Background to this inspection
Updated
31 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’
This inspection took place on 24 and 25 July 2018 and was unannounced.
The inspection team was made up of one inspector.
Cathedral Nursing Home was registered in August 2017 under a new registered provider, Hayworth Care Limited. At our last inspection of Cathedral Nursing Home in February 2018 we found five breaches of the regulations and the service was rated 'Inadequate'. This was because the registered provider failed to ensure that here were systems and processes in place to assess, monitor and improve the quality and safety of the service. The service was placed into special measures and we issued a Notice of Decision to impose conditions on the service, including a restriction on further admissions to the service and staff competency checks. At this inspection we found that overall improvements had been made and the service was now rated 'Requires Improvement.'
Before our inspection we gathered and reviewed other information we held about the service such as notifications (events which happened in the service that the provider is required to tell us about) and information that had been sent to us by other agencies including the local authority contracting and safeguarding teams.
During our inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not speak with us. We spoke with the registered manager, the deputy manager, the provider, the administrator, four members of care staff, the cook, the laundry assistant and six people who lived at the service. We also spoke with four relatives and two visiting healthcare professionals.
In addition, we looked at several areas of the service to see what improvements had been made to the environment since our last inspection. These included shared areas, two medical rooms, the laundry, the upstairs and downstairs sluice, bathrooms, bedrooms and the gardens.
We did not request a Provider Information Return (PIR) for this inspection. This was because we had imposed a condition on the provider to send us weekly progress reports on improvements made to the service since our last inspection. A PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We looked at a range of records related to the running of and the quality of the service. These included five staff recruitment and induction files, staff training information, meeting minutes and arrangements for managing complaints. We looked at the quality assurance audits that the registered manager and the provider completed. We also looked at care plans and daily care records for seven people and medicine administration records for five people who lived at the service.
Updated
31 October 2018
We undertook a comprehensive inspection on 24 and 25 July 2018. The inspection was unannounced.
Cathedral Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service is registered to provide accommodation for up to 38 younger adults, older people or people living with a dementia type illness. There were 22 people living in the service during our inspection.
There was a registered manager in post at the time of our inspection. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our last inspection of Cathedral Nursing Home in February 2018 we found five breaches of the regulations and the service was rated 'Inadequate'. This was because the registered provider failed to ensure that here were systems and processes in place to assess, monitor and improve the quality and safety of the service. The service was placed into special measures and we issued a Notice of Decision to impose conditions on the service, including a restriction on further admissions to the service and staff competency checks. At this inspection we found that overall improvements had been made and the service was now rated 'Requires Improvement.'
This is the first time the service has been rated ‘Requires Improvement’.
Staffing levels had improved and staff had security checks prior to starting work to ensure that they were appropriate to care for people. Medicines were administered by competent staff. All areas of the service were clean and improvements were being made to the environment, trip hazards and lighting.
People received care and support from staff who understood their care needs. The delivery of care was coordinated and person-centred. People were provided with their choice of food and drink. Staff referred people in a timely manner to other healthcare professionals when their condition changed. Staff followed the guidance in the Mental Capacity Act 2005 and people were lawfully deprived of their liberty.
People and their relatives were enabled to be involved in planning their care. Staff focused their care on the individual person, and there was little evidence of task oriented care. People were treated with kindness and compassion.
People received care that was responsive to their individual needs and preferences. Systems were in place to enable people to make a complaint if they wished to do so. Staff respected a person’s end of life care needs.
People, their relatives and staff had a voice and could contribute to the running of the service. Improvements had been made to the monitoring of the quality of the care provided. Policies and procedures had been reviewed and reflected nations guidance. There were visible leaders in post and staff knew who to turn to for advice and guidance. The registered manager had made significant improvements to the standards of care in the service.