Muscliff Nursing Home

We found the following examples of good practice.

Visiting arrangements were in line with current government guidance. This included professionals visiting the service showing evidence of their vaccination status. The home was fully open to all visitors who were all required to complete an LFT the day of their visit and show evidence of a negative result. Families told us communication was very good and they felt kept up to date with a weekly email or letter. One relative told us, “(Home) were incredibly careful and stuck by the rules which was important to us as it kept (relative) safe.”

All areas of the home were clean and robust audits ensured that cleaning standards were maintained. Staff had been trained in safe infection, prevention and control, (IPC), procedures, including handwashing and applying PPE correctly. Records showed us that competencies were checked regularly by staff who had lead responsibility for IPC. PPE was in good supply and we observed staff wearing it correctly.

People living at the home, and staff, were participating in both the vaccination and testing programmes. Staff had been able to access one to one counselling to discuss any concerns they had about receiving a vaccination. If people had been assessed as unable to make a decision about vaccination and testing a best interest decision had been taken in line with the principles of the mental capacity act. This ensured their legal rights were being protected.

Changes to the environment, in response to the pandemic, included areas being created for both staff and visitor testing, additional quiet areas with seating for visiting, changes to dining arrangements to enable social distancing and a window visiting area with a telecom system fitted. Staff had a designated area for changing in and out of their uniforms, which were washed and ironed on the premises, reducing risks of contamination outside the home.

Staffing levels had been increased at the onset of the pandemic as part of the organisations COVID strategy. This meant that care agency staff had not been used and people were receiving care from a consistent work force that knew them well. The organisation worked collaboratively with other organisations to keep up to date with best practice and share learning.

Muscliff Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Muscliff Nursing Home provides personal and nursing care and treatment for up to 40 people some of whom may be living with dementia and or have nursing needs in Bournemouth. There are bedrooms on the ground and first floor and there a number of communal lounge and dining areas on the ground floor. At the time of the inspection there were 35 people living at the home.

There was a manager in post who had been registered for eight years. 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 protected from potential abuse and avoidable harm by staff who were knowledgeable about recognising and reporting different signs of abuse.

There were enough appropriately qualified staff available on each shift to ensure people were cared and supported safely. There was a stable staff team at the service.

Risks to people were well managed and medicines were managed effectively. People were protected by the prevention and control of infection.

There was a system in place to review and learn from incidents when things went wrong.

Staff received training to meet the individual needs of people. Staff told us they felt well supported to carry out their roles and told us everyone worked very well together as a team for the benefit of the people living at Muscliff Nursing Home.

People had access to nutritious, home cooked food that they enjoyed and were given choice in their menu selections.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's independence and wellbeing was enhanced by the environment of the home.

There was an open, friendly and homely atmosphere. People and staff were relaxed and comfortable with each other. People were supported with kindness and compassion by staff who knew them and understood the care they needed.

People were treated with dignity and respect and were supported to make their own choices.

People received outstanding personalised care and support in the ways they preferred. Staff took the time to get to know people and their life and social histories so they could truly understand their experiences. People’s needs and preferences were consistently assessed or planned for and met.

The responsive care and support people received had an extremely positive impact on their lives. People and their representatives were actively involved in developing and contributing to their care plans.

There was an emphasis on personalised, meaningful activity that was based on people’s interests and experiences. People took part in individual and group activities and events both at Muscliff Nursing Home and in the local community.

Complaints and concerns were encouraged and seen by the provider and registered manager as part of driving improvement.

The registered manager and provider demonstrated its commitment to promote a positive culture within the home by being open and transparent to new ideas and collaborative working which had a positive impact on the care provided to people.

The service was led by a management team that was approachable and respected by the people, relatives, professionals and staff.

There was a strong emphasis on quality assurance within the service which was led by the management team within the service. There was an emphasis on continuous improvement which was done through the results of any audits, learning from complaints and incidents and accidents. These were all used as a learning opportunity, and feedback was provided to staff to drive improvements.

The home had a registered manager who was available during 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 about how the service is run.

People who used the service, and their relatives, told us that they felt safe and well looked after.

Staff met people's needs effectively and people told us that they were all kind and caring. Staff told us that they enjoyed working at the home and they were very knowledgeable about people's needs, preferences and life experiences. Staff respected people's privacy and dignity.

Staff had a good understanding of what constituted abuse and told us that they would be confident to recognise and report it.

We looked at how the home was being staffed. We saw there were enough staff to provide safe care and social activities. People we spoke with were satisfied with staffing levels.

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working in the home.

Staff managed medicines safely. They gave them as prescribed and entered, stored and disposed of them correctly. People were able to manage their own medicines if they were able to do so safely. People said staff gave them their medicines when they needed them.

People were well-supported with their health needs and the provider sought information and advice swiftly where needed.

People told us they were offered a choice of meals. They said the meals were good and they were offered snacks and drinks, day and night.

Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People's care records were mostly comprehensive and detailed people's preferences. Records were regularly updated to reflect people's changing needs. People and their families were involved in the planning of people’s care.

People's risks were considered, managed and reviewed to keep people safe. All the people we spoke with told us they felt safe at Muscliff Nursing Home. Where possible, people had choice and control over their lives and were supported to engage in activities within the home.

People participated in a range of daily activities in the home which were meaningful and promoted their independence.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

People using the service and their relatives had been asked their opinion via surveys.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

One relative told us "X is so much calmer now they used the sensory room regularly. It really helps them to relax".

We spoke with three care staff and confirmed that they had received safeguarding training and were able to say what action they would take if concerns were raised or observed. The manager told us that 98% of the care staff had been awarded the National Vocational Qualification (NVQ) levels 2 or 3.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The service has been accredited by the 'Gold Standards Framework (GSF), this is a system to promote a gold standard of care for all patients at the end of life.