This inspection took place on 8 December 2015 and was unannounced. At our previous inspection on 8 January 2014 the service was meeting the regulations inspection. Hamilton Nursing Home provides nursing care and support to up to 28 older people, some of whom have dementia. At the time of our inspection 26 people were using the service.
The service had 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.
People were provided with care and support that was tailored to their needs. Staff assessed people’s personal care and nursing needs, and developed care plans about how those needs should be met. Staff were knowledgeable about people’s needs and supported them in line with their care plans.
Staff were aware of people’s likes, interests and routines. Staff liaised with people’s relatives to obtain information about their life story including previous occupations and significant events. This information was used to help staff to provide personalised care.
A wide range of activities were provided at the service, so that all people could take part in activities. This included using the Namaste programme which stimulated people’s senses, and did not rely on people being able to communicate verbally or be physically active.
Staff were aware of people’s communication needs, and communicated with people in a way people understood. This included the use of hand gestures and body language. Staff offered people choice about their day to day care and respected their decisions.
Staff were aware of the principles of the Mental Capacity Act (MCA) 2005. Staff arranged for MCA assessments to be undertaken to establish if people had the capacity to consent to care decisions. ‘Best interests’ meetings were held for people that did not have the capacity to consent. The registered manager had organised for people to be assessed as to whether they required a Deprivation of Liberty Safeguard (DoLS) to keep them safe. For those that had a DoLS in place, staff adhered to the conditions stipulated. DoLS is a way of making sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.
Staff were aware of the risks to people’s safety, and supported them to manage those risks. This included risks associated with developing pressure ulcers, falling and malnutrition. Staff supported people with their nutritional needs, and liaised with other healthcare professionals to support people with their healthcare needs. There were safe medicines management processes in place and staff ensured people received their medicines as prescribed.
Staff were aware of their duties in regards to safeguarding people and reporting concerns, incidents and accidents. Incidents were reviewed and action was taken to minimise the risk to people and to keep people safe and free from harm.
There were sufficient staff to meet people’s needs. There were robust induction, training and supervision programmes in place to ensure staff had the knowledge and skills to meet people’s needs.
The management team undertook regular checks on the quality of care provided, and attended meetings to discuss the care provided to people. Where it was identified that improvements were required, the registered manager ensured these were implemented.
There was open and transparent communication amongst the staff team, and with people’s relatives. There were mechanisms in place to obtain feedback from people and their relatives about the care their received. Staff were encouraged to express their opinions about the service and to suggest ways of improving the care delivered.
The registered manager adhered to the requirements of their registration with the Care Quality Commission.