Archived: Sedra Nursing Home

There was a registered manager at the service at the time of our inspection. 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.

Sedra Nursing Home offers accommodation and personal care for 19 older people, 12 of whom were living with dementia. There were 13 single rooms and three shared rooms. The registered manager told us that all rooms will eventually be single rooms, which will reduce capacity to 16. There were 18 people in residence at the time of our inspection.

Staff did not always follow the procedure for recording, storing and safe administration of medicines. This meant that people were at risk of not receiving their medicines safely.

The service employed one activities coordinator and we saw there were organised activities on the day of our inspection. However the delivery of those was disorganised and did not take into account people’s individual choices and needs.

The care plans we looked at were signed by people or their relatives where possible, and we saw evidence of best interest assessments where people lacked the capacity to make decisions about their care and support.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were reviewed and updated monthly and included detailed instructions for staff to follow to ensure people’s needs were met. Care plans contained information about people’s daily routines and preferences.

The provider had processes in place for the recording and investigation of incidents and accidents. Risks to people’s safety were identified and managed appropriately.

There were enough staff on duty to meet people’s needs in a timely manner.

People felt safe when staff were providing support. Staff had received training and demonstrated a good knowledge of safeguarding adults.

People’s capacity to make decisions about their care and treatment had been assessed. Processes had been followed to ensure that, when necessary, people were deprived of their liberty lawfully.

Staff received regular supervision and an annual appraisal, and told us they felt supported by their manager. There were regular staff meetings and meetings with people and their relatives.

Staff had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service.

Recruitment records were thorough and complete and the provider had ensured that staff had a Disclosure and Barring Service (DBS) check prior to starting work.

There was a complaints process in place and people told us they knew who to complain to if they had a problem. Relatives were sent questionnaires to gain their feedback on the quality of the care provided.

People told us they felt safe at the home and trusted the staff. They told us staff treated them with dignity and respect when providing care. Relatives and professionals we spoke with confirmed this.

We saw people being cared for in a calm and patient manner.

People gave positive feedback about the food and we observed people being offered choice at the point of service. People had nutritional assessments in place. People had access to healthcare professionals as they needed, and the visits were recorded in their care plans.

The provider had a number of systems in place to monitor the quality of the service and put action plans in place where concerns were identified.

People, relatives and professionals we spoke with thought the home was well-led and the staff and management team were approachable and worked well as a team.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to person-centred care and safe care and treatment. You can see what actions we told the provider to take at the back of the full version of this report.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to make sure that staff recorded accidents and incidents, complaints and other concerns and took action when required. This reduced risks to people and helped the service to continually improve.

The provider had suitable procedures to manage health and safety and medical emergencies and staff had the necessary training to do so.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and staff were aware when they needed to make a referral for an assessment. This means that people's human rights were safeguarded as required.

Staff were appropriately trained to meet the needs of people using the service and keep them safe and regular training updates were provided. There was suitable induction training for new staff and on-going supervision to ensure that staff carried out their duties safely.

Is the service effective?

People using the service experienced care that was planned and delivered to meet their needs and mitigate any risks. People using the service and their relatives were involved in the development of their care plans.

Care needs were reviewed on a regular basis and care plans could be modified if needs changed. Records showed that the care delivered reflected the current care plan. We observed that staff were attentive and kind to people on the day of our visit.

Forms for consent to care and treatment were signed by people using the service or their representatives after reading the care plan to indicate agreement to the care that they received. Staff were aware of the importance of consent and took steps to ensure people's consent at all times when providing care and support.

The provider worked with a range of other health care professionals to ensure that other health needs were met. There was well documented liaison and cooperation with other services and health providers. People were supported to attend external appointments when necessary and had access to other services within the home. There was evidence that input and advice from other health care professionals was incorporated into care planning for people using the service.

Is the service caring?

People were supported by attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People requiring individual attention had appropriate support to meet their needs.

There was a programme of activities organised by the activities coordinators to help to keep people involved in the daily life of the home and interact with others. People were offered choices and supported to attend outside visits, outings and appointments.

People we spoke with were satisfied with the care and support they experienced. A family member of one person remarked, 'They're all very caring and helpful and very gentle.' Another relative commented, 'The staff are extremely kind and always listen to what we say and take it on board', while a person using the service told us, 'They're very welcoming here. People are well cared for and the staff are very helpful.'

Is the service responsive?

People using the service and their relatives completed an annual satisfaction survey and there were regular meetings held where people were encouraged to express their views. There was evidence that the provider was responsive to this feedback and took steps to improve the service.

There was a written complaints procedure which was readily available for people using the service. People were confident that they know how to complain if they were unhappy about the quality of the service although awareness of the written procedure was low. As no complaints had been documented it was not possible to assess how the provider would investigate and respond to complaints.

Is the service well-led?

The provider had a variety of systems to monitor the quality of service provided and audit their performance. People using the service and their relatives had regular opportunities to provide feedback on their care and express their views. There were appropriate procedures for dealing with complaints and reporting accidents and incidents.

Staff felt well supported and well managed, and were encouraged to pursue further training and professional development.

We spoke with one of the GPs from the practice covering the home who told us, 'They're very sensible, proactive and well managed at Sedra.'

During this inspection we found that people and/or their representatives were being involved in care planning. We observed the lunchtime meal and saw that people were being supported in a respectful way and at a pace that suited them.

People told us that the staff were polite and helpful. One person said, "they (staff) treat me very well." Another told us, "the staff are very helpful."

We found that recruitment checks had been completed to ensure that staff were suitable to work with vulnerable people.

People's needs were assessed and care plans developed informing staff how to meet them. We found that care plans did not always contain details of people's likes, dislikes and preferences.

Appropriate arrangements were in place to ensure that people were protected from abuse and people told us they felt safe in the home.

Recruitment checks were not always thorough enough to ensure that the staff employed were suitable to work with vulnerable adults.

Records in the home were variable and did not always contain sufficient information.