This was an unannounced inspection which took place on 12 October 2015. We had previously inspected this service in March 2015 when we identified five breaches of the Health and Social
Care Act 2008 (Regulated Activities) Regulations 2014. These related to staffing levels, support for staff, management of medicines, care and treatment of people who used the service and ineffective quality assurance systems.
Following the inspection in March 2015 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. This inspection was undertaken to check whether the required improvements had been made.
Hyde Nursing home is a purpose built care home and is registered to provide accommodation for people who require nursing and personal care. There are 100 beds in total, 60 of the beds are in use by Hyde Nursing Home. Godley Court and Newton units provide general nursing care for up to 35 people in total. Werneth is a unit providing care for up to 25 people living with a dementia. There were a total of 46 people using the service at the time of the inspection.
The service did not have a registered manager in place. 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. A new manager had been in post since May 2015. They had submitted an application to register with CQC as manager for Hyde Nursing Home.
During this inspection we found a breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because there were not always sufficient numbers of staff available to meet people’s needs. You can see what action we have told the provider to take at the back of the full version of the report.
People who used the service told us they felt safe in Hyde Nursing Home and had no concerns about the care they received.
Staff had received training in safeguarding adults. They were able to tell us of the correct action to take should they witness or suspect any abuse had occurred. Staff also told us they would feel confident to use the whistle blowing procedure in the service to report any poor practice they observed.
Staff had been safely recruited. Records we reviewed showed staff had received the induction, training and supervision they required to be able to deliver effective care. Staff told us they enjoyed working in the service and received good support from the manager. They told us the atmosphere in the service had improved since our last inspection.
Although improvements had been made to the way medicines were managed in the service, some aspects of the new procedures introduced had yet to be fully implemented.
All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. Regular checks were also in place to ensure staff were aware of the action they should take in the event of a fire at the service.
People’s care records contained sufficient information to guide staff on the care and support required. People told us they always received the care they needed. The care records showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that staff had made referrals to health professionals to help ensure people received effective care.
We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The manager was aware of the action to take to ensure any restrictions in place were legally authorised under the Deprivation of Liberty Safeguards (DoLs).
People told us they generally enjoyed the food provided in Hyde Nursing Home. We observed the food to be well presented and nutritionally balanced. Although there were systems in place to help ensure people’s nutritional needs were met, we observed people did not always receive the individual assistance they needed to eat their meals.
People we spoke with told us that staff in Hyde Nursing Home were always kind and caring. Although we observed kind and respectful interventions between staff and people who used the service, we also saw there were occasions on which staff interventions with people were limited and mainly task focused.
A programme of activities was in place to help promote the well-being of people who used the service. Records we reviewed showed people were supported to access activities on both a group and individual basis.
There were effective systems in place to investigate and respond to any complaints received by Hyde Nursing Home. All the people we spoke with told us they would feel confident to raise any concerns they might have with staff or the manager.
Quality improvement processes in the service had improved since our last inspection. The manager had introduced daily meetings with staff from each part of the service to help monitor the quality of the service provided.