Whitstable Nursing Home

Updated 4 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector.

Service and service type

Whitstable Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Whitstable Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 2 relatives about their experience of living at the service. We observed staff interactions with people in the communal areas. We spoke with 8 members of staff including the registered manager, the nominated individual, deputy manager, team leader, carer, domestic, agency carer and activities co-ordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people’s care plans and all the medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including checks and audits were reviewed.

Updated 4 March 2023

About the service

Whitstable Nursing Home is a residential care home providing personal and nursing care to up to 34 people in one large adapted building. The service provides support to older people who require nursing care who may be living with dementia. At the time of our inspection there were 22 people living at the service.

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

People told us they felt safe living at the service. However, potential risks to people’s health and welfare had been assessed but there was not always detailed guidance for staff to mitigate the risks. Staff had not maintained accurate records about people’s care and support. There was a risk people had not received the care required to keep them safe and well.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff had not always recorded how and why decisions had been made to support people in a way that may have been restrictive.

Checks and audits had been completed to assess the quality of the service. These had not always been effective in identifying shortfalls such as the shortfalls found at this inspection. When shortfalls had been identified action had been taken to rectify them. This included supporting staff to highlight incidents as quickly as possible and improving the system of reporting concerns to the local safeguarding authority.

People were supported by staff who had been recruited safely and received training and supervision to develop their skills. There were enough staff to meet people’s needs, any gaps were filled by regular agency staff.

Medicines were managed safely by nursing staff, people received their medicines as prescribed. People were referred to healthcare professionals when their needs changed, and staff followed the guidance given.

People and staff were asked their opinions on the service and for their suggestions. Improvements had been made to the activities programme and the menu as a result of suggestions by people.

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

Rating at last inspection: The last rating for this service was good (published 14 March 2019).

Why we inspected

We received concerns in relation to the management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whitstable Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to record keeping, risk management, decision making and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.