CQC report explained · a nursing home
What the CQC found at Newford Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks to people were assessed, recorded and reviewed, and staffing levels were considered sufficient. However, medicines were not always securely stored, and hoist slings were shared between people.
- Effective?
- Good
- Staff had the training and support needed for their roles. People were supported with eating and drinking, consent and access to healthcare.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were encouraged to be involved in care planning and decisions.
- Responsive?
- Good
- Care plans reflected people's individual needs, and there was a broad programme of activities. People and relatives knew how to complain and felt listened to.
- Well-led?
- Good
- Inspectors found open communication, supportive leadership and effective quality checks. These systems had helped bring about significant improvements since earlier inspections.
What inspectors found, November 2017
Newford Nursing Home is rated Good; inspectors found kind, effective care and strong improvements, but medicines were not always stored securely.
This was an unannounced inspection on 9 and 13 October 2017. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They reviewed care records, medicines records, accident records, complaints, recruitment files and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were assessed and reviewed, staffing was sufficient, staff were trained, and people were supported with food, drink, healthcare, activities and daily choices.
There were two issues to note. The medicines room and cabinets were left unlocked while medicines were being given, and hoist slings were shared rather than assigned to named people. The provider said these matters would be addressed.
Improved risk management
The home had introduced clearer handovers and risk plans. Inspectors found that risks such as falls, pressure care, nutrition and challenging behaviour were assessed and reviewed.
“The risks associated with people's individual care and support needs had been assessed, recorded and reviewed, and plans implements to manage these.” from the report
Kind and respectful care
Staff knew people well and supported their dignity, privacy, independence and choices.
“Staff treated people with kindness and compassion, and took the time to get to know them well.” from the report
Activities suited to individuals
The home used information about people's interests and abilities to plan activities, including sensory activities for people cared for in bed.
“The provider's three activities coordinators were responsible for organising and delivering purposeful activities throughout the week that people would find stimulating and enjoyable.” from the report
Supportive leadership
The registered manager had more time and support to lead the home. Staff and relatives described communication and teamwork positively.
“The management team promoted open communication with people, their relatives and the community professionals involved in people's care.” from the report
Medicines not always locked
seriousInspectors saw the medicines room and cabinets left unlocked while medicines were being administered. This increased the risk of unauthorised or accidental access.
“However, whilst the administration of people's medicines was underway, we saw the door to the medicines room, and the medicines cabinets within this, were left unlocked.” from the report
Shared hoist slings
needs fixingHoist slings were shared between people instead of being assigned to named people. Inspectors said this did not reflect current best practice for infection prevention and control.
“However, we found hoist slings were shared amongst people living at the home, as opposed to being used by a named person.” from the report
- 01How do you now make sure the medicines room and medicines cabinets stay locked whenever medicines are being administered?
- 02What action have you taken about sharing hoist slings, and how do you prevent infection risks?
- 03How often are my relative's risk assessments reviewed, and how are changes passed to staff at handover?
- 04How would you use the activities programme and sensory equipment to match my relative's interests and abilities?
- 05How do you make sure agency staff are paired with experienced staff when needed?
This was an unannounced inspection covering all five quality areas and included records, observations and discussions with people, relatives, staff and healthcare professionals. This explanation was written from the published report of 1 November 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2016
Rated Requires Improvement; inspectors found staffing and some medicine controls were safe, but risks and management systems were not consistently effective.
This was an unannounced focused inspection on 10 October 2016. Inspectors checked whether improvements had been made after legal breaches found at the comprehensive inspection on 26 April 2016. They spoke with people, relatives, staff, the registered manager and the provider, and checked care, medicine and management records.
Some improvements had been made. Boxed medicine records balanced, staff knew how to report abuse, there were enough staff, and call bells were answered quickly. People and relatives said the registered manager was approachable and staff felt supported.
However, the home still had legal breaches. Records for prescribed nutritional supplements did not match stock levels. Some people's risks were not properly planned or followed, including risks linked to behaviour and falls. Quality checks and management arrangements did not reliably identify or address these problems.
Enough staff
Inspectors found enough staff to meet people's needs promptly. Recruitment procedures were also being followed.
“We saw that there were enough staff available to meet people's needs in a timely way and call bells were answered swiftly by staff.” from the report
Protection from abuse
Staff understood how to recognise and report suspected abuse. Required safeguarding referrals had been made.
“People were protected from abuse because staff understood how to recognise and report suspected abuse.” from the report
Approachable manager
People, relatives and staff said they could approach the registered manager with concerns and felt supported.
“People and their relatives told us the registered manager was approachable and they felt comfortable raising any concerns with them.” from the report
Supplement records did not match stock
seriousAll four people's nutritional supplements checked had less stock than the medicine records stated. Inspectors could not be assured that supplements had been given as prescribed.
“We checked four people's nutritional supplements and found that they all had less in stock than the MARs stated.” from the report
Risk plans were not consistently followed
seriousCare plans did not always explain how to manage known risks, and staff gave inconsistent accounts. One person was supported in a wheelchair despite a plan requiring a specialist chair and then fell.
“The above evidence showed people were at risk of harm because their risks were not consistently planned and managed.” from the report
Weak quality monitoring
needs fixingChecks did not always identify missed care-plan instructions, supplement stock errors or missing fluid records. The home had no system to check whether fluid charts had been completed.
“This meant that further improvements were needed to ensure effective systems were in place to monitor the service.” from the report
Limited management oversight
needs fixingThe registered manager spent three of four working days as the nurse on duty, limiting time to manage the home. An improvement plan existed, but many actions were still incomplete.
“This meant that the registered manager was unable to have a clear overview of the service.” from the report
- 01How do you now check that prescribed nutritional supplements are given and that stock matches the medicine records?
- 02How do you make sure staff follow each person's current risk and mobility plan?
- 03What system do you use to check that fluid charts and other required records are completed?
- 04What actions from the improvement plan have been completed, and which remain outstanding?
- 05How much dedicated time does the registered manager now have to oversee the home and monitor quality?
This was a focused inspection of Safe and Well-led only, checking two previous legal breaches; Effective, Caring and Responsive were not assessed in this report. This explanation was written from the published report of 10 November 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Newford Nursing Home
3 rated inspections over a year: the service has improved, from Requires improvement to Good.
- November 2017Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 16 March 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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