Sidmouth Nursing Home

Updated 16 February 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 checked 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 comprehensive inspection was carried out on 23 and 25 October 2017. The first day of the inspection was unannounced. The inspection team consisted of one adult social care inspector and an expert by experience. An expert by experience is a person who has experience of using, or caring for someone using, this type of service. The second day of the inspection was announced and completed by one adult social care inspector.

We reviewed all information the Care Quality Commission (CQC) held about the service before the inspection. This included all contacts about the home, previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to tell us about by law.

We reviewed the Provider Information Return. 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 used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the inspection we spoke with seven people who lived at the service and four visitors. We also spoke with the registered manager, the Nominated Individual, the clinical lead (known as the management team), a registered nurse, five care staff, and the chef. Prior to the inspection we received feedback from one relative; following the inspection we received feedback from two other relatives.

We requested feedback from eight health and social care professionals before the inspection. We received feedback from six professionals, including a dietician; two palliative care nurse specialists; a GP; pharmacist and health commissioner. We also met three health professionals during the inspection. We looked at records relating to the management of the service including four people’s care plans and associated records including medicines administration records. We looked at one staff personnel file, along with staff training and records. We reviewed a selection of compliments and the complaints log as well as the accident/incident records. Documentation relating to the maintenance and safety of the premises was also inspected.

Updated 16 February 2018

Sidmouth Nursing Home is registered to provide accommodation for up to 29 adults who require nursing or personal care. The home has people with complex physical nursing needs and people with dementia or mental health needs. 27 people were using the service at the time of the inspection. One person was in hospital.

At the last inspection in September 2015 the service was rated good overall with caring rated as outstanding. At this inspection we found the service continued to provide outstanding care in the caring domain and had strengthened their practice in well-led, which is now rated outstanding. We found the management team had continued to develop the service and the culture and ethos was extremely positive and person centred. The safe, effective, and responsive domains remain rated as good. However, the service is now rated outstanding overall.

This comprehensive inspection was carried out on 23 and 25 October 2017. The first day was unannounced and announced on the second day.

A registered manager was in post. 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.

The registered manager; management team and staff team were committed to ensuring people experienced an enhanced quality of life, which took into account individual wishes and beliefs. This meant people were valued and treated with equality. The inclusive ethos supported people to carry on living their lives, pursuing their interests and maintaining and building important relationships.

People consistently told us about the excellent care and support they received. People using the service, their relatives and visiting professionals said the service was “Exceptional”; “One of the best…” and “Excellent…” All said the service was safe. Comments included “They (staff) make sure I am safe”; “Mum has made it very clear to me that she feels safe and protected by the staff” and “I wish to state that the care at this nursing home is exemplary…”

People experienced exceptional high standards of care. End of life care was provided by staff who were skilled and competent and ensured effective pain and symptom management. Palliative care specialists and GPs were high complimentary of the care provided at the end of life. Comments included, “The care here is of a really high standard…They (staff) pre-empt people’s needs” and “The patient care delivery is in my opinion to a high standard taking into account the patient’s individual needs.”

People’s wellbeing and happiness was central to this service and the management and staff team actively promoted a person centred culture. Staff had developed a positive rapport with people and they were gentle, attentive, kind and respectful in their approach. People’s independence was encouraged and people were supported to do as much as possible for themselves. Comments included, “They (staff) are so marvellous” and “There is nowhere like it. You read terrible things…but here carers care.”

The culture within the service was open, friendly and welcoming. People, staff and professionals expressed a very high degree of confidence in the management team. The ethos created was open and transparent. The management team acted as role models for the staff team who were motivated to offer care that was kind, considerate and put people at the heart of everything they did. The management team placed emphasis on continuous improvement of the service and promoted links with the community, which benefitted people using the service.

People’s views were sought and taken into account in how the service was run. The provider made changes and improvements in response to feedback. There was a robust system of monitoring the service to identify any improvements that needed to be made. The management team acted on the results of audits and surveys to improve the overall quality of the service.

People were protected from harm by staff who had a good understanding of the actions to take if they suspected someone was being abused or neglected. Risks to people had been assessed and measures were in place to prevent avoidable harm and to help ensure their independence was supported and respected. Accidents and incidents were monitored to identify themes and to help prevent any reoccurrence. There were sufficient numbers of experienced and caring staff to support people. People’s medicines were managed safely. The service had safe recruitment systems in place to ensure staff were suitable to work at the service.

People were protected by good practice in relation to decision making. The registered manager and staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS); ensuring people’s rights were protected.

People were promptly referred to health care professionals when needed and health care professionals expressed their full confidence in the service, telling us people’s health needs were monitored and managed very well. People enjoyed varied and nutritious meals and mealtime were sociable and relaxed occasions.

People received care and support that was based on their individual needs and preferences. Personal care records included people's individual plans of care, life history, likes and dislikes and preferred activities. People were offered a range of interesting and diverse activities and were supported to pursue hobbies and pastimes that were of interest to them, and that were suited to their varying abilities. People and their relatives felt confident to raise any concerns and told us they were confident any concerns would be resolved without delay.

Staff received training, induction and supervision to ensure they understood people’s needs and were able to work effectively and safely. Staff said they were well supported to do their job.