviewed in a timely manner. We have recommended that the provider review their system to ensure records were completed in a timely way.

Staff were recruited appropriately. Checks had been undertaken so that people were kept safe. There were sufficient numbers of staff deployed to meet the needs of people who used the service.

People received their medicines as prescribed and medicines were managed safely. Infection control processes were in place to minimise the risks and spread of infection.

Staff were well supported and received induction, training and supervision to carry out their role. People had sufficient food and drink and were provided with choices at meal times. Access to healthcare services to maintain people's health and well-being was provided.

People’s capacity to make their own choices and decisions were recorded and they or their representatives were involved in important decisions about their lives. However, some information was unclear and confusing. We have recommended that the service look at best practice guidance in relation to capacity and risk to ensure that high quality care is provided to everyone in the service.

The premises were purpose built and had been extended and adapted to meet people's needs. People had comfortable rooms which were personalised to their taste.

The staff were very caring, kind and compassionate. They knew people extremely well and were sensitive to their needs. People were encouraged to be as independent as possible and staff treated them with dignity and courtesy. Staff ensured people’s privacy was maintained and respected.

People received a service from staff who responded to them with excellent care and attention. Care plans were individual and recorded people’s diverse needs, wishes and preferences. People were actively involved in developing the service they received and feedback from them and their relatives about the service was very complimentary.

People had opportunities to participate and pursue their own leisure interests. One to one and group activities and events were offered and people could choose to get involved. Volunteers provided support, company and entertainment.

Information on how to raise concerns or complaints was available and people and their relatives were confident that any concerns they had would be listened to and acted upon.

End of life care for people and their families was outstanding. The service had achieved the Gold Standard Framework and had been commended for the quality of its care for people at the end of their life.

The management team were visible in the service and well respected. There were systems in place to regularly assess and monitor the quality of the service. Audits of the service were undertaken and analysed to ensure the service was operating safely. The service was delivering high quality care to people who used the service.

Further information is in the detailed findings below.