Background to this inspection
Updated
27 May 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.
This inspection was carried out on 19 and 21 April 2016. It was unannounced. The inspection team consisted of the lead inspector and a specialist advisor on the second day.
Before the inspection the registered manager 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 looked at the PIR and at all the information we had collected about the service. This included previous inspection reports and information received from health and social care professionals. We also looked at notifications the service had sent us. A notification is information about important events which the service is required to tell us about by law.
During the inspection we spoke with six people who use the service. We spoke with the registered manager, two regional managers, two registered nurses and two care assistants. We observed interactions between people who use the service and staff during the two days of our inspection. We spent time observing lunch in the dining room. As part of the inspection we requested feedback from four health and social care professionals and two local authorities. We also asked for feedback from three relatives.
We looked at four people's care plans, associated documentation and medicine records. We looked at the recruitment files for two members of staff, staff training and staff supervision log. Medicines administration, storage and handling were checked. We reviewed a number of documents relating to the management of the service, for example, audits, the utility service certificates, service risk assessments, the complaints and compliments records and incidents records.
Updated
27 May 2016
This inspection took place on 19 and 21 April 2016 and was unannounced. Thamesfield Nursing Home is a care home with nursing that provides a service to up to 12 older people. At the time of our inspection there were 12 people living in the home.
The service had a registered manager as required. A registered manager is a person who has registered with the 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. The registered manager was present and assisted us during this inspection.
People told us they felt safe living at the home. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident it would be addressed appropriately. There were robust recruitment processes in place. All necessary safety checks were completed to ensure prospective staff members were suitable before they were appointed to post.
People told us staff were available when they needed them and staff knew how they liked things done. The service ensured there were enough qualified and knowledgeable staff to meet people’s needs at all times. The provider had employed skilled staff and took steps to make sure the care was based on local and national guidance. Staff were knowledgeable and focused on following the best practice at the service making sure people received appropriate care and support.
People told us they were encouraged to do things for themselves and staff helped them to be independent when they could. Risk assessments were carried out to ensure people’s safety. Staff recognised and responded to changes in risks to people who use the service. People received effective personal care and support from staff who knew them well and were trained and supervised. There were contingency plans in place to respond to emergencies.
People received support that was individualised to their personal preferences and needs.
Their needs were monitored and care plans reviewed regularly or as changes occurred. People were given a nutritious and balanced diet and hot and cold drinks and snacks were available between meals. People had their healthcare needs identified and were able to access healthcare professionals such as their GP. Staff knew how to access specialist professional help when needed.
People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure those rights were promoted. People were treated with care and kindness. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. The managers and staff were knowledgeable about Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). At the time of our inspection no one was deprived of their liberty. Staff were following the principles of the MCA when supporting people to make a decision.
People received their prescribed medicine safely and on time. Storage, handling and records of medicine were accurate. People and relatives told us good things about the service they received. Our observations and the records we looked at confirmed the positive descriptions people and relatives had given us. Staff understood the needs of the people and we saw care was provided with kindness and compassion. People and their families told us they were happy with their care.
People were able to engage in meaningful activities or spend time with their visitors or by themselves. Their choices were always respected. People's wellbeing was protected and all interactions observed between staff and people living at the service were respectful and friendly. People confirmed staff respected their privacy and dignity. People benefitted from living at a service that had an open and friendly culture.
People felt staff were happy working at the service and had a good relationship with them, each other and the management. Staff told us the management was open with them and communicated what was happening at the service and with the people living there. People told us they felt the service was managed well and that they could approach management and staff with any concerns.
The registered manager assessed and monitored the quality of care consistently with the help of staff and other members of staff in the company. The home encouraged feedback from people and families, which they used to make improvements to the service.
Throughout our inspection we saw examples of appropriate support that helped make the service a place where people felt included and consulted. People and their families were involved in the planning of their care.