Staplehurst Manor Nursing Home provides nursing and personal care for up to 30 older people, some of whom were unable to move independently. Some people were living with dementia and others required support because of illness or other age related conditions. End of life care is also provided. Staplehurst Manor is a large detached property set in extensive, well maintained grounds. There were 23 people receiving nursing care at the time of our inspection.
We inspected the service on 13 October 2014. At our last inspection on 18 October 2013 we found that the service met the essential standards of quality and safety we looked at.
A new manager had been employed at the service since May 2014. Their application to become the registered manager was being processed by the Care Quality Commission (CQC) at the time of this inspection. 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 and associated Regulations about how the service is run.
The provider had taken steps to make sure that people were safeguarded from abuse and protected from risk of harm. People told us they felt safe. People were protected from harm; risks to their safety were assessed and managed appropriately. People were involved as far as possible in their assessments and action to minimise risk was agreed with them.
The provider operated safe recruitment procedures which included carrying out legally required checks on every applicant to make sure they were suitable to work with the people who lived at this service. Staff told us there was a good atmosphere and staff worked as a team. They told us there were enough of them to care for people and keep them safe. People told us they did not have to wait long when they needed help or support.
Staff were provided with suitable training to enable them to carry out their roles. People told us, “Staff have been very good.” “All the nurses and carers are good” and, “They look after me well”.
Staff understood their roles and responsibilities. They told us they felt well supported and were provided with essential training, including induction to make sure they had the knowledge and understanding to provide effective care and support for people. Nursing staff were supported to continue their professional development. All staff received regular supervision and appraisal to make sure they were competent to deliver appropriate care and treatment. Care staff received regular supervision with their line manager where they were able to discuss their work. Nursing staff told us that they received regular clinical supervision regarding their nursing practice.
Staff received Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) training to make sure they knew how to protect people’s rights. There was no one living in the home for whom it had been necessary to make an application under DoLS to restrict their liberty. Staff understood the importance of obtaining consent from people before care or treatment was provided.
People told us they enjoyed the food. They said, “They (staff) go to no end of trouble to please you where food is concerned”. People were offered choices about what they wanted to eat and drink. People who needed support to eat were helped discreetly. Meal times were managed well to make sure that people received the support and attention they needed.
People were supported to manage their health care needs. Nursing staff carried out regular health checks on people who lived in the home and these were recorded. People told us they were able to see a GP whenever they wanted to. Records showed that people saw other health professionals such as physiotherapists, chiropodists, dentists and opticians when they needed to.
People were treated with respect, kindness and compassion. People told us they were happy and felt cared for. They said, “The care here is excellent” “The carers are good and kind” and “Everyone is treated with respect”. All agreed that they felt listened to.
Each person had an individual care plan. These were continually reviewed and updated to make sure all their needs were understood by staff who provided their care and treatment. People told us they had been consulted about how they wanted their care to be delivered.
Information about people was treated confidentially and records were stored securely. Staff were discreet in their conversations with one another and with people who were in communal areas of the home. Staff were careful to protect people’s privacy and dignity.
People received personalised care or treatment when they needed it. People told us they did not have to wait long if they needed any help. They said, “I use the buzzer if I need them and they respond pretty quickly.” and, “I have no complaints at all; they can’t do enough for you”. Staff knew people well. They were calm and patient with people, they communicated effectively, responded quickly and appropriately to people’s requests. Staff offered people choices. For example, about what they wanted to eat and where and how they wanted to spend their time.
People’s needs were assessed with them before they moved to the home to make sure the home was suitable for them. Care plans were regularly reviewed with the person concerned to make sure they were up to date and reflected their individual preferences, interests and aspirations. People were provided with a range of suitable activities they could choose from. Everyone we spoke with told us there were activities on offer.
The manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. All the people we spoke with felt able to raise any concerns with staff or the management.
People spoke positively about the way the home was run. They told us the manager and staff were approachable. One person said, “I’ve been in a lot of places in the world and this is the best place I’ve been in”. Relatives told us they felt that the home was well run and could speak to the manager at any time if they had any questions or concerns. The organisation had clear vision and values. These values put people at the centre of the service and had been successfully cascaded to staff. People were comfortable with the management team and staff in the home. Staff understood their roles and responsibilities and the staff and management structure ensured clear lines of accountability.
There were systems in place to review the quality of all aspects of the service regularly. Improvement plans were developed where any shortfalls were identified. Annual ‘customer satisfaction surveys’ and quarterly ‘resident’ and relatives’ meetings gave people the opportunity to comment on the quality of the service. People were listened to and their views were taken into account in the way the service was run.
Any accidents and incidents were monitored to make sure that causes were identified and action was taken to minimise any risk of reoccurrence.