Archived: Nayland House

Updated 21 December 2018

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 was a comprehensive inspection and was carried on 27 September 2018 and this visit was unannounced. The inspection team consisted of two inspectors and an assistant inspector.

Before our inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service: what the service does well and improvements they plan to make. We looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

During our inspection we spoke with eight people, two visitors and observed care to help us understand people experiences. We also spoke with the registered manager, the deputy manager, four care staff and two senior care staff. We reviewed six care files, four staff recruitment files and their support records, audits and policies held at the service.

Updated 21 December 2018

Nayland House is owned by Larchwood Care Homes (South) Limited. It provides accommodation and personal care and support for up to 54 people, at the time of our inspection there were 49 people living in the service. The service is supporting a range of people's needs, including older people and people living with dementia. Nursing care is not provided at Nayland House. There was a registered manager 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 our last inspection, in November 2016 we rated the service Requires improvement in all key questions apart from Caring, which we rated as Good. Which meant the overall rating for this service was requires improvement. At this comprehensive inspection, which we carried out on 27 September 2018 we found evidence that the service had made the necessary improvements for us to rate the service as Good in all key questions.

During that last inspection we found evidence that improvements were needed to ensure staff were consistently monitoring for any potential risks during care delivery that could impact on people's welfare. Also, although staff received training they did not always put it into practice. We found shortfalls in staff's knowledge of supporting people living with dementia.

We also believed that improvements were needed to ensure all people had access to stimulating occupation or activities, which met their individual needs. During our previous inspection we found that systems were in place for assessing and monitoring the quality of the service that people received. However, implemented changes and improvements were not always being effectively embedded in practice to drive continuous improvements.

During this inspection people living in this service told us that they felt safe and very well cared for. There were systems in place which provided guidance for care staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe. Risk assessments were in place to identify how the risks to people were minimised. There were sufficient numbers of trained and well supported staff to keep people safe and to meet their needs. Where people required assistance to take their medicines there were arrangements in place to provide this support.

Both the registered manager and the staff understood their obligations under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager knew how to make a referral if required. Meaning that people living in the home were still being supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s needs were assessed and the service continued to support people to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and to have access to healthcare services.

We saw many examples of caring interactions between the staff and people living in the service. People were able to express their views and staff listened to what they said and took action to ensure their decisions were acted on. Staff continued to protect people’s privacy and dignity.

People received care that was personalised and responsive to their needs. The service listened to people’s experiences, concerns and complaints. Staff took steps to investigate complaints and to make any changes needed. People were supported at the end of their lives to have a comfortable, dignified and pain free death.

The registered manager told us that they were well supported by the organisation. The people using the service and the staff they managed told us that the registered manager was open, supportive and had good management skills. There were still good systems in place to monitor the quality of service the organisation offered people to ensure it continued to meet their needs.

Further information is in the detailed findings below