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Care Services

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Bluewater Nursing Home, Portsmouth.

Bluewater Nursing Home in Portsmouth is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and dementia. The last inspection date here was 20th November 2019

Bluewater Nursing Home is managed by Bluewater Care Homes Limited.

Contact Details:

    Address:
      Bluewater Nursing Home
      143-147 Kingston Road
      Portsmouth
      PO2 7EB
      United Kingdom
    Telephone:
      02392008855

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Requires Improvement
Caring: Good
Responsive: Good
Well-Led: Requires Improvement
Overall:

Further Details:

Important Dates:

    Last Inspection 2019-11-20
    Last Published 2019-02-07

Local Authority:

    Portsmouth

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

31st July 2018 - During a routine inspection pdf icon

This inspection took place on the 30 July 2018 and was unannounced; at time of the inspection 13 people were accommodated at the service.

Bluewater Nursing Home is a ‘care home’ and is registered to accommodate up to 60 people. People in care homes receive accommodation and personal care as single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection. This home provides a service to older people some living with dementia or mental health needs.

The home had a registered manager. 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. A second general manager had also been appointed who was in the process of registering with the CQC to become a joint registered manager.

We last inspected the service in October and December 2017 and rated it ‘inadequate’ overall. We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made; however, there was a need for further improvements and the opportunity for the changes to become embedded into practice and sustained to ensure people received the care and support they required in a safe and effective way. Improvements had been made in respect of breaches of regulations 12 and 18; however, these regulations remain in breach and further improvements were required to achieve compliance. Not all risks for people were being managed safely and in a consistent manner. There were not always enough suitably qualified and competent staff deployed to meet people's needs. In respect of the other previous breaches of regulation 9 and 11 sufficient action has been taken to become complaint although there remains room for further improvement such as the development of more specific end of life care plans and ensuring legislation designed to protect people's rights was followed consistently.

Medicines were managed safely; systems were in place to ensure people received medicines as prescribed and that medicines were stored safely.

There were systems in place to protect people by the prevention and control of infection although staff were not following these in respect of one area of the home.

Staff protected people's privacy although people were not always treated with dignity or respect when they had to wait for care to be provided which caused them anxiety and distress. We observed positive interactions between people and staff throughout the inspection.

Appropriate recruitment procedures were in place and staff felt supported in their role by managers.

People felt safe. Staff knew how to identify, prevent and report abuse.

Staff had completed a programme of training.

People's nutrition and hydration needs were met. When people needed support to eat, this was provided done a dignified way.

Adaptations had been made to the home to make it supportive of the people who lived there.

People were supported to access healthcare services when needed. Staff made information available to other healthcare providers to help ensure continuity of care. Each person had a care plan that was centred on their needs and reviewed regularly.

People's needs were met in a personalised way. People were supported at the end of their lives to have a comfortable, dignified and pain-free death.

People had access to a range of activities including access to the community. They knew how to make a complaint and a complaints procedure was in place.

Managers were visible and approachable. Staff were organised and felt engaged in the way the service was run. They demonstrated a commitment to the values of putting people first.

Visitors were welcome

31st October 2017 - During a routine inspection pdf icon

The first day of inspection took place on 31 October 2017 and was unannounced. Following this day of inspection we received notifications about two safety incidents during which a person using the service sustained a serious injury and another where a person died. These incidents are subject to a separate investigation. However, the safeguarding investigation shared with the CQC about the incident relating to the serious injury substantiated that appropriate medical attention had not been promptly sought. On 4 December 2017 two inspectors undertook a further day of unannounced inspection to review risks related to this concern and follow-up on information from the first day of the inspection.

Bluewater Nursing Home provides accommodation and personal care for up to 60 people, the service does not provide nursing care. There were 19 people living at the home when we visited. The service also provided some day care and on the second day of the inspection two people were receiving a day care service. The service was operating at approximately one third occupancy during the inspection. People were all accommodated on the first floor of the home. All areas of the home were accessible via a passenger lift and there were communal areas on the ground floor. There was an accessible outdoor courtyard garden.

Bluewater Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. We found the home to be clean and tidy throughout the inspection.

The home had a registered manager. 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.

Since 2015 all comprehensive inspections of the service have resulted in Inadequate or Requires Improvement ratings.

The last comprehensive inspection of this service was in October 2016 when the service was rated Requires Improvement; we found three regulatory breaches. In July 2017 we undertook a focused inspection to check on these breaches and found sufficient improvements had been made

At this comprehensive inspection we found five breaches of regulations. This was within six months of the focused inspection in July 2017; this demonstrated that the provider of this service was unable to sustain improvement in the long term. There were systemic failings identified during this inspection which had already been identified at the last three comprehensive inspections of the service. All three regulatory breaches from the last comprehensive inspection in October 2016 were repeated. Failures to provide safe and care and treatment, person centred care, good governance and failing to act in accordance with the Mental Capacity Act 2005 were common themes.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Quality and safety monitoring systems were ineffective in identifying and directing the service to act upon and mitigate risks to people who used the service and ensure the quality of service provision.

Care plans were not consistently person centred and lacked detailed guidance for staff to ensure people received care in a safe way. Risk assessments that related to peoples health and safety did not ensure that all risks were effectively assessed. Action had not always been taken to reduce identified risks to ensure the safety of people. This exposed people to a risk of neglect and unsafe or inappropriate care or treatment.

Records relating to the management of the service had not been effectively reviewed and assessed; we found errors, omissions and discrepancies that had not

28th July 2017 - During an inspection to make sure that the improvements required had been made pdf icon

This inspection took place on 28 July 2017 and was unannounced. This was a focused inspection to review the actions taken by the provider following our previous inspection in October 2016 when we identified that improvements were required. This means not all aspects of the service were assessed and therefore the quality ratings for the service were not been reassessed. This will be undertaken at the next comprehensive inspection.

The home provides accommodation for up to 60 older people with personal care needs. There were 15 people living at the home when we visited. All areas of the home were accessible via a lift and there were communal rooms and areas on the ground floor and adjacent to people’s bedrooms. There was accessible outdoor space from the ground floor. All bedrooms were for used for single occupancy and had en-suite facilities.

The home did not have a registered manager. 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 manager had submitted an application to the commission to become the home’s registered manager.

The provider had taken appropriate action to address the concerns identified at previous inspections. People’s legal rights were protected and the provider’s systems to support this were in accordance with the Mental Capacity Act 2005. People received care that was personalised to meet their individual needs. Care plans and individual risk assessments were comprehensive and reviewed regularly to help ensure they reflected people's needs. These and other records related to the care people had received were well maintained and up to date.

19th October 2016 - During a routine inspection pdf icon

The inspection took place on 19 October 2016 and 20 October 2016. It was unannounced. At our previous inspection in April 2016 we found breaches of nine of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to manage risks associated with people’s care and support, avoidable harm and abuse, the environment of the home and the management of medicines. The provider had failed to make sure there were sufficient staff to support people safely and to make the necessary checks before staff started work. The provider had not met legal requirements where people were at risk of being deprived of their liberty, and staff were not supported by effective induction, training and supervision. People were not always treated with dignity and respect, and did not always receive care and support that met their needs. The provider did not have effective systems to monitor the quality of the service and had not displayed their previous ratings as required by regulations. We gave the service a rating of inadequate and placed it in special measures.

Services that are in special measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements had been made, and it is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of special measures.

Although the service was no longer in special measures, there remained continuing breaches of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we told the provider to take at the end of the full version of this report. We also made a recommendation about risk assessments.

Bluewater Nursing Home is registered to provide accommodation, personal care and nursing care for up to 60 older people. There were 16 people resident at the home with another person who used the home as a day care service. One of the 16 people was in hospital at the time of our inspection. None of the people resident at the time of our inspection was receiving nursing care from the provider. This meant the home was less than one third occupied, and our observations of and judgements on systems and processes reflect that level of occupation.

The home provided accommodation on four floors. Two floors were not in use at the time of our inspection. The ground floor comprised shared areas including the dining room, lounge, cinema, conservatory with indoor herb garden, hair dressing salon and sensory room. The first floor contained the occupied rooms and a small shared area. The rooms were large, with en suite bathroom facilities and double glazed windows. There was an internal courtyard garden with an aquarium and aviary, which could be moved inside for people who were not able to go outside. The provider had made installations to provide interest for people on all four floors of the home.

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 registered manager had been in post since April 2016, and had completed the registration process with us on 4 October 2016. Prior to this manager’s appointment there had been no registered manager at the service since November 2014.

Where risks to people’s safety and welfare were identified and assessed, appropriate actions were carried forward into people’s care plans, but we found examples of risks that had not been identified, documented and assessed. However the provider had put suitable arrangements in place to protect people from the risks of avoidable harm and abuse. Sta

6th April 2016 - During a routine inspection pdf icon

We carried out a comprehensive inspection of this service on 27 and 28 October 2015 and found the provider was not meeting the legal requirements in relation to standards of care and welfare for people who use the service. Care and treatment was not designed to meet people’s needs or preferences. There was a failure to ensure systems and processes were in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of people, or to improve the quality and safety of services provided.

After this comprehensive inspection three warning notices were served on the registered provider on 23 December 2015 requiring them to be compliant with the Regulations by 23 January 2016. The service was placed into special measures. The registered provider sent us an action plan in December 2015 and an operational improvement plan in January 2016 to tell us the actions they would take to be compliant with the Regulations.

On the 6, 7 and 14 April 2016 we carried out an unannounced comprehensive inspection of the service to check they had met the legal requirements. We found the registered provider had failed to meet the required legal requirements in relation to standards of care and welfare for people who use the service. This inspection found that there was not enough improvement to take the provider out of special measures. CQC is now considering the appropriate regulatory response to resolve the problems we found.

Bluewater Nursing Home is registered to provide accommodation and nursing care for up to 60 older people. The home is a large, converted property and accommodation is arranged over four floors, the ground floor offering dining, recreational and reception facilities, with the additional three floors of accommodation which also contained some smaller recreational areas. Two lifts are in place to assist people to move between the four floors. Most rooms are for single occupancy and have en-suite facilities. There were 20 people living over the first and second floor of the home at the time of our inspection. At the time of our inspection nursing care was not being provided.

A registered manager had not been appointed for the service since November 2014. 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 provider had employed a number of managers since November 2014 however these had not become registered with the Commission before employment with the provider ceased.

Whilst people felt safe at the home and relatives had no concerns about the safety of people, risk assessments had not always been completed to ensure people received safe and effective care in the home. A new electronic system for recording plans of care and the risks associated with this had been implemented in the home and required further embedding in the service. People’s preferences and needs were not always included in these records.

Staff at the home had not been guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked the capacity to make decisions. The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Three people who lived at the home were subject to a DoLS. Whilst all appropriate actions had been taken to support these people, staff lacked knowledge and understanding of the MCA and DoLS.

People were not always protected by staff that had a good understanding of the risk of abuse against vulnerable people. Whilst staff felt confident to report any concerns they may have through the appropriate channels, they had not received appropriate training in this area. The provider had not identified areas of concern in relation to the safeguarding of

25th February 2015 - During a routine inspection pdf icon

We carried out an unannounced inspection of this service on 25 February 2015 following concerns which had been raised by members of the public. Bluewater Nursing Home is registered to provide accommodation and nursing care for up to 60 older people. The home is a large, converted property and accommodation is arranged over four floors, the ground floor offering dining, recreational and reception facilities, with an additional three floors of accommodation which also contained some smaller recreational areas. Two lifts are in place to assist people to move between the four floors. All rooms are for single occupancy and have en suite facilities. There were 13 people living on the first floor of the home at the time of our inspection.

The service was inspected but not rated at our visit as it was newly registered with CQC in September 2014 and accommodated the first people for residence in November 2014. We do not have enough evidence to rate the service.

Immediately following the registration of the service with CQC the registered manager left the service. At the time of our inspection, a registered manager had not been in post since September 2014. However, a new manager had been appointed in December 2014 and had submitted an application to CQC to become registered. 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 felt safe at the home. Relatives had no concerns about the safety of people. However, risk assessments had not always been completed to ensure people received safe and effective care in line with their health conditions such as epilepsy or breathing difficulties. Care plans, whilst individualised to include people’s preferences, often lacked clarity and clear guidance for staff on how to meet the needs of people with a health condition.

Staff at the home had not been guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked the capacity to make decisions. Staff lacked knowledge and understanding of the MCA The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Two people who lived at the home were subject to a DoLS. Whilst all appropriate actions had been taken to support these people, care records did not reflect the impact these DoLS had on the people and actions staff should take to ensure their safety.

People were protected by staff that had a good understanding of the risk of abuse against vulnerable people. Staff were confident to report any concerns they may have through the appropriate channels. However, not all staff had received appropriate training in this area.

There was sufficient staff available to meet the needs of people. Through recruitment and training processes, people were cared for by people who had the right skills to meet their needs.

People were supported by competent staff to take their medicines safely. People had access to health and social care professionals as they were required.

People found staff to be caring and supportive. Staff knew people at the home well; they addressed people in a calm and dignified way and understood their needs.

Staff encouraged people to participate in activities, and offered them choice when they did not want to participate in any planned events. People were happy in the home.

People were provided with opportunities to express their views on the service through meetings and in discussion with the providers and manager. Meetings were being planned to implement a new format of care records with people and their relatives/representatives to allow them to express their views.

A programme of audits was completed by the manager to ensure the welfare and safety of people. These audits and reviews had identified concerns with care records and a lack of information around the capacity of people to consent to their care and treatment. These areas were being addressed.

People who worked and lived at the home felt able to express any concerns they may have and have these responded to promptly. The manager and provider promoted an open and honest culture of communication in the home and people responded well to this. Processes were in place to address and learn from any complaints, incidents and accidents.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of this report.

1st January 1970 - During a routine inspection pdf icon

We carried out an unannounced inspection of this service on 25 February 2015 following concerns which had been raised by members of the public. At this inspection we found the registered provider was not meeting all the required legal requirements in relation to standards of care and welfare for people who use the service. We did not rate this service due to the low number of people who lived in the home and the short length of time since the service had been opened. The provider sent us an action plan dated 14 May 2015 stating they were compliant with the regulations.

On the 27 and 28 October 2015 we carried out an unannounced comprehensive inspection of the service. We found the registered provider had failed to meet the required legal requirements in relation to standards of care and welfare for people who use the service.

Bluewater Nursing Home is registered to provide accommodation and nursing care for up to 60 older people. The home is a large, converted property and accommodation is arranged over four floors, the ground floor offering dining, recreational and reception facilities, with the additional three floors offering accommodation which also contained some smaller recreational areas. Two lifts are in place to assist people to move between the four floors. Most rooms are for single occupancy and have en suite facilities. There were 21 people living on the first and second floor of the home at the time of our inspection.

A registered manager had not been appointed for the service since September 2014. A manager who was present at our inspection in February 2015 had since left the service. However, a new manager had been appointed in July 2015 and had submitted an application to CQC to become registered. A registered manager is a person who has registered with the Care Quality Commission (the 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 felt safe at the home. Relatives had no concerns about the safety of people. However, risk assessments and care plans had not always been completed to ensure people received safe and effective care in line with their needs. Risks associated with the medicines people took were not always identified and addressed.

Whilst staff had a good understanding of the signs and risks of abuse systems in place to record the outcome of safeguarding incidents were not robust.

Staff at the home had not been guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked the capacity to make decisions. Records were not always consistent and up to date regarding people’s consent to care.

There were sufficient staff available to meet the needs of people. However the registered provider was unable to identify how they would meet the increased needs of people as more people moved into the home. Through recruitment and training processes, people were cared for by people who had the right skills to meet their needs. Training records did not always reflect they had received the training the registered provider had identified as being required to meet people’s needs. However a new program of training was being introduced by the provider.

People had access to health and social care professionals as they were required. Community nurses visited the home to meet the nursing needs of people who lived there. The registered provider was planning to employ registered nurses to meet the nursing needs of people.

People found staff to be very caring and supportive. Staff knew people at the home well; they addressed people in a calm and dignified way and understood their needs. People were happy in the home. They were able to participate in activities of their choice.

People and their relatives were able to express their views of the service to the staff on a daily basis; however systems were not in place to record people’s views of the service to enable the manager or registered provider to consider these.

A programme of audits completed by the registered provider and manager to ensure the welfare and safety of people had not identified the concerns we identified at this inspection.

People who worked and lived at the home felt able to express any concerns they may have and have these responded to promptly. The manager and provider promoted an open and honest culture of communication in the home and people responded well to this.

We found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

 

 

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