24 July 2018
During a routine inspection
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.