Neville House Residential Home

We found the following examples of good practice.

The provider had policies and procedures in place to ensure staff followed effective infection control guidance. Staff and visitors had access to personal protective equipment (PPE) and there was a plentiful supply. We saw staff wearing PPE in line with current guidance. The home was very clean throughout and additional cleaning measures were in place.

Professional visitors were required to carry out a lateral flow test, complete a COVID-19 questionnaire and provide evidence of their vaccination status, prior to entry. Visiting arrangements were robust and in accordance with the most recent government guidance.

Social distancing was observed as far as it was practicable to do so. Staff had completed training in infection control, COVID-19 and putting on and taking off PPE.

Staff and people using the service were tested regularly for COVID-19 and action taken if a test was positive.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Neville House Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

Neville House is located in Chadderton, Oldham. The home provides care and accommodation for up to 22 older people. Bedrooms are situated on the ground floor and first floor of the home. Access between floors is via a passenger lift and staircase. The building is situated in its own grounds with gardens and off-road parking. At the time of our inspection 20 people were living at Neville House Residential Care Home.

There was a registered manager in place. 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.

We made an recommendation that the service refer to the latest best practice in supporting people with their sensory needs.

We made a recommendation that the service refer to the latest best practice in relation to activities in order to provide more stimulation for people.

Staff knew people's care needs, preferences, personal histories and backgrounds. People said staff protected their privacy and their dignity was respected. People were supported to be independent.

People said staff treated them with kindness and compassion. Comments included, “I am happy and like living here. Everyone is kind. It is a friendly, homely place," and "[Registered manager] is very approachable, good and caring.”

People received care from staff who were appropriately trained to effectively carry out their job roles. People were supported to have maximum choice and control of their lives. The service acted in accordance with the Mental Capacity Act (2005).

People's nutritional needs were met and they were supported to maintain good health and receive ongoing healthcare support.

Staff were aware of their responsibilities to safeguard people from abuse. Safe recruitment practices were in place and the service followed national and local safeguarding guidance.

There were sufficient staff to care for people. Risks to people's safety were assessed and medicines were administered safely.

We found records were written in a positive and respectful way and provided appropriate guidance on how to support people safely.

Neville House had arrangements in place to receive feedback from people that used the service, their relatives, external stakeholders and staff members about the services provided. This information was used to support continuous improvement.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there and their relatives. Staff had regular supervisions and were invited to team meetings.

The service has a registered manager who has been registered with the Care Quality Commission since December 2010. 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.

Neville House Residential Home provides support with personal care needs for up to 18 older people. There was 17 people receiving a service at the time of this inspection. The home provides accommodation on both the ground and first floors in eight single and five shared rooms. A passenger lift is available. On the ground floor there is a large lounge and a conservatory which is used for dining.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The registered manager had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, however the applications were still awaiting authorisation.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. For example we saw evidence that the home regularly made contact with district nurses, community nurses for mental health issues, and peoples own doctors. Other health professionals such as dieticians, dentists, occupational therapists and opticians were also requested as needed.

People told us that they received their medicines on time. Our observation of part of two medication rounds together with our review of records provided evidence that medicines were safely administered.

There were robust recruitment procedures in place, and there were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff told us they felt supported by the manager and provider. However, formal supervisions and appraisals were still being brought up to date. The registered manager has agreed a timescale for these to be in place.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked. We observed people being offered a second helping during breakfast and lunch. Snacks of fruit and biscuits and drinks were also available for people throughout the day.

People were able to access activities. We observed a quiz and we saw people enjoying being pampered in the morning. The registered manager told us that dedicated time is allocated during the morning and afternoon to facilitate activities.

Staff were positive about the registered manager and the way in which she led the service. They told us that the registered manager was always around and was approachable and proactive in trying to make the service as good as possible. The registered manager had clear goals for the service and spoke about future developments for the home which included an extension to the building.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. We noted from the records that no formal complaints had been received. The registered manager told us that niggle’s and minor concerns were dealt with straight away so they did not escalate into formal complaints.

There were systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager. The reports included any actions required and these were checked each month to determine progress.

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

This summary is based on a visit to the home where we spoke to the manager and observed staff interactions with people using the service. We looked at records and talked in private with four visiting relatives, three people using the service two health or social care professionals and three members of staff.

The full report contains the evidence to support this summary.

Is the service safe?

The people we spoke with at the inspection visit were positive about the care provided by the home. Visitors told us they thought their relatives were safe.

Staff who we spoke with told us they believed people using the service were protected from abuse or exploitation. Comments from staff included: 'I couldn't work with poor care being delivered'; '[the best thing is] the way people are treated'; and '[safe?] very much so'.

There was documentary evidence that staff had received training in the safeguarding of vulnerable adults. This was confirmed by staff who we asked. Staff also told us they understood the need to be vigilant and, to whistle blow if necessary.

We had a quick tour of the building. This included communal areas and a small selection of people's bedrooms. No obvious hazards to people's health and safety were seen. Staff were provided with disposable gloves and aprons to help minimise the risk of cross infection.

Is the service effective?

Each individual's care needs were assessed and reviewed. A care plan was developed on the basis of the assessment. People who used the service and their relatives where appropriate could contribute to decisions about the best way to meet their needs. People who used the service and visitors who we asked, all told us they were listened to by the staff at the home.

Staff were made aware of the up to date needs of each individual. Staff told us that communication within the home was good.

Staff followed advice from health care professionals

Is the service caring?

Observations of interactions between staff and people using the service indicated a warm and caring atmosphere.

All people who used the service and their relatives spoke positively about the caring attitude and approach of the staff. Comments included: '[staff are] pleasant and interested in people'; 'I feel comfortable with them [staff]. I don't feel embarrassed or shy because they put your mind at ease' and 'Brilliant. Carers can't do enough for them [people who used the service]'.

Is the service responsive?

We did not look specifically at the service's complaints procedure at this visit. However, people using the service and visitors who we asked during our visits said they believed they would be listened to if they had a complaint. Staff were confident that the registered manager would respond positively to any issues which were raised.

People who used the service and their relatives said that they were comfortable talking to staff and believed that their views were listened to. One person told us that amongst the best things about the home was 'you can always go to anyone you need to and they will listen to you.'

There were quality monitoring and quality assurance systems in place.

Is the service well led?

The registered manager provided strong leadership and gave staff a clear understanding of what good practice was. Staff told us that the registered manager was approachable, supportive and encouraged staff to further improve their practice by attending training.

Staff also confirmed that the registered manager provided good leadership. One staff member said 'Rachel is clear and we know what we are meant to do'.

Several visitors and people who used the service commented on how approachable the registered manager was. Comments included 'you can talk to Rachel [the registered manager]. She is very good and makes you feel happier' and 'Rachel is absolutely fantastic ' can't praise her enough'.

People were consulted about their day to day care needs and we saw that they received respectful and supportive care from staff. The three care staff we spoke with demonstrated a good understanding of providing individual support to people.

People said the manager was approachable and they could voice a concern or complaint and be confident that it would be addressed.

The management of medication and staff recruitment practices were appropriate. Records were kept up to date and maintained securely.