We carried out a review of the data available to us about North Shore Nursing home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about North Shore Nursing home, you can give feedback on this service.
North Shore Nursing Home is a nursing home providing personal care to support up to 25 people who live with dementia and/or a physical disability. At the time of our inspection there were 25 people living at the home. It is situated in a residential area of Blackpool close to the promenade. There are three floors with 23 single rooms and a double room. There are on-site gardens and several communal areas for people’s comfort and enjoyment. North Shore Nursing Home will be referred to as North Shore within this report.
People’s experience of using this service and what we found
People’s safety was at the heart of care delivery. One relative told us, “They were excellent before the pandemic and they are excellent still now. I sleep easy at night.” The registered manager had strict, effective infection control measures in place.
The management team and provider continued to deliver outstanding care focused on the individual and their diverse needs. Different levels of managers regularly checked during the day to ensure levels of care and compassion remained high. A relative said, “The care is second to none.”
We found the same exceptional quality assurance and risk management of care delivery as we did at our last inspection. North Shore had excellent management and highly skilled staff whose priority was giving people the best possible lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was outstanding (published 25 May 2018).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we received about the service. The inspection was prompted in part due to concerns received about risk assessment and mitigation, people’s privacy and dignity, quality assurance and leadership. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for North Shore on our website at www.cqc.org.uk.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
North Shore is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.
A registered manager was 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.
At the last inspection on 20 October 2015, the service was rated Good. At this inspection, we found the service had improved to Outstanding.
During this inspection, a relative told us, “The place is perfect. It demonstrates high quality care and should be used as an example to other homes.” We found the provider accessed systems, tools and partnerships known to benefit the person’s welfare and treatment. Care delivery centred on excellent communication systems and highly detailed records about each person. A wide range of models were utilised and reviewed to ensure people received the best possible support. We saw multiple examples where this enhanced their lives and optimised their welfare.
The registered manager was proactive in ensuring people accessed healthcare services quickly. Their pioneering techniques greatly improved people’s lives because they assisted staff to implement treatment before problems deteriorated.
The management team had exceptional procedures for the preparation of meals, delivery of nutritional support and monitoring of associated needs. For example, food moulds and observational review of staff support greatly improved people’s nutrition intake and enjoyment of their meals.
People were 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. We found for each area of people’s support staff completed additional decision-specific, individual deprivation of liberty care plans. Staff maintained up-to-the-minute documentation to assure they continuously met the person’s changing capacity and support requirements.
The registered manager had an exceptional initiative for training and to assist staff to apply their learning in practice. They used team meetings, handovers, supervision and group discussions to follow training up with observation, question and answer sessions, competency testing and role-play. The review of staff skills assisted them to provide remarkable support for people who lived with dementia. A relative told us they were highly reassured by this and said, “I know the staff are well trained because there’s a list up on the wall of the courses they have to attend.”
We observed the provider deployed very high staffing levels and skill mixes at the home to deliver care that flowed smoothly and effortlessly. People and their relatives said this was very reassuring because it meant staff had time to provide compassionate, dignified care. The registered manager had implemented a ‘Dignity Challenge Initiative.’ The project focused on how staff should provide dignified support that improved people’s self-confidence and independence.
Staff had a very good grasp of the Human Rights Act 1998 and implemented this in their work. They had relevant training and demonstrated an in-depth awareness of inclusion, discrimination, diversity and prejudice. We found staff continuously kept people and their representatives fully informed and involved, which helped them to take ownership of their treatment. One relative said, “Every time I come in [the management team] give me an update and talk with me about my [relative’s] care plan.”
End of life care ethos at the home was one of exceptional dedication, compassion and empathy, reinforced with technical expertise. Staff frequently evaluated care documents to ensure they were updated to people’s changing wishes and health to optimise their end of life experiences.
The provider’s high staffing levels enabled staff to provide activities for long periods throughout the day. Staff had training and role-play to assist them to better understand people’s interests. Relatives we spoke with said they felt this was an outstanding part of care delivery.
The registered manager had staff, people and visitors at the heart of their continuous improvement drive. This meant developments were quickly embedded and more successful because everyone was involved. People and their relatives told us North Shore had strong leadership.
The management team promoted an authentic culture of transparency at North Shore through extensive quality assurance audits and feedback systems. We found multiple examples where people’s lives had drastically improved because the home’s management focused heavily on their welfare and safety.
We noted the registered manager followed safe recruitment procedures to ensure suitable staff were employed to work with vulnerable adults. A relative commented, “The manager seems to recruit staff based on how compassionate they are.”
Each person had a detailed medication care plan to guide staff to their associated support requirements. We observed medicines were administered safely, patiently and with a very caring approach.
When we discussed safeguarding with staff, we found they understood their responsibility to protect vulnerable adults from abuse and poor practice. Care records we looked at held detailed risk assessments to support staff to maintain their safety. People, staff and visitors experienced a clean and tidy environment.
The inspection visit at North Shore was undertaken on 20 October 2015 and was unannounced.
North Shore provides nursing care and support for a maximum of 25 people who live with dementia and/or a physical disability. At the time of our inspection there were 24 people living at the home. North Shore is situated in a residential area of Blackpool close to the promenade. There are three floors with 23 single rooms and a double room, of which sixteen are en-suite. There are on-site gardens and several communal areas for the use of people who live at the home.
A registered manager was in place. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection on 23 April 2014, we found the provider was meeting all the requirements of the regulations inspected.
During this inspection, we found people were supported in a safe environment. Accidents and incidents were properly assessed to reduce the risk of harm to people, staff and visitors. Care records contained risk assessments intended to protect people from the risks of receiving unsafe care and treatment. Staff demonstrated a good understanding of how to protect people from potential harm or abuse.
We observed staff worked in a patient and unhurried way in their duties. The provider had ensured North Shore was well resourced with high staffing ratios and good skill mixes. There were 16 day staff to support up to 25 people, with a range of skills to meet their needs. The management team had followed safe recruitment procedures to protect people from unsuitable personnel. A range of training was provided for all levels of staff to assist them in their roles. This included support for nurses to sustain the requirements of their professional registration.
We observed medicines were administered to people in a safe, discrete and appropriate manner. These were stored in a secure, clean environment. All processes were regularly audited to assess and maintain the safe management of people’s medicines.
Staff had been trained to assisted people to meet their nutritional requirements. We observed they did this in a caring and supportive manner and ensured they were offered choice of meals.
Staff demonstrated a good understanding of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. We observed people were not deprived of their liberty during our inspection. We found care records contained documented evidence of their consent to care.
We found people were respected and involved in their care planning. Staff were kind, friendly and courteous when they engaged with individuals who lived at the home. Care records were tailored to people’s wishes and we observed staff consistently promoted their privacy and dignity. One staff member told us, “I’ve got to know the residents and them me, which is very important to their care needs.”
Care records we checked were tailored to the needs of each person who lived at North Shore. The management team had regularly assessed people’s requirements to guide staff to their ongoing support. Staff had involved individuals and their representatives in care planning and review to ensure support was responsive to their needs.
Staff told us the registered manager and provider were supportive. They said there was good leadership and the management team worked closely with them to maintain people’s quality of care. There was a variety of audits in place to check the safety and welfare of people, staff and visitors. Individuals and their representatives were assisted to comment about their experiences of living at North Shore.
North Shore Nursing Home provides accommodation for up to 25 people who require nursing or personal care. At the time of our visit the home was fully occupied. The home provides care and support for people with dementia or physical disabilities.
The manager at North Shore Nursing Home had been in post since March 2014. They had commenced the process to apply to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.
We used a number of different methods to help us understand people’s experiences of the care and support they received. This was because some people had complex needs and were not able to tell us about their experiences. During our visit, we spent time in all areas of the home, including the lounge and the dining areas. This helped us to observe the daily routines and gain an insight into how people's care and support was managed. During our visit we saw that staff had developed a good relationship with the people they supported. Those people who were able to talk with us spoke very positively about the service and told us they felt safe and well cared for. One person told us, “The staff here are lovely, I am really well looked after.”
Suitable arrangements were in place to protect people from the risk of abuse. People told us they felt safe and secure. Safeguards were in place for people who may have been unable to make decisions about their care and support.
People were involved and consulted with about their needs and wishes. Care records provided good information to direct staff in the safe delivery of people’s care and support. Records were kept under review so information reflected the current and changing needs of people. Information was stored securely ensuring confidentiality was maintained.
Staff worked closely with healthcare agencies so that people received the care and treatment they needed. Information was shared with other services so that people continued to receive safe and effective care.
Staff spoken with were positive about their work and confirmed they were supported by the manager. Staff received on-going training and development in the areas of care and support people required. This helped to ensure staff had the knowledge and skills needed to meet the specific needs of people.
Discussions with the senior staff confirmed that they had received training on the Mental Capacity Act and Deprivation of Liberty Safeguards and understood what actions to take to safeguard people.
One relative we spoke with told us,' the food is always nicely cooked and made on the premises.' New staff were supported through an induction process which included mandatory training and shadowing opportunities. There were a range of audits and systems in place to monitor the quality of the service being provided.
Therefore we spent sometime observing people and how staff interacted and supported them. Staff were seen to be helpful and polite when offering assistance and support to people.
We did have an opportunity to speak with one person and their visitor. The visitor said 'There always seems to be enough staff around if you needed them', 'They make you very welcome' and 'They [the staff] keep in contact with family if there's anything they need to know'.
Care records were in place to guide staff in the delivery of care. These would be enhanced with more personal information about people's wishes and preferences.
Accommodation provided for people was well maintained and the d'cor was of a good standard.
Sufficient staffing levels were provided to meet the needs of people living at North Shore. We also spoke with staff during our visit. One carer told us that the team was; 'A happy and loyal team'. Staff spoken with confirmed they received regular training and supervision to guide them in their work.