Archived: Cathedral Nursing Home

Updated 31 March 2017

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 took place on 16 January 2017 and was unannounced. The inspection team was made up of one inspector, a specialist advisor for infection control and medicines and an expert by experience.

An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We did not ask the provider to complete a Provider Information Return (PIR) before our inspection. This was because we were following up on previous breaches of the regulations.

We looked at information we held about the provider. This included notifications which are events which happened in the service that the provider is required to tell us about.

During our inspection we spoke with the registered manager, a registered nurse, two members of care staff, the cook, a kitchen assistant, the housekeeper, the activity coordinator and 11 people who lived at the service and four visiting relatives. We also observed staff interacting with people in communal areas, providing care and support. In addition we spoke with two visiting healthcare professionals.

We looked at a range of records related to the running of and the quality of the service. These included five staff recruitment and induction files, staff training information, meeting minutes and arrangements for managing complaints. We looked at the quality assurance audits that the registered manager and the provider completed. We also looked at care plans for nine people and medicine administration records.

Updated 31 March 2017

We carried out an unannounced comprehensive inspection of this service in March 2016. Breaches of legal requirements were found and we rated the service as 'requires improvement'. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

The inspection took place on 16 January 2017 and was unannounced.

The Cathedral Nursing Home is registered to provide accommodation and nursing and personal care for up to 38 older people or people living with dementia. There were 37 people living at the service on the day of our inspection.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons. Registered persons have the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. Several people living at the service had their freedom lawfully restricted under a DoLS authorisation.

Staff undertook appropriate risk assessments for all aspects of a person’s care to keep them safe from harm. Care plans were developed to support people’s individual needs. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. People received their prescribed medicine safely from staff that were competent to do so. The registered provider ensured that there were always sufficient numbers of staff on duty to keep people safe.

People were supported to have a healthy and nutritious diet and hot and cold drinks and snacks were available throughout the day. People had their healthcare needs identified and were able to access healthcare professionals such as their GP and dentist. Staff knew how to access specialist professional help when needed.

People were at the centre of the caring process and staff acknowledged them as unique individuals. Relatives told us that staff were kind and caring and we saw examples of good care practice. People were always treated with dignity and respect. People were cared for by staff that were supported to undertake training to improve their knowledge and advance their skills to enable them to perform their roles and responsibilities effectively.

People were supported to have an active life and were encouraged to take part in hobbies and interests of their choice. Relatives commented that their loved ones were well looked after.

People where able, were supported to make decisions about their care and treatment and maintain their independence. People and their relatives had access to information about how to make a complaint. Relatives told us that they could approach staff with concerns and knew how to make a formal complaint to the provider.

The registered provider had introduced robust systems to monitor the quality of the service and make improvements. Staff had access to professional development, supervision and feedback on their performance. People, their relatives and staff found the registered manager approachable.

Overall, we found that the registered manager had led their team to introduce and sustain improvements to the service, such as medicine management, infection control and monitoring the quality of the service.