Swallownest Nursing Home

We found the following examples of good practice:

At the entrance of the home, information was displayed to inform visitors about any infection control procedures to be followed. Temperature checks were completed, along with a questionnaire to establish if visitors had recently displayed any symptoms of COVID-19.

The home had a robust process in place for facilitating controlled visits for people receiving end of life care including the use of; a lateral flow test upon arrival, temperature checks, use PPE and being escorted to and from the bedroom.

Zoning arrangements were used when people had tested positive for COVID-19 and needed to self-isolate in certain areas of the home such as bedrooms.

COVID-19 testing was in place for staff and people using the service. All people living at the home and the majority of staff had received their COVID-19 vaccination.

We saw enough personal protective equipment (PPE) and hand sanitizer was available.

We found Swallownest Nursing Home to be clean and tidy. A dedicated domestic team, with the assistance of care staff, carried out scheduled infection control procedures tasks throughout the day. Regular infection control audits were undertaken to ensure standards were maintained.

Risk assessments were completed where certain groups may be at higher risk of harm id they contracted the virus. There were enough staff to care for people safely. Staff had received additional infection control training during the pandemic.

Swallownest nursing Home is care home providing care and support for older people, including nursing needs and people living with dementia. The service can support up to 64 people.

People’s experience of using this service and what we found

On the day of our inspection there were predominantly adequate numbers of staff available to meet people’s needs. However, on the upstairs unit due to the layout and ineffective deployment of staff, we found people’s needs were not always met in a timely way. The registered manager had already identified this and since our inspection we have received confirmation that staffing levels have been increased to ensure people’s needs are met. Safe recruitment systems were in place and followed. Medication management was safe, although we found some of the documentation could be improved. Risks associated with people’s care and support had been identified, however, some lacked detail to ensure risks were managed safely, these were being updated at the time of our inspection and were all completed by the end of the day.

People were safe, and staff understood safeguarding and whistleblowing procedures and when they would be required to instigate. Accidents and incidents were monitored, and lessons were learnt.

Staff were very knowledgeable about people's needs, care was person-centred and individualised. Staff said training was good and from talking with staff and our observations it was effective. Staff were supervised and supported.

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

People received a balanced diet. People told us they enjoyed the food provided. People had access to health care professionals. The environment was well maintained and homely. There was also access to outside space.

When staff engaged with people they were kind and caring and compassionate. People told us the staff were lovely and genuinely cared. People were involved in their care planning to ensure their decisions and choices were reflected.

We looked at care records and found although they were not always easy to follow had identified people’s needs and reflect people’s choices. People received individualised, personalised care. People were listened to and complaints were appropriately dealt with and resolved. End of life care was included in care plans to ensure people’s decisions were respected.

The service had an activities coordinator and a varied calendar of social stimulation was provided, including entertainment, faith meetings, outings and in-house activities.

A new manager had been appointed and commenced employment at the service in January 2019. They were registered with CQC. Quality monitoring was carried out using various audits tools. These were effective. Although we had identified some minor issues during inspection these had already been picked up by the registered manager and were being actioned. The service promoted an open, inclusive and positive culture. People and relatives were involved in the service, quality questionnaires were sent out and regular meetings were held.

Rating at last inspection

The last rating for this service was good (published 22 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We have received written confirmation that staffing has been increased and the works required to install a kitchenette on the upstairs unit have been approved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 5 and 6 January 2017. The inspection was unannounced on the first day. When we visited the home in February 2015 we rated the home as Good.

The home had a registered manager. 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.

All of the people who used the service and most visiting relatives we spoke with gave positive feedback about the home, the staff, the food, the activities and the care provided.

People are 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.

There was a homely feel and everywhere was clean. People were well cared for and there were warm interactions between people who used the service and staff. People’s views and opinions were sought and taken in to consideration and staff demonstrated a good knowledge of people.

There were sufficient staff, who were well supported through a system of induction, training, supervision, appraisal and professional development.

The recruitment systems were designed to make sure new staff were only employed if they were suitable to work at the service.

The staff were aware of their responsibility to protect people from harm or abuse. People who used the service and staff were confident to raise any concerns.

There was a comprehensive, formal quality assurance process in place. This meant that the service was monitored to make sure good care was provided and planned improvements and changes could be implemented in a timely manner.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. One person told us they were happy for staff to administer their medication. Another person said, 'The staff explain to me why I need to take my medication. They (staff) are very good."

Staff received training in the control and prevention of infection and they were provided with equipment to prevent the risk of cross infection. Policies and procedures were in place to ensure the home was cleaned to a sufficient standard to control the risk of infection.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

People were protected from the risks of unsafe or inappropriate care and treatment because their records had been reviewed and updated regularly.

People we spoke with told us that staff were kind and always treated them with respect. One person said 'Staff help me to get dressed and I stay in my room and staff brings me my meals.' People were encouraged to maintain their independence. One person told us 'I know the help I need and I am happy with the care and support I get from staff.'

Relatives we spoke with told us that they were happy with the care provided, although one relative told us they had raised a number of concerns which had been looked into by the manager.

Staff received training in the control and prevention of infection and they were provided with equipment to prevent the risk of cross infection. Policies and procedures were in place. However we found some areas of the home were not cleaned to a sufficient standard to control the risk of infection.

We found systems did not protect people who used the service against the risks associated with the unsafe use and management of medication.

The organisation had robust recruitment procedures and ensured staff received training to enable them to deliver care safely.

Complaints were investigated and responded to in a timely manner.

Some records did not reflect the care and treatment provided to people who used the service.

We spoke with visiting professionals who felt that staff referred people on to appropriate services as required. One professional said, 'People's needs are being met.'

We spoke with four relatives of people who used the service. Generally people were happy with the standard of care. One person said, 'The standard of care is good, but they do seem to be extremely short staffed. It's a good place and the activities are good.'

We spoke with people who used the service and they told us that they felt safe in the home. They also felt that staff were respectful. One person said, 'Staff treat me with respect and maintain my privacy.'

We spoke with four members of staff who told us that they enjoyed their job and they felt supported by the manager. One member of staff said 'I am supported by the manager and I enjoy working with the team.' Staff felt that there were enough staff on each shift to meet the needs of the people who used the service.