Trent Nursing's first inspection rated the service Good overall but Requires Improvement in Well-led, due to limited provider oversight of care delivered with third parties and the absence of formal partnership policies. Care was safe, effective, caring and responsive, with well-trained staff providing person-centred specialist support, though some medicines records, care plans and complaints information needed strengthening.
Concerns (10)
moderate
Governance
: “The provider did not always have clear oversight of the care being provided by staff.”
moderateGovernance: “The provider did not have a formal policy or procedure in place with third parties for the oversight of the actions of staff.”
minorMedication management: “Medicines were managed safely but some information around administration was not recorded.”
minorRecord keeping: “administration was recorded on daily notes rather than a medicines administration record (MAR). The person's care plan also did not include information around use of the nebuliser.”
minorCare planning: “While people's needs and choices were assessed, the care plan completed by the provider required more specific information.”
minorCare planning: “In the care plan the provider developed, the person's personal history was not included and there was limited information on their interests.”
minorStaff training: “We did identify one staff member had not received training around epilepsy and this was identified as a risk to the person they supported.”
minorComplaints handling: “The provider did not always give relatives information on the official complaints process which was outlined in their complaints policy.”
minorCommunication with families: “Another relative felt they were not engaged with by the registered manager.”
minorCommunication with families: “The registered manager was not aware of the Accessible Information Standard”
Strengths
· Staff received extensive and specialist training (e.g. suctioning, ventilation) tailored to people's needs
· Staff genuinely cared for people and treated them with kindness, dignity and respect
· Strong multi-disciplinary working with case managers, physiotherapists and other health professionals
· Safe recruitment with enhanced DBS checks and structured shadowing/induction
· Effective support with nutrition and hydration, including specialist needs such as PEJ feeds
Quality-Statement breakdown (21)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversity; respecting and promoting privacy, dignity and independenceNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Meeting people's communication needsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; working in partnership; continuous learningNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people, public and staff; duty of candourNot rated