Newquay Nursing and Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The providers oversight and governance systems and processes were not always effective. Processes designed to assess and review people’s care and nursing needs were not always effective. The manager and provider used a 'dependency tool' when carrying out ongoing assessments on people's care needs. The purpose of the dependency tool was to support the manager to calculate the right ratio of staff against people's needs. However we noted this tool had not been reviewed since March 2022. Throughout of inspection staff were rushed in their duties and people had to wait to have their support needs met. The were insufficient governance arrangements in place to ensure people received good quality care. The provider and registered manager failed to adequately assess, monitor and drive improvement within the service. This was a breach of Regulation 17 (Good governance).

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager told us his roles and responsibilities had not been reviewed for some time due to staffing shortages. These staffing shortfalls had also impacted on the managers ability to carry out their roles and responsibilities as a registered person, because they were often having to cover shifts.

At our last inspection of the service we found systems and processes had not been effective in identifying and making required improvements to the quality of the service. The registered manager was not aware of the issues we identified. Due to the seriousness of some of our concerns the provider and registered manager accepted support from the local authority.

Staff told us they had confidence in the Registered Manager and felt they could raise concerns which would be dealt with. The Registered Manager and staff confirmed they had meetings before and after each shift for new information and concerns to be shared across the staff team. Some people commented about not having enough to eat, not having enough choices, one person commented “The food here is not so good, presentation skills are lacking; I was given a mix of a tiny portion of fish, six cold chips, cottage-pie and mushy peas all on one plate last Friday. I sent it back; there is no cooked breakfast just cereal and toast, the soups and sandwiches for tea are ok”. One person said, “The food is lovely”. The registered manager told us they had asked a member of staff to obtain people’s feedback about food and drink every 6 months. However there was no records to support the findings sought during this process or the number of people that gave feedback.

We asked the registered manager how they sought people views and experience of the care provided to them. The registered manager stated that surveys were completed with people. However, the last record of this taking place was between 2021 and 2022. We asked the Registered manager how they currently obtain feedback and we were told “I walk around every morning, I am here and I will speak to the residents and staff, if the staff are happy, they will deliver the best care for the people”.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We asked the registered manager for evidence of audits at management level for quality assurance systems. The registered manager told us they were behind with all the audits and provided the audit records they had completed last for care files, people weight, hydration and medicines. These were dated between 2019- 2022. The registered manager told us the provider visited the service every 6 to 8 weeks and they discuss improvements needed, the registered manager was not able to provide any evidence of this.

At our last inspection of the service we found systems and processes were not effective in identifying and making required improvements to the quality of the service. The systems and processes in place to monitor the safety and quality of care remain ineffective and had not identified the concerns found during the assessment. This included records, risk management, building safety, the Mental Capacity Act 2005, medicines, staffing, cleaning and person-centred care.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Some staff told us they had received up to date training however other staff informed us they had not had training. The registered manager provided us with the most recent training record however this did not include some new members of staff and we noted some training was out of date.

The registered manager told us they do not audit incidents and accidents. The registered manager was not able to provide any evidence of governance following an incident and responding to that risk. This response alongside the findings of our assessment identified a culture that was not based on learning. This meant that when things had gone wrong, the potential for re-occurrence was possible because there was no action taken to review, investigate and reflect on incidents. The provider was not using learning to make improvements required at the service. They had not taken sufficient action since out last inspection to meet breaches in regulations that were identified. We identified further breaches at this assessment.