Archived: Jesmund Nursing Home

Updated 16 December 2017

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.

We undertook an unannounced inspection on 27 and 28 June 2017. The inspection was undertaken by two inspectors.

Prior to the inspection we reviewed the information we held about the service and since our February 2017 inspection we were in regular contact with representatives from the local authority and clinical commissioning group (CCG) for feedback about the service.

During our inspection we spoke with two people and six staff, including the registered manager and provider, as well as the consultant providing support to staff. We reviewed three people’s care records and two staff recruitment records, as well as the staff team’s training, supervision and appraisal records. We reviewed medicines management arrangements and records relating to the management of the service.

Many of the people living at the service had advanced dementia and were unable to engage in meaningful conversations with us. Therefore we undertook general observations and used the short observation 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. After the inspection we spoke with four health and social care professionals who were providing support to staff. This included representatives from the local authority’s commissioning team, the local authority’s safeguarding team, the care home support team and the CCG.

Updated 16 December 2017

We undertook an unannounced inspection on 27 and 28 June 2017. We previously inspected this service on 21 February 2017 at which time we rated the service ‘inadequate’ overall and for the two key questions relating to ‘Is the service caring?’ and ‘Is the service well-led?’. We rated the other three key questions ‘requires improvement’. We identified breaches of four regulations relating to safe care and treatment, dignity and respect, good governance and submission of notifications. In response to the February 2017 inspection we placed the service in special measures and took urgent action to protect people from the risk of harm. We undertook this inspection in June 2017 to reassess the level of risk to people’s health and welfare.

Jesmund Nursing Home provides accommodation, nursing and personal care for up to 25 older people. At the time of our inspection 21 people were using the service, most of whom were living with dementia.

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.

At this inspection we found significant improvements had been made, however, concerns remained in regards to the governance and management of the service. There were plans to improve the registered manager’s auditing and checking processes but these were not in place at the time of inspection. There was a lack of robust procedures to ensure appropriate action was planned and taken to address any concerns identified in a timely manner.

Staff treated people with dignity and respect. Staff were responsive to people’s requests for assistance and provided the help required to meet a person’s needs whilst still enabling them to have some independence. Staff interpreted people’s non-verbal communication and provided support in a kind and caring manner.

Risks to people’s safety had been identified, reviewed and management plans were in place to mitigate the risks. This included environmental risks and risks associated with people’s individual needs. Some risk management records did not include specific information about how risks were to be managed but there were plans to include this and staff were aware of how to support people safely. Incident reporting and recording had been improved to ensure all incidents and accidents were recorded and appropriate action was taken to support the individual, including liaising with the local authority safeguarding team when required.

There were sufficient staff to meet people’s needs and safe recruitment practices were undertaken to ensure appropriate staff were employed. Staff received regular training to ensure they had the knowledge and skills to undertake their duties and meet people’s needs.

Staff supported people with their nutritional and hydration needs. They liaised with healthcare professionals as required to ensure people’s health needs were met. People received their medicines as prescribed. Staff provided people with the level of support they required and additional information had been obtained to ensure staff were able to provide personalised care. Staff supported people in line with the Mental Capacity Act 2005 and adhered to any restrictions included in Deprivation of Liberty Safeguards authorisations.

The provider had arranged for an additional performer to visit the service and the activities on offer had been increased to ensure people had opportunities to be stimulated and engaged. The provider had liaised with the Alzheimer’s Society to obtain advice about how to adapt their environment to meet the needs of people living with dementia. An action plan was in place to make improvements to the environment but at the time of inspection these had not been undertaken.

The provider had worked with health and social care professionals from the local authority and the clinical commissioning group to help improve practices and had employed external consultants to further provide advice and guidance. Regular meetings were held with staff and people to obtain their views and opinions and these were taken on board when developing the service.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

However, we identified a continued beach of regulation relating to good governance. We will continue to monitor compliance with this regulation and liaise with the provider about the sustainability of continuous improvement.