Archived: The Mews Nursing Home

Updated 30 June 2016

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 inspection took place on 27 April 2016 and was unannounced.

The inspection team consisted of three adult social care inspectors.

Before our inspection we reviewed the information we held about the service including notifications the provider had made to us. This helped to inform us what areas we would focus on as part of our inspection. We had requested the service to complete a provider information return (PIR); this is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We received this prior to our inspection and used the information to help with planning.

We contacted the local authority safeguarding team, the local commissioning team and the local Healthwatch organisation to obtain views about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. No concerns were raised with us.

During the inspection we also carried out observations in all public areas of the home and undertook a Short Observational Framework for Inspection (SOFI) during the lunchtime meal period. A SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with ten people who used the service. We also spoke with the registered manager, three qualified nurses, one care staff member, a cook and kitchen assistant, a laundry assistant and two activity coordinators.

We looked at a number of records during the inspection including eight medication administration records, six care records, four staff personnel files and records relating to the management of the service.

Updated 30 June 2016

This was an unannounced inspection which took place on 27 April 2016. The service was last inspected on 7 August 2013 when we found it to be meeting all the regulations we reviewed.

The Mews Nursing Home comprises of three units situated over four floors. Nursing care is provided by qualified nurses who are supported by care assistants. The staff are able to access specialist nursing services when required. On the day of our inspection there were 47 people living in the service.

The service had a registered manager in place at the time of our inspection. 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.

During this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We looked in one shower room and found the ceiling was stained, the shower seat was ripped with the foam exposed causing an infection control risk. A toilet we looked in had wall tiles missing and stained flooring. Two toilets we looked in did not have hand wash facilities in place for people to wash their hands after using the toilet or providing personal care. These issues posed an infection control risk.

Overall medication arrangements in place were satisfactory however, one of the medicine administration records (MARs) we looked at on The Huntington Unit showed that the person was prescribed a medicine that was to be given 'when required'. We found that information was not available to guide staff as to when they may need to administer medicines prescribed in this way. If information is not available to guide staff about 'when required' medicines need to be given, people could be at risk of not having their medicines when they actually need them. The registered nurse agreed to put this information in place straightaway.

The service had a nutritional policy and procedure in place which stated that “All healthcare professionals who are directly involved in patient care should receive education and training, relevant to their post on the importance of providing adequate nutrition.” However, records we looked at and confirmation from the registered manager showed that none of the staff employed at The Mews had received training in nutrition.

Some training had been undertaken by staff members although not all staff were up to date with mandatory training requirements. The service had induction training in place for new staff members. A small percentage of staff had received a recent supervision.

Care records we looked at contained risk assessments. We saw these were reviewed on a regular basis to ensure they remained relevant.

We found robust recruitment processes were followed by the registered manager when recruiting new staff. All the relevant checks were undertaken ensuring their suitability to work at the service.

Staff we spoke with told us and records we looked at showed that they had received training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were able to demonstrate a sound understanding of their responsibilities in relation to this.

The care records showed that people had access to external health and social care professionals. This meant that the service was effective in promoting and protecting the health and well-being of people who used the service.

There were a number of communal areas where people could socialise and we saw these being used frequently.

We observed saw that staff knocked and waited for an answer before entering bathrooms, toilets and people’s bedrooms. This was to ensure people had their privacy and dignity respected.

We found the atmosphere in the service was warm and friendly. We saw that staff had time to sit and talk to people who used the service. We observed call bells were answered in a timely manner and people were not rushed.

Two registered nurses had received accreditation in the Six Steps to End of Life training. This training aims to guarantee that every possible resource is made available to people in order to facilitate a private, comfortable, dignified and pain free death.

Care plans we looked at showed that people’s religious and/or cultural preferences were identified.

The registered manager told us that some people had visited Lourdes in Frances to meet their religious wishes.

Records we looked at showed that satisfaction surveys were sent out to gain feedback from staff, service users and relatives. Regular residents and relatives meetings were held.