Background to this inspection
Updated
18 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by three inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
The Julie Richardson Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager, who was registered with the Care Quality Commission. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced and took place on 18 February 2020.
What we did before the inspection
We looked at all the information we held about the service including notifications. A notification is information about events that the registered persons are required, by law, to tell us about. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 5 people who used the service and 5 relatives to gather their views about the care provided. We also spoke with 11 members of staff, including the provider, the registered manager, two nurses, four care staff, the chef, one ancillary staff member and the activities co-ordinator.
As the majority of people were not able to give us feedback we spent time observing how staff interacted with people. We also 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.
We reviewed a range of records. This included five people’s care records and samples of people’s medicine records. We looked at two staff files in relation to recruitment and staff’s supervision and training records. A variety of records relating to the management of the service, including complaints, accidents and samples of audits were also viewed.
After the inspection
We contacted 27 external professionals to gather their views about the service. We also contacted two more staff members and three more relatives.
Updated
18 April 2020
About the service
The Julie Richardson Nursing Home is a care home registered to provide accommodation and personal and nursing care. The service can accommodate up to 40 people in one adapted building. At the time of our inspection 37 people were supported by the service. The majority of people at the service were living with various stages of dementia.
People’s experience of using this service and what we found
People received care and support that had an extremely positive impact on their wellbeing. The staff excelled in using personalised, responsive techniques when caring for people who could display behaviour that may challenge. This created a warm, a home-like environment, filled with positive, meaningful interactions and constant stimulation for people. People’s relatives were very complimentary and one relative said, “The ethos of this place is a continuation of life, not the end of it.”
The service had an established reputation of being able to meet the needs of people who could be seen as presenting with very complex care needs. Professionals were extremely impressed with the care provided by the staff at The Julie Richardson Nursing Home. We received only exemplary feedback from external professionals, comments used included, “I wish every nursing home would be like this.”
People had been offered personalised activities. The team excelled in creating opportunities for people to reduce social isolation and anxiety caused by for example, repetitive behaviours triggered by living with dementia. Staff explored people’s life histories which aided having an excellent understanding of the reasons for people’s behaviour. As a result, people were provided a carefully identified, personalised approach that enabled people to live a worry free and content life.
There was a positive, welcoming atmosphere and people benefitted from meaningful caring relationships with staff that had an in-depth understanding of people’s needs. There was a strong commitment to providing excellent care that appreciated people, valued their life histories and build on their experiences. Staff excelled in providing one to one support that considered a person and their all senses, such as smell and sound. There were documented success stories how these therapies positively influenced people’s sense of contentment.
The registered manager led their team by example. The registered manager was described by her team as a role model and someone they aspired to. The registered manager acted as an advocate for people living with dementia. They wrote to the local council with suggestions to make the local amenities more dementia friendly.
The registered manager remained extremely passionate about continuously improving the practice and they worked towards a degree with a well -known university that specialised in practices surrounding dementia. The registered manager encouraged and empowered staff to implement new projects that were in line with the current good practice and had a positive impact on people. One of the new initiatives, ‘A breath of fresh air’ project had been successfully implemented. The project aimed at bringing people out to the local community. This included individual outings as well as a big, summer picnic when all people living at the service had been taken to the local park.
People benefitted from exceptional care as there was a dedicated, long standing staff team. The feedback from staff about both the registered manager and the provider showed there was a well embedded, caring and positive culture. There was an emphasis on empowering and motivating staff. Many staff members had been appointed as champions in various areas and it was clear the quality assurance was everyone’s business.
The provider looked for ways to continuously improve the service and worked well with a number of external parties and partners. This included sharing lessons learnt and participating in local and national learning and networking opportunities.
The environment was bright, clean, fresh and welcoming. This included dementia friendly signage, thematic areas, such as photo wallpapers of local landmarks and a sensory room.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People remained safe living at the service and there were always sufficient staff available to meet people's needs. This included when people had been assessed as requiring one to one approach. Risks to people’s needs were assessed and the was information how these risks needed to be managed. Medicines were managed safely.
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 good (published 25 August 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 reinspection programme. If we receive any concerning information we may inspect sooner.