Archived: Clara Nehab House

Updated 6 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on 6 June and 4 July 2017, and was unannounced. It was undertaken by one inspector for social care, a pharmacist inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed information we held about the service. This included information from previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we met and spoke with nine people living at the service and seven relatives who were visiting on the day of the inspection. We also spoke with the registered manager, two deputy managers, a member of the care staff, the finance manager and a member of the kitchen staff.

Following the inspection we communicated with the provider’s chief executive and obtained feedback from three health and social care professionals.

As part of the inspection we observed the interactions between people and staff and discussed people’s care needs with staff. We also looked around the premises including the garden and two bedrooms.

We looked at four records related to people’s individual care needs, and three staff recruitment files. We checked supervision records for four members of staff and the supervision chart for the team for 2017. We also checked all staff training records..

We looked at the records associated with the management of medicines, including eleven medicine administration charts, and checked medicine stocks against records for eight people.

We also checked management of people’s money, complaints, accidents and incidents and safeguarding. We also reviewed documentation related to essential services such as gas, electricity and the maintenance of equipment.

Updated 6 September 2017

We inspected this service on 6 June and 4 July 2017. The inspection was unannounced. Clara Nehab House is a care home registered for a maximum of 25 people of the Jewish faith.

At the time of our inspection there were 22 people living at the service. The service was located in two adjoining houses on a residential street with access to a back garden. There was a lift to access upstairs and there were accessible bathing facilities for people with mobility problems.

We previously inspected the service on 13 January 2017 when we found repeat breaches of the regulations in relation to the safe management of medicines and the recruitment of staff. Following the inspection in January we served the provider with two Warning Notices in relation to the repeat breaches. This inspection was carried out to review actions taken in relation to the Warning Notices and to also undertake a full comprehensive inspection of the service.

At the time of the inspection, there was a registered manager in place 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.

People were happy living at the service and we saw kind and caring interactions between staff and people living at the service on the day of the inspection.

We found recruitment processes had improved and appropriate references and checks were now in place prior to staff starting work at the service.

Medicines were now safely managed at the service.

Staff understood people’s needs and preferences and told us they were supported in their role. Supervision had been taking place more regularly since January 2017 and we could see that refresher training was planned for staff. Although staff understood about safeguarding and consent their understanding was not always appropriate to their role within the service.

Care records were up to date and staff had appropriate information to support people living at the service.

There was a range of activities at the service and people enjoyed participating in both collective and individualised activities and trips out.

People were supported to maintain good health through regular access to healthcare professionals such as GPs and the local general hospital.

People were happy with the range of food available. People’s cultural and religious needs were facilitated by staff.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We found the service to be compliant with the legislation.

Quality assurance audits were now taking place in a number of key areas and we could see that the registered manager had made improvements to the service following the warning notices issues earlier in the year. The service was no longer in breach of the regulations relating to the safe management of medicines or the recruitment of staff.

There was a record of essential services such as gas and electricity being checked, and equipment was safely maintained. There was clear documentation relating to complaints and accidents and incidents.

We saw fire drills were now taking place regularly and staff had received training in fire safety. Since January 2017 the provider had commissioned a fire safety consultant to work with the service.

We have made recommendations in relation to safeguarding and following best practice in relation to head injuries.