9 November 2017
During a routine inspection
The Village Nursing & Care Home @ Murton provides personal and nursing care to a maximum of 40 people some of whom are living with a dementia. At the time of the inspection there were 37 people who used the service.
This inspection took place on 9 November 2017. The inspection was unannounced, which meant that the staff and provider did not know we would be visiting. At the last inspection of the service on 30 September 2015, we rated the service as Good. At this inspection the service remained Good.
The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff understood the procedure they needed to follow if they suspected abuse might be taking place.
Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. In general medicines were managed safely with an effective system in place. However, we did note some areas in need of improvement and the registered manager wrote to us after the inspection confirming these improvements had been made.
Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.
People and relatives told us there were suitable numbers of staff on duty to ensure people’s needs were met.
Pre-employment checks were made to reduce the likelihood of employing people who were unsuitable to work with people.
The registered manager had systems in place for reporting, recording, and monitoring significant events, incidents and accidents. The registered manager told us that lessons were learnt when they reviewed all accidents and incidents to determine any themes or trends.
People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.
People were supported with eating and drinking and feedback about the quality of meals was positive. Special diets were catered for, and alternative choices were offered to people if they did not like any of the menu choices. Nutritional assessments were carried out and action was taken if people were at risk of malnutrition.
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. However, further work was needed to ensure decision specific Mental Capacity Assessments and best interest’s decisions were in place when people lacked capacity.
The premises were clean and tidy and people and their relatives told us they liked the homely atmosphere. The service was well maintained with appropriate furniture throughout. The registered manager had carried out research, attended workshops and training to ensure there were some dementia-friendly aspects to the environment in the ‘memory loss’ area of the service.
We observed numerous examples when staff were kind, caring and courteous. Privacy and dignity of people was promoted and maintained by staff. Explanations and reassurance was provided to people throughout the day.
Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care need. Staff encouraged people to actively participate in meaningful leisure and recreational activities that reflected their social interests and wishes and maintain relationships with people that mattered to them. The service had a clear process for handling complaints.
The registered manager was aware of the Accessible Information Standard that was introduced in 2016. The Accessible Information Standard is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need.They told us they provided and accessed information for people that was understandable to them. They told us their service users guide and other information was available in different formats and fonts.
Staff told us they enjoyed working at the service and felt supported by the registered manager and senior staff. Quality assurance processes were in place and regularly carried out to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.