Coalville Nursing Home

Coalville Nursing Home provides accommodation, nursing and personal care for up to 40 older people, some of whom may be living with dementia, physical disabilities and sensory impairments. At the time of our inspection there were 22 people using the service.

People’s experience of using this service and what we found

The service was well-staffed to meet the challenges of keeping people safe throughout the COVID-19 pandemic. A relative said, “Hats off to the staff who have dealt with the situation, working long and extra hours to keep the home open through this pandemic.”

Staff knew how to keep people safe and had improved medicines systems to ensure people had their medicines when they needed them. Some improvements were needed to people’s care records. Staff and managers were addressing this.

The provider had good systems in place to protect people, visitors and staff from infection. Managers and staff wore the correct PPE (Personal Protective Equipment) and followed infection control guidance to keep people safe.

Staff enabled people and relatives to stay in touch during the pandemic with regular phone calls, garden visits, and online meetings. Relatives said staff kept them up to date with changes to their family members’ care needs.

People, relatives and staff shared their views of the service through surveys and discussions. A relative said, “The staff and management have been very good – they have shown very good care.”

A new manager was in post and supported by senior management with a view to becoming registered with CQC. The new manager knew which areas of the service needed improvement and had action plans in place to address these.

The provider’s audit systems ensured all areas of the service were subject to oversight and monitoring. The service worked to an action plan to continually improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a focused inspection based on concerns we had received about the service. These were in relation to people's care. As a result, we undertook this focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has stayed the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Coalville Nursing Home on our website at www.cqc.org.uk

Whilst people received their medicines safely and as prescribed by their GP, the storage of some medicines needed attention.

The registered manager monitored the service being provided to make sure people received the safe care and support they required. A recommendation was made regarding the auditing of people’s medicines.

People felt safe living at Coalville Nursing Home and with the staff team who supported them. The staff team were aware of their responsibilities for keeping people safe from avoidable harm.

Risks associated with people’s care and support had been appropriately assessed and managed.

There were overall, suitable numbers of knowledgeable and experienced staff on duty to meet people’s individual care and support needs.

People were protected by the providers policies and procedures for the control and prevention of infection.

The registered manager ensured lessons were learned when things went wrong.

People were supported to access healthcare services when they needed them and they were supported to eat and drink well. They were involved in making decisions about their care and support and their consent was always obtained.

People’s individual care and support needs had been identified and plans of care developed.

People were treated with kindness and compassion and their privacy and dignity respected.

The staff team had the skills and knowledge they needed to meet people’s care and support needs and they knew the needs of the people they were supporting well.

Checks had been carried out on new members of staff to make sure they were suitable to work at the service. The staff team felt supported by the management team and involved in how the service was run.

People were provided with a clean and comfortable place to live and there were appropriate spaces to enable people to either spend time with others, or on their own.

Formal complaints process was displayed and people knew who to talk to if they had a concern of any kind. Complaints received by the registered manager had been appropriately managed and resolved.

Staff meetings and meetings for the people using the service and their relatives had been held. These provided people with the opportunity to have a say and to be involved in how the service was run. Surveys had also been used to gather people's feedback.

The registered manager worked in partnership with other agencies to ensure people received care and support that was consistent with their assessed needs.

More information can be found in the detailed findings below.

Rating at last inspection: Good (report published 22 June 2016)

About the service: Coalville Nursing Home provides accommodation for up to 40 people who require nursing or personal care. There were 36 people using the service at the time of our inspection including people living with dementia.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Coalville Nursing Home provides accommodation for up to 40 people who require nursing or personal care. There were 37 people using the service at the time of our inspection including people living with dementia.

The service had two registered managers. 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 told us they felt safe living at Coalville Nursing Home. Relatives we spoke with agreed with this. Staff we spoke with were aware of what to look out for if they suspected that someone was at risk of harm, although there was one incident during our visit when a person’s safeguarding plan had not been followed.

Risks associated with people’s care and support had been assessed. These assessments provided the management team with the opportunity to reduce and properly manage the risks presented to both the people using the service and the staff team.

People’s care and support needs had been identified before they had moved into the service. This was so that the management team could be sure that each person’s needs could be met. From the initial checks, plans of care had been developed. These provided the staff team with the information they needed in order to properly support the people in their care.

Appropriate checks had been carried out when new members of staff had started working at the service. This was to check that they were suitable and safe. An induction into the service had been provided for all new staff members and ongoing training was being delivered. This enabled the staff team to provide the care and support that people needed.

People were receiving their medicines as prescribed by their doctor. Medicines were being appropriately stored and the necessary records were being kept. There were systems in place to audit the management of medicines and these were effective in picking up any shortfalls within the documentation held.

People we spoke with felt there were currently enough members of staff on duty each day because their care and support needs were being met. Their relatives agreed with what they told us.

People were supported to maintain good health. They had access to relevant healthcare services such as doctors, district nurses and opticians and they received ongoing healthcare support.

People told us the meals served at Coalville Nursing Home were good. People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was being provided. For people who had been assessed to be at risk of not getting the food and fluids they needed to keep them well, records were kept showing their food and fluid intake.

On the first day of our visit we noted that some people’s experiences of mealtimes were better than others. This was because the staff team didn’t always interact well with those they were supporting. The second day however was much better, with the staff team making sure that they spoke with the people they were supporting.

The staff team involved people in making day to day decisions about their care and support. When people were unable to make their own decisions, we saw that decisions had been made for them in consultation with people who knew them well and in their best interest. The staff team were working in line with the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards.

People told us that the staff team were kind and caring and they treated people with respect. The relatives we spoke with agreed and we observed the staff team treating people kindly throughout our visit.

People were supported to follow their interests and take part in social activities. Two activities leaders were employed and they supported the people using the service with both one to one and group activities that they clearly enjoyed.

Relatives and friends were encouraged to visit and they told us that they were made welcome at all times by the staff team.

Staff meetings and meetings for the people using the service and their relatives were being held. These provided people with the opportunity to have a say and to be involved in how the service was run.

Staff members we spoke with felt supported by the management team. They explained that they had been provided with the opportunity to meet a member of the management team on a one to one basis to discuss their progress. They also told us that there was always someone available for support and advice should they need it.

The people using the service and their relatives knew what to do if they had a concern of any kind. A formal complaints process was in place and this was prominently displayed. Everyone we spoke with were confident that any concerns that they had, would be taken seriously and acted upon.

There were systems in place to regularly monitor the quality and safety of the service being provided. Regular checks had been carried out on the environment and on the equipment used to maintain people’s safety and a business continuity plan was in place for emergencies or untoward events.

People received their medicines at the right time and saw the doctor as and when required. One person told us they had no concerns about their medicines and said 'I know exactly what I need to take and when. I have absolutely no complaints it or anything else here.'

Effective recruitment processes were followed and appropriate checks were carried before staff began to work. Staff were supported, supervised and trained to ensure people's care and support needs were met. Staff maintained their skills and knowledge through regular training to provide the care and support needed.

The Care Quality Commission found the registered manager was qualified, experienced and fit to manage Coalville Nursing Home on a day to day basis.

People received personalised support that promoted their rights and independence. People were treated with respect and their care needs met safely. People had a range of assessments and care plans in place that detailed the care and treatment they needed. Records showed people's health and care needs were monitored and reviewed regularly.

People's health and care needs were met by enough qualified nurses and care staff. Staff were trained to look after the people using the service. A visiting relative said: 'Staff are polite and know how to care for her' and 'there's always something happening to keep people occupied.'

Arrangements were in place to support people safely and to deal with foreseeable emergencies. Equipment identified through the assessment of needs was available and maintained in good working order to assist in the safe provision of care.

People had opportunities to make comment about the service and had information about how to make a complaint. They were confident to raise concerns with the registered manager. One person said: 'When I've told them about a problem, they've sorted it out straight away, so I've not had to complain.'