Saxlingham Hall Nursing Home

Updated 6 July 2022

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 carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Saxlingham Hall 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. Saxlingham Hall 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection a registered manager was not 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 sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people who used the service and eight relatives of people using the service. We spoke with one nurse, four health care assistants, the manager, the deputy manager, the administrator and the operations manager. We received feedback via email from three health and social care professionals. We reviewed five people's care records and six medicines records. We also reviewed two staff training and recruitment records, and other documents relating to the safety and quality of the service.

Updated 6 July 2022

About the service

Saxlingham Hall Nursing Home is a care home providing personal and nursing care to up to 36 people. The service provides support to older people. At the time of our inspection there were 31 people using the service.

Saxlingham Hall accommodates people in a large period manor house in a rural setting. Bedrooms have en-suite toilets and a communal dining and living area is available on the ground floor. The extensive grounds are accessible to people.

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

We have made a recommendation that the provider review staffing levels. This is because people and staff did not always feel there were enough staff, however this did not impact significantly on people and how their needs were met. People were not always provided with opportunities to provide formal feedback on the support provided or delivery of the service. This meant person-centred care was not fully underpinned and culturally embedded within the home. Written records did not always evidence people’s wishes and needs. Some areas had not been updated when people’s needs had changed.

Staff and the management team understood principles of person-centred care and recognised further work was required in this area. Whilst further work was required people and relatives provided examples where the delivery of care was person-centred because staff listened and knew people well.

People received their medicines safely and as prescribed. People were supported to stay safe as staff took action to identify and respond to risks. In some instances, risks had been managed very well and so people’s quality of life had improved. Very few safeguarding concerns or incidents had occurred; when they had appropriate actions had been taken to help keep people safe. People were living in a clean and hygienic environment. Appropriate actions were taken in response to infection control.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to eat and drink enough although some people felt the food provided did not fully meet their preferences. People were supported by competent and knowledgeable staff who were well supported to meet people’s needs. People were happy with the accommodation provided and the physical environment met their needs.

Staff were kind and respectful, they knew the people they supported well. Staff listened to what people had to say and responded to any issues or concerns they raised.

People, staff, and relatives were positive about the activities on offer. Where people preferred to spend time in their rooms this was also considered and one to one social visits were provided. Staff ensured people were comfortable at the end of their lives and this included making sure anticipatory medicines were available.

A new management team was in place. Whilst they had only been in place for a few weeks they had a good understanding of the needs of the people living in the service and what needed to be improved. Staff were positive about the support and changes planned. Governance systems were in place to help ensure oversight of the service and drive improvements.

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 the service under the previous provider was requires improvement, (published on 14 October 2019).

The previous provider completed an action plan after the last inspection to show what they would do and by when to improve.

At our last inspection we recommended that the previous provider reviewed best practice in using equipment which restricts people’s movements. At this inspection we found no issues in this area under the new provider.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

We have made a recommendation that the provider reviews staffing levels.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.