About the service

Isle Court Nursing Home is a residential care home that was providing personal and nursing care to 61 people aged 65 and over at the time of the inspection. The service can support up to 80 people across three separate units. One of the units specialises in providing care to people living with dementia.

People’s experience of using this service

People were not always supported to have maximum choice and control of their lives. Staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

We have made a recommendation people, relatives and significant others are involved in care reviews.

We have made a recommendation that the management team ensure all staff receive formal supervision in line with company policy.

We have made a recommendation that the management team gather people’s experiences of care delivered on all three units of Isle Court Nursing Home.

We received mixed feedback on how people were treated with dignity and respect. People told us staff availability impacted on the care they received but staff were caring. We observed positive interactions and saw staff had a good rapport with people.

Medicines were managed safely. Infection prevention was managed to minimise risk and keep people healthy. Staff had received training on what constituted abuse and the actions to take should it be witnessed. There were robust recruitment procedures to ensure suitable staff were employed.

All staff received induction shadowing and mentoring to promote effective knowledge of their role. The registered manager worked with other agencies to promote positive health outcomes for people. People said the food was good and plentiful, with the appropriate support being offered. Isle Court Nursing Home was well maintained and free from hazards to minimise environmental risks.

Everyone at Isle Court Nursing Home had a care plan. These were under review to ensure people’s long-term needs were appropriately identified. Staff had received training around people’s communication needs. There was a staff member employed to co-ordinate activities for people. These included activities within the home, trips out and arranging visiting entertainers.

During the inspection process the registered manager post became vacant. The registered provider placed a senior manager on site as house manager to provide stability until a new registered manager could be recruited. The registered provider had created a new role of pastoral support co-ordinator to support people, families and staff. The registered provider advertised this role as a listening ear for everyone. Clinical and quality audits monitored the quality and safety of the service.

Rating at last inspection: At the last inspection the service was rated good (published 07 September 2016.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement: Action we told provider to take (refer to end of full report)

We have identified breaches in relation to staff availability to meet people’s needs and good governance to meet all statutory regulations at this inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection was carried out on 27 July 2016 and was unannounced.

Isle Court Nursing Home is registered to provide accommodation with personal care for up to a maximum of 55 people. There were 54 people living at the home on the day of our inspection. Some people were living with dementia, they lived on the Forget Me Not unit. The home provided a rehabilitation service for up to 10 people to help regain their confidence after a period of ill health or a fall.

There was a registered manager in post who was present during the inspection. 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.

People and their relatives felt people were safe and well cared for. Staff were knowledgeable about the different forms of abuse and discrimination and how to report concerns. Risks associated with people’s needs had been assessed and guidelines had been put in place to minimise the risks.

Staff knew how to deal with accidents and incidents and these were overseen by the registered manager who took appropriate action to prevent these happening again.

There were enough staff to keep people safe and meet their needs. The provider carried out recruitment checks to ensure prospective new staff were suitable to work at the home prior to them starting work there. Staff felt well supported and received training relevant to their roles.

People were supported to take their medicine as prescribed. Medicines were stored safely and accurate records maintained. Staff monitored people’s health and well-being and arranged health care appointments as and when required to promote good health.

People were impressed with the choice and quality of food provided. People’s nutritional needs were routinely assessed, monitored and reviewed. Staff were aware of people’s dietary and nutritional needs and supported people to feed themselves where required.

Staff sought people’s consent before supporting them. People were provided with information in a way they could understand to help them make decisions. Where people were unable to make certain decisions for themselves, these were made in their best interest by people who knew them well to protect their rights.

People were supported by staff who were considerate and kind. Staff had built up good working relationships with people and their relatives. People were able to spend their time as they chose to and their preferences were respected. Staff treated people with dignity and respect and promoted their independence.

The provider sought people’s views on the quality of the service and were confident that any concerns would be dealt with promptly. The provider had a clear complaints procedure which was followed by staff.

People and their relatives found the registered manager and senior staff approachable. The registered manager provided clear leadership and direction. The provider had systems in place for monitoring the quality of the service and to drive improvements.

Not all the people we met were able to speak with us about the care they received and their experience of living in the home. Therefore we observed how staff interacted and supported people. This helped us to make a judgement on how their needs were being met.

During this inspection we spoke in private with people who used the service, staff and visitors. We also spoke with the registered manager.

People told us that they were treated with respect and had their dignity maintained.

Comments included, "Everybody's very kind and helpful”. “I’m happy here”. “On the whole it’s jolly good”.

Staff had a good understanding of the care needs of individual’s living at the home. People were able to participate in discussion and decision-making in connection with their care needs.

People told us they felt safe living at Isle Court. Staff were aware of their responsibilities to remain vigilant and to take action if they had any concerns about the safety or wellbeing of the people using the service.

There were enough suitably skilled members of staff to provide the level of

service that people living at the home required. People using the service told us, “Staff are very good here”. “They bring a tray of tea and cakes when your visitors arrive. It makes me feel quite special”.

There was a complaints policy and procedure in place. People we spoke with told us they knew who to raise any concerns with and they felt confident their concerns would be addressed.