New Milton Nursing Home

Updated 3 October 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector and an Expert by Experience who made telephone calls to relatives following the inspection visits.

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

New Milton Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. New Milton Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 3 August 2023 and ended on 21 August 2023. We visited the location’s office/service on 3 August 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people living in the home. We spoke with 13 relatives following the inspection visits. We spoke with 6 members of staff including the registered manager, deputy manager, nursing and care staff. We reviewed a range of records, including 3 people's care records and multiple medicine records. We looked at 3 staff recruitment files in relation to safe recruitment. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

Updated 3 October 2023

About the service

New Milton Nursing Home is a nursing care home providing personal and nursing care to up to 24 people. The service provides support to older people and people who have dementia. At the time of our inspection there were 20 people using the service. People were supported in 1 adapted building and had access to communal areas consisting of a lounge and dining area as well as a conservatory and some outside space.

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

Medicines were not managed consistently. Risks had not always been properly assessed. Lessons were not always being learned when things had gone wrong. Environmental and building checks were being completed regularly. Staff were being safely recruited. Staff used PPE appropriately which supported the infection control for everyone in the care home.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People had care plans although these lacked details and contained discrepancies. People received suitable balanced diets appropriate to their needs. Staff worked with a variety of organisations to ensure people accessed and received appropriate support when needed. The care home had been adapted and was undergoing redecoration.

Systems were not always robust or effective in driving improvements. The registered manager had not been notifying CQC of certain events and changes in line with regulations. New systems were being put in place to monitor and support management oversight, which included an electronic recording system. Management was approachable and promoted communication with people, relatives and staff. People and relatives were involved in their care and staff worked in partnership with other professionals and agencies.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 29 June 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

The provider plans on applying to CQC to change their legal entity. This application will be reviewed when it is received.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about medicines management, training, staffing and care planning. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Milton Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people’s safe care and treatment, consent and the overall governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.