Nottingham Care Village Ltd

Nottingham Care Village is a care home registered to provide personal and nursing care to younger adults and older people, including to those living with dementia. The service can support up to 35 people. At the time of our inspection 21 people were living at the home and no one was in receipt of nursing care. Nottingham Care Village is purpose built and split over two floors with communal areas on each floor and outdoor communal space surrounds the property.

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

People and their relatives told us they felt safe. Staff were knowledgeable about how to protect people from the risks of harm, abuse and neglect.

Safe recruitment practices were in place to ensure only suitable staff worked at the service.

People received their medicines in a safe and timely manner and people were supported to remain as independent as possible when administering their own medicines.

The service focused on building and maintaining open and honest relationships with people and their families and friends. People were consistently treated as individuals and changing needs were responded to quickly.

There was an open culture in which all safety concerns raised were addressed and valued as integral to learning and improvement.

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.

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 16 October 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect

Nottingham Care Village is residential care home which provides accommodation for up to 35 people who require nursing or personal care. At the time of the inspection 18 people were either living at the home or using the service for respite.

People’s experience of using this service:

Since our last inspection improvements had been made to the way risks associated with people’s care were assessed and acted on. This included the process for making people safe in an emergency. Improvements had also been made to the way people’s medicines were managed.

People told us they felt safe with staff. The provider ensured any concerns about people’s safety were investigated and the relevant authorities notified. There were enough staff to support people safely. People felt staff were available to respond to their care needs. Agency staff were used at the home; however, a formal induction process was not yet in place for these staff. The risk of the spread of infection was safely managed. The provider had systems in place to help staff to learn from mistakes.

People received care in line with their assessed needs. Staff training was up to date and staff received supervision of their practice. People received the support they needed to maintain a healthy diet, although some fluid monitoring charts required more detail when being completed. People had access to other health and social care agencies where needed. The home was well-maintained and adapted to support people living with dementia or disability.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives liked the staff. They found them respectful, kind, caring and felt they treated them or their family member with dignity. People’s independence was encouraged and people were able to contribute to decisions about their care. People felt listened to and staff respected and acted on their views. People’s records were stored securely and handled appropriately to protect their privacy.

People’s care records were person-centred and contained guidance for staff to support them in their preferred way. Some records required archiving to ensure only the most up to date information was available for staff. Efforts had been made to provide people with information in formats they could understand. People felt the quality of the activities provided had improved since our last inspection. People felt staff responded to complaints or concerns raised. The complaints procedure did not contain the correct details of who could investigate complaints if they were not satisfied with the outcome. End of life care was provided where required. Efforts were being made to ensure that all people had the opportunity to have their wishes recorded.

The manager had been in place for ten months; however, the provider had not ensured they were registered with the CQC which is a requirement for their role. Quality assurance processes had improved since our last inspection and aided the provider to identify and act on areas which could pose a risk to people’s safety. The manager and provider had a good knowledge of the regulatory requirement to report concerns to the CQC. People’s views about the quality of the service provided were requested. The results had not yet been analysed, but the responses were positive in most areas. People praised the approach of the manager, they found her to be supportive and approachable.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 28 August 2018). The service’s rating has now changed to good.

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 re-inspection programme. If we receive any concerning information we may inspect sooner.

Nottingham Care Village 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.

Nottingham Care Village can accommodate 63 older people and people living with dementia, in one adapted building. Accommodation is provided on two floors; a passenger lift is available. At the time of our inspection 17 people were using the service. Also, within the home are eight apartments that on the upper floor and rented to people independent of the care home. There is no separate access entry to these apartments.

There was a registered manager at the service. 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 inspection identified shortfalls in how risks associated with people’s needs and the environment were assessed and managed. Staff did not always have the required information to effectively manage known risks. Checks on the premises to ensure people lived in a safe environment, were not undertaken within the expected timeframes or managed and monitored as required to ensure people’s safety.

Shortfalls were identified in the management of people’s medicines that had potential to impact on people’s health needs. Short notice of staff’s unavailability had impacted on how the service was effectively managed. Safe staff recruitment procedures were in place and followed.

Improvements had been in the management of infection control, following an audit by the local clinical commissioning group earlier in the year. Accidents and incidents were recorded and falls were analysed for lessons learnt. Records of injuries people sustained were not effectively completed.

Staff had not received the expected training and support, and staff had received limited opportunities to discuss and review their work and performance.

People received sufficient to eat and drink, but wanted a more varied menu. Nutritional needs had been assessed, but information relating to dietary needs and risks had not appropriately been shared with kitchen staff.

Staff understanding of the principles of The Mental Capacity Act 2005 varied. Where people lacked mental capacity to consent to specific decisions, documentation did not show how best interest decisions had been made. Where concerns had been identified in relation to the Deprivation of Liberty Safeguards, action had been taken to safeguard people.

Systems were in place to share information with external agencies. People’s needs were assessed and included consideration of the protected characteristics under the Equality Act. The design and layout of the building considered people’s needs. However, apartments were not part of the service. This meant there was a potential risk to people, including their right to privacy and dignity because of unknown visitors to apartments of people who rented independently and had no separate entry.

People were positive about the care provided by staff who they thought were knowledgeable about their needs, preferences and routines. Advocacy information was available for people. People had opportunities to discuss their care and support needs.

People received limited social activities and opportunities to pursue their interests and hobbies. Information available for staff about people’s needs was either not current or was contradictory or not followed by staff. The provider’s complaint procedure was available for people.

The systems and processes in place to check on quality and safety were found to be ineffective. The provider had failed to identify the shortfalls in the fundamental standards that were identified during this inspection. There was a lack of oversight and accountability and no action plan to drive forward improvements. The registration requirements had not always been followed to notify CQC of certain information.

During this inspection we found two breaches of the of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. One breach of the Care Quality Commission (Registration) Regulations 2009.

You can see what action we told the provider to take at the back of the full version of the report. Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work there.