Carisbrooke Nursing Home

Updated 13 September 2022

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 one inspector and an assistant inspector.

Service and service type

Carisbrooke 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. Carisbrooke 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the service registered under the new provider. We sought feedback from the local authority quality improvement team. 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 six people who used the service and two relatives about their experience of the care provided. We spoke with 16 members of staff including the provider, administrator, nurses, bank nurses, care workers, chef, kitchen porter, cleaning staff and laundry assistant. We reviewed a range of records. This included nine people's care records and multiple medication records. We looked at three staff files in relation to induction, recruitment and supervision. A variety of records relating to the management of the service, including, training records, audits, quality assurance and policies and procedures.

After the inspection

We reviewed information the provider had sent to us and continued to seek clarification from the provider to validate evidence found.

Updated 13 September 2022

About the service

Carisbrooke Nursing Home is a residential care home providing the regulated activities of personal and nursing care and treatment of disease, disorder or injury to up to a maximum of 25 people. The service provides support to older people. At the time of our inspection there were 16 people using the service.

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

People told us they were well cared for, and staff were kind, friendly and good humoured. People said they enjoyed living at the service and felt safe.

People’s needs in relation to their emotional and social care needs, were not met. Although people told us they were supported well with their physical care needs, people said they did not have the opportunity to take part in activities and they were left to entertain themselves.

Risks to people's safety and welfare were identified and plans were in place to help minimise risks. Checks were carried out on the facilities and equipment, to ensure they were safe. Whilst some fire safety checks were completed, records did not demonstrate all fire safety checks and safety practices were completed as they should. We made a recommendation about this.

Processes were in place to prevent and control infection. However, we were not fully assured that staff were always using PPE in line with best practice guidance. We made a recommendation to the provider to take action to update staffs’ practice accordingly.

The registered manager was not present during the inspection and people and staff told us the registered manager had not worked at the service since the beginning of the year. The provider had not notified CQC about this, as required.

The services quality assurance systems and processes in place had not always been effective at identifying areas for improvement and ensuring action was taken in a timely manner.

During the inspection we observed there were enough staff to provide safe care and support. However, people's feedback was varied with some people reporting staff were “rushed off their feet” and did not have any time to spend with them. Relevant checks were completed to ensure staff were suitable to work in a care setting.

People told us staff were well trained and they knew how to care for them. New staff received an induction, and all staff were enrolled on the providers online training programme.

Although staff had opportunities to discuss work performance, staff supervisions had not been completed consistently. We made a recommendation the provider review their systems in place, making sure staff received on-going support and supervisions.

Staff told us that communication from the management was not always good and meetings had not taken place consistently since the provider had taken over the running of the service.

Recent improvements had been made to ensure that people were engaged with and consulted about the care they received. Surveys had been sent out to people and changes to the service provision had been made to meet people’s needs and requests.

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 told us they enjoyed the food and had enough to eat. People's care plans contained information about their dietary needs and preferences. People were protected from the risk of malnutrition and from the risk of choking. People’s food and fluid intake was monitored, and people received a modified diet following assessments by health professionals.

People were supported to access healthcare services. Records showed staff made referrals to health care professionals in response to people's changing needs.

People made decisions about how they wanted to receive care and support and were involved in planning their care. Person-centred care plans and risk assessments were in place to guide staff about how people liked their support to be provided.

People told us they felt able to raise concerns. The provider had systems in place to log, investigate and respond to complaints.

Systems and processes were in place to support people at the end of their life to have a comfortable, dignified and pain-free death. Staff worked closely with the local doctor and hospice services to ensure people had access to the care and support they needed.

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

This service was registered with us on 5 November 2020 and this is the first inspection.

Why we inspected

We undertook this inspection as part of our inspection programme.

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.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, good governance and the requirement to inform CQC of the registered manager absence.

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.