Newquay Nursing and Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

There were no effective processes in place to assess and review people’s care and nursing needs. People told us their care was not always reflective of their needs. Care plans were not always clear and did not always provide appropriate guidance to staff to keep people safe. Some peoples care plans lacked up to date personalised information as to how the people wished to be supported with personal care, what their preference were for food and drink, how they wished to spend their time and their life histories. People were not involved in the development of their own care needs. This was a breach of Health and Social Care Act 2008 Regulation 9 (Person-centred care). The provider failed to ensure it acted in accordance with the requirements of the Mental Capacity act 2005. This was a breach of Health and Social Care Act 2008 Regulation 11 (need for consent).

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We spend time with people to learn more about their experiences of using the service. Peoples told us they didn’t always get to spend the day how they wanted to. One person told us that they would love to be able to visit the church, while another person described how they had not been out of the service “for over 20 months”, They told us “I’m stuck here”. Care records for both people did not show any information or guidance on how staff could support them with their personal needs and preferences.

The service had a clipboard in the main communal ground floor lounge with a routine for 17 people to be supported with their continence needs. We asked the Registered Manager about this institutionalised practice, and we were informed every person is repositioned and toileted every 3 hours. This meant people did not receive person-centred care.

Records relating to person centred care were incomplete and lacking in detail surrounding important aspects of peoples' lives such as life stories and food and drink likes and dislike. People who required support with their catheters were placed at an increased risk of harm because the provider failed to follow national guidelines related to catheter care. Care records did not include information and guidance on how staff could support a person with their catheter care needs. We raised this concern with the registered manager on the day of our assessment who completed a safeguarding referral to the local authority.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

During our visit we became aware and concerned about one person’s dental needs. We were informed by the registered manager that the person had access to dental care. However, there were no records of any dental visits taking place. We asked for further information relating to peoples optical and podiatry needs being met. The service could not demonstrate this, therefore we could not be assured that these visits were taking place. People did have access to weekly visits from their GP.

The registered manager told us they gain support from a care home support service, however records did not always show professional visits or involvement.

The services local GP visits weekly and confirmed this.

The registered manager informed us the dentist had visited, records did not show this. The people living at the service did not have regular visits from podiatrist, opticians and dentist. The Registered Manager told us since COVID-19 they have been waiting for these visits to re start.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We spend time with people to learn more about their experiences of using the service. Peoples feedback did not highlight any concerns. However, our findings from this assessment demonstrate that people’s outcomes were not always maximised.

Staff told us they did not have training around behaviour that may challenge others and the services training record confirmed this. Staff were able to tell us people’s signs of distress and how they would support people however the response was not always consistent.

Records such as care plans did not contain information about how staff should respond to people with emotional or mental health needs. We identified incidents where a people had become upset and aggressive. However care plans and risk assessment did not provide guidance to staff on how to best support the person.

We spent time with people to learn more about their experiences of using the service. Peoples feedback did not highlight any concerns however it was not clear if people have given consent or if the provider was acting lawfully on their behalf before any care or treatment was provided.

One person had been assessed as lacking capacity to make decisions about their care. However, this was not carried out in line with MCA code of practice 2005. We asked the provider how they were supporting this person through the best interest process and when they last had a best interest meeting to review their ongoing needs. The registered manager told us “None have happened for years. It is difficult to bring together all of the staff”. Other records relating to people’s capacity to make safe decisions were often incomplete or lacking decision specific detail.

People were not always supported to have maximum choice and control of their lives. Where people had been identified as needing equipment that restricts such as bedrails there was no record to demonstrate if they had consented or lacked capacity to consent.