Archived: Eversley Nursing Home

We found the following examples of good practice.

The provider had developed new ways of recording observations about people’s health. These were shared with healthcare professionals in advance of appointments to facilitate smooth and timely consultations and reduce risk. People were screened twice a day for COVID-19 symptoms.

The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread COVID-19. All staff and visitors had their temperature and oxygen levels measured and a COVID-19 lateral flow test on entry. Where any concerns were raised, visitors were asked to wait outside and were provided with advice and guidance over the phone by the care service manager or lead nurse.

Visitors entered into an agreement with the service to abide by infection prevention and control rules and their contact details recorded. Information and instructions for visitors were clearly displayed and explained in person. Staff were adhering to personal protective equipment (PPE) and social distancing guidance.

People were supported to speak to their families on the phone or via video call through a wide rage of platforms. Visits were also available in the garden with risk reduction measures in place. The service had strict arrangements to facilitate reduced risk indoor visits for people at the end of their life.

The provider had robust isolation arrangements in place for people who were infected with COVID-19, or for people who had been admitted to the home from hospital or the community. There was clear information and procedures for staff to care for people who were isolating. This effectively reduced the risks of transmission of COVID-19 within the home.

To ensure reduced risk of transmission of COVID-19, staff had breaks scheduled so that they were on their own and not mixing with others.

The provider had ensured risk assessments had been carried out for all staff to determine their vulnerability to COVID-19 and where it was not safe for staff to be at work, the provider organisation had financial and other support arrangements in place to protect staff and people.

There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The last inspection took place on 30 September 2015, and the service was assessed as being 'good' in all domain areas and had a rating of 'good' overall.

At this inspection we found standards had been sustained and again rated the service as 'Good' overall.

There were clear lines of accountability. The service had effective leadership and direction from the registered manager who was passionate about providing a high standard of care. The visions and values of the service were embedded into practice and the management team promoted best practice to make further improvements. Partnership working was excellent, for example, working with health care professionals which had been sustained over time.

Staff spoke positively about the registered manager, stating they were approachable, caring and responsive to people's and staff's needs. Involvement through partnership working was sought and guidance implemented within people's care and service delivery.

The service liaised well with external healthcare professionals and people's healthcare needs were being met. A high standard of end of life care was provided; the service had been awarded a ’beacon status’ for the Gold Standard Framework in relation to this.

People were treated with a high level of dignity and respect by both staff and the management team. Staff were patient with people, and skilled in using different methods of communication which reassured people. Good, caring relationships had been developed and staff and the registered manager knew people well. There was a positive, inclusive and person centred culture within the home.

Staff were given regular training updates, supervision and development opportunities. People spoke positively about staff and the support they received. Staff demonstrated a good knowledge of the people and topics we asked them about.

People received their medicines in line with good practice and staff had sufficient knowledge on how to administer, record and dispose of people's medicines safely.

People had access to a range of suitably nutritious food. Individual preferences were catered for. People's nutrition was closely monitored and action taken to investigate any weight loss.

People told us they felt safe and secure living in the home. Staff understood people well and knew how to keep them safe. Risk assessments were in place which provided detailed information to staff on how to maintain people's safety.

Staff were able to recognise abuse and knew how to report concerns if they suspected a person was being abused. Systems were in place to discuss potential safeguarding issues so they were escalated appropriately.

There was a complaints procedure available in the service for people and relatives to raise concerns.

Staffing levels were calculated using a dependency tool, and we observed that people were attended to regularly. Some people told us that would like to see more staff and sometimes felt lonely. The provider and staff members confirmed that additional staffing was brought in where needed, or in the case that a person deteriorated suddenly.

Activity provision was delivered in the form of Namaste care. This is undertaken on a one to one basis, and can include but is not limited to, musical reminiscence, talking, looking at photos, or massage. People can chose how they spend the time, and what they find meaningful. Some people felt that they would like more of this, and a representative of the provider told us that they had increased the provision to now include weekends.

People's consent was gained before care and support was provided. The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Some areas of documentation relating to MCA assessments required improvement, but the registered manager was taking prompt action to rectify this.

We looked at the care records held by the service which showed that information about people's needs was available to staff at all times and guided them in meeting those needs safely. People who used the service or their families had been involved in preparing care plans wherever possible.

The service ensured that people were treated with dignity and respect and we observed this during our inspection in the way that staff spoke with people who used the service. The service ensured that families were kept informed about their relative's condition and offered support where needed at a difficult time.

Records we looked at were well maintained and clear and were readily available.

People were complimentary about the approach of the staff who supported them. One person said, "They (staff) are very good." Another person said, "They (staff) know me well." Another said, "The carers are nice, they will do anything for you."

We observed the care and support provided to people and we saw that the staff interacted with people in a caring, respectful and professional manner. Before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We looked at the care records of three people who used the service. These records showed that people experienced care, treatment and support that met their needs and protected their rights.