Archived: Selly Wood House Nursing Home

We found the following examples of good practice.

An indoor visiting pod was available to support people to have contact with their loved ones safely.

Records of people’s observations were analysed to identify symptoms of COVID-19. This supported staff to monitor for any decline in people’s health.

A designated room was used to carry out staff testing for COVID-19 efficiently and safely. A nearby fire exit was used for staff who required a test after returning from annual leave.

A cleaning schedule was in place for clinical equipment. People had individual medication spoons in their rooms which were sterilised daily.

The staff room had a protocol for ensuring the area was cleaned after use and used crockery was safely transported to the kitchen. Records of when staff had taken breaks together were kept. This meant that close contact could be traced in the event of positive COVID-19 cases.

Selly Wood House is a care home providing nursing and personal care for 37 people aged 65 and over at the time of the inspection. The service can support up to 44 people.

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

People were safe using the service. Staff knew how to protect people from harm and reduce the risk of accidents and incidents. At the time of our site visit, we found there were enough suitably recruited staff on duty to meet people’s needs and to keep people safe. People were supported by staff who knew their needs well. Staff supported people with their medicines and this was done safely. Staff understood how to prevent and control the spread of infection.

People had been assessed before being accepted to the service to ensure the provider could meet their needs. Assessments addressed people's physical and health needs, their cultural and language needs, and what was important to them. Staff received training which helped them to deliver personalised care. People were happy with the choice of food available and where appropriate, received additional support with their dietary needs. The provider worked well with external health and social care professionals and people were supported to access these services when they needed them to ensure their health was maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way and in their best interests; the policies and systems in the service required some improvement to ensure the provider continued to support this practice.

Staff were knowledgeable about people’s care and support needs. People and relatives told us how caring the staff were. Staff enjoyed their work and got on well with the people they supported. Staff encouraged people’s independence, protected their privacy and treated them with dignity.

The provider had appropriate governance systems in place to monitor the delivery and quality of the service provided for people to maintain improvements.

Some of the people using the service at the time of the inspection could not always tell us about their experiences. Whilst on site, we saw positive interactions between people and staff and people looked comfortable with the way they were being supported. Relatives we spoke with gave us positive feedback on the service and the way the staff supported their family members to remain safe. Staff provided responsive care to people in line with their preferences and choices. Where people communicated non-verbally staff knew how to engage with them.

People were supported by staff who knew their preferences. Complaints made since the last inspection had been investigated and relatives knew who to contact if they had any concerns. Relatives and staff were happy with the way the service was being led and there was a culture amongst the staff team in providing person-centred care.

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

Rating at last inspection:

The last rating for this service was overall good (published 11 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We undertook a comprehensive inspection of this home in October 2015. We found that the home had continued to provide a good service, although we identified some concerns with medicines management and issued a requirement notice. A specialist pharmacy inspector re-visited the home in December 2015 and found the issues had all been fully addressed. The home was compliant with the requirements of the law and meeting people’s needs well in the other four of the five key questions we looked at.

The home has a registered manager. 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 that they felt safe. People’s relatives, staff and health professionals supported this view. Staff had been trained in adult safeguarding and when we spoke with them they showed a good level of knowledge about possible signs of abuse and the action they would take in reporting any concerns.

People received their medicines safely and there were effective systems in place to monitor medicines administration.

The feedback we received about staffing was mixed. Some people reported that they had the support they required and did not have to wait an unreasonable amount of time for support or for a response to their call bell. Other people told us, and some of our observations supported that people were left for long periods without staff support, and some people had to wait a long time for help when they needed the toilet, to change positions or when they called their call bell.

Staff told us they had received induction, sufficient training and on-going support. There were handovers between staff at each shift change. During our inspection we observed that the handovers were not always effective at ensuring temporary staff had the information they needed to support people safely.

Staff had some knowledge of the Mental Capacity Act (MCA) (2005) and described how they supported people with making choices. Restrictions to people's liberty had been identified. When necessary the relevant applications had been made and kept under review.

People had access to regular healthcare and specialist healthcare advice. The nursing care provided was good and followed published good practice guidelines.

People’s feedback about the food provided was generally positive. Some people really enjoyed the food. People were able to eat communally in the dining room, or in their bedroom. The staff supported people in a dignified and respectful way when they required help to eat and drink.

We received consistent feedback that the quality of care provided by individual staff was good and people told us that staff were kind and caring. Many of the staff we met had been in post for a long time and they demonstrated that they knew the people they supported well. During our observations we saw good staff practice that ensured people were treated with dignity and respect.

People told us that they were able to be involved in planning their care. This ensured it would meet their individual needs and preferences. Reviews of care happened regularly and records showed the involvement of people or their relatives to ensure people were still happy with the care they were receiving.

People and their relatives were supported to think about the care they would like to receive at the end of their life. The nursing and management staff had developed positive networks with specialist end of life practitioners, to ensure people received good support that enabled them to die without unnecessary pain and with dignity.

There were opportunities for people to join in group activities held in the homes lounges. People were also able to sit in their bedrooms, and quieter lounges. There were some opportunities for people to have one to one time with staff. This was an area both we and the registered provider identified needed further development.

People were generally satisfied with the service and there had been a low number of complaints. Feedback was that the management team were very approachable and that people could approach them at any time if they had concerns. Records showed that complaints were investigated thoroughly and the correspondence showed respect and compassion for the person raising the concern.

People and their relatives all told us the management team were approachable and that they led the home well. They told us they felt able to approach them with concerns or feedback. The systems in place to monitor the quality and safety of the service had largely been entirely effective. Numerous developments and improvements had been identified and action planned since our last inspection to ensure the service provided continued to improve.

People told us that the standard of care was generally very good, and comments from people included, 'I am very happy with my care and support (my carer) is very respectful. I can do most things if I want to, there is nothing I would change, there's nothing that needs changing, I'm quite happy.'

We had previously raised concerns about the food and drinks provided to people who were at risk of malnutrition or dehydration. At this inspection we found significant work had been undertaken to improve on the quality of food offered to people, and the recording of the amount taken. We found that people who were able to choose their food, and eat independently were offered a good choice of interesting and nutritious meals.

People told us they felt safe. One person said, 'They are very good. I have never been mistreated.' We found that systems were in place to reduce the risk of people being at risk of abuse.

The systems in place to check that the home was operating safely and to a good standard had been improved since our last inspection. We found a robust schedule of checks and audits were in place. These were undertaken by staff with different roles within the organisation and by external consultants. This ensured people lived in a well organised environment and received good quality care.