Archived: The Mains Nursing And Residential Home

Updated 13 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection visit took place over one day on 1 July 2015. This visit was unannounced which meant the staff and provider did not know we were visiting. The inspection team consisted of one adult social care inspector.

The provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed all of the information we held about the service including statutory notifications we had received from the service. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale.

During our inspection we spoke with six people who lived in the home, three visitors, three care staff, two ancillary staff, a senior carer, the registered manager and one of the proprietors. We observed care and support in communal areas and spoke with people in private. We also looked at care records of four people to see if their records matched with the care needs they said they had or staff told us about. We also looked at records that related to how the service was managed.

As part of the inspection process we also reviewed information received from the local authority who commissioned the service.

Updated 13 August 2015

The inspection visit took place on the 1 July 2015 and was unannounced which meant the staff and provider did not know we were visiting.

The Mains Nursing and Residential Home is registered to provide personal care for up to 48 people. It caters for people with residential care needs only and is situated in Redmarshall, close to Stockton on Tees. At the time of our visit there were 14 people who used the service.

We last inspected the service on 21 February 2014 and found the service was compliant with regulations at that time.

There was a registered manager in post. 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.

There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know when an application should be made and how to submit one. We spoke with staff about DoLS and not everyone knew exactly who had a DoLS in place and exactly what this meant for the person. We discussed this with the manager to perhaps undertake further training or discussion in this area to ensure all staff were aware of what the implications were for people affected.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people. The service had a very consistent staff team most of who had worked at the home in excess of eight years.

People told us they felt safe at the service, and we witnessed people being reassured during a violent thunder and lightning storm which affected the power supply to the service for a short period. We spoke with staff who were knowledgeable about procedures to follow if they suspected abuse and there was information about this displayed around the service. People told us there were enough staff and we witnessed people being supported to attend hospital appointments with care staff. The staff team were supportive of the registered manager, owners and each other.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. Medicines were stored in a safe manner. We witnessed staff administering medication in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace. People’s healthcare and access to it were well monitored and staff supported people to attend appointments.

There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. Staff also received mandatory training and training to meet the needs of the people who used the service. Recent training staff had undertaken included dementia and end of life care. We spoke with kitchen staff who had a good awareness of people’s dietary needs and staff also knew people’s food preferences well.

We saw people’s care plans were personalised and people had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved the person where they were able. We saw people being given choices and encouraged to take part in all aspects of day to day life at the service.

The service encouraged people to maintain their independence and although the service did not have a dedicated activities staff member, care staff told us about the types of activities they offered.

The service undertook questionnaires with people who lived at the home and their family to seek the views on the care and service provided. Relatives we spoke with praised the home and staff highly and told us the communication was very good. We also saw that there was a regular programme of staff and resident meetings where issues where shared and raised. The service had an accessible complaints procedure and people told us they knew how to raise a complaint if they needed to. This showed the service listened to the views of people.

Any accidents and incidents were monitored by the registered manager to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks. Risks were also clearly recorded both for people using the service and the environment and these showed regular review

The service had a range of audits in place to check the quality and safety of the service and equipment at The Mains.