13 July 2022
During a routine inspection
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.