Newlands Nursing Care Centre improved from Requires Improvement to Good following a focused inspection of Safe and Well-led domains, with previous breaches of Regulations 17 and 19 now remedied. A new management team has implemented effective governance, audit systems and personalised care planning, resulting in a safe, well-organised service with positive outcomes for people.
Strengths
· Detailed, personalised care plans in place with clear risk assessments and management plans for individual needs including dietary and mobility risks.
· Safe recruitment practices fully reinstated; all DBS checks and references completed before staff commenced work.
· Sufficient staffing levels maintained using permanent and bank staff only, with no agency staff required.
· Robust quality assurance audits implemented covering medicines, infection control, incidents and health and safety, monitored via action plans.
· Positive, open culture with strong communication to relatives including newsletters and regular care reviews every six months.
Quality-Statement breakdown (10)
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
Newlands Nursing Care Centre was rated Requires Improvement following breaches of regulations 12, 17 and 19 relating to statement of purpose, good governance and safe recruitment, with people in their own homes lacking care plans and risk assessments. Responsive care remained good with positive feedback on activities, complaints handling and end-of-life support, but governance audits had failed to detect the identified shortfalls.
Concerns (6)
criticalCare planning: “For three people, who were cared for in their own homes there were no care plans or risk assessments in place.”
criticalRecord keeping: “An accurate, complete and contemporaneous records in respect of each person's care were not always maintained.”
criticalStaff competency: “Safe staff recruitment practices were not in place to reduce the risk of unsuitable staff from being employed.”
criticalGovernance: “The provider did not always operate effective systems to monitor, assess and improve the quality of service they provided.”
moderateInfection control: “An external organisation identified a "low" risk of legionella in the home's plumbing systems in February 2022... A comprehensive record was not available”
moderateMedication management: “Following a medicine error in August 2022, the provider had completed refresher medicine competency checks to ensure all staff working in people's homes were following their medicine policy.”
Strengths
· People and relatives reported feeling safe and spoke positively about staff and management
· Sufficient staffing levels observed with staff having time to support people's wellbeing
· Effective infection prevention and control measures in place, including PPE use and testing
· Responsive person-centred activities, communication support and end-of-life care
· Open and transparent management, working in partnership with GPs and other professionals
Quality-Statement breakdown (14)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safely; Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
safe: Systems and processes to safeguard people from the risk of abuseGood
responsive: Planning personalised careGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationshipsGood