About the service: Netherton Green Care Home is a care home that was providing personal and nursing care to 112 people aged 65 and over at the time of the inspection. The service was split into four units. Windmill and Primose unit provided care to people with a diagnosis of Dementia, Darby unit provided care to people who required end of life care and Saltwells unit was a short stay rehabilitation unit.

People’s experience of using this service:

People’s care needs were not always responded to in a timely way. There were some errors in the recording of medication. People were supported by staff who knew how to manage risks to keep them safe and report any concerns of abuse. Staff followed safe practices in relation to infection control.

People were supported by staff who were trained in how to meet their needs. People’s needs were assessed prior to moving into the home. People had their dietary needs met and had access to healthcare services where required. People had their rights upheld in line with the Mental Capacity Act.

People were supported by staff who were kind and caring to them. People were treated with dignity and their independence was encouraged. People were supported to make choices and be involved in their care.

People’s needs were met by staff who knew their likes, dislikes and preferences with regards to their care. People who required end of life care had been asked about their wishes. Complaints made had been investigated and resolved.

There were systems in place to monitor the quality of the service and identified areas for improvement were being acted upon. People were given opportunity to feedback on their experience of the service.

Rating at last inspection: Requires Improvement (Published 05 March 2018)

Why we inspected: This was a planned inspection based on previous rating.

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

This comprehensive inspection took place on 17 and 18 January 2018 and was unannounced. The service had been registered with us previously and was rated as requires improvement. There has been a change to the provider’s legal entity and this was the first inspection since this service was re-registered in November 2017.

Netherton Green is purpose built and consists of four separate single storey buildings each accommodating up to 30 older people. It provides nursing care older people whom live with dementia and people who require rehabilitation and palliative care. At the time of our inspection 104 people were using the service.

There was a registered manager in place who was present during our 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.

During our inspection visit we received information of concern about people experiencing unpleasant odours, falls, poor support with personal care and how people who lived with dementia were supported to stay safe. We found the provider was taking action to address these issues however improvements in staff training was required to support people living with dementia.

Staff were attentive and supported people promptly, however staff did not demonstrate they had sufficient skills and knowledge to support people who lived with dementia. The premises were suitable to meet the needs of the people who used the service however, further work was required to meet the specific needs of people who lived with dementia. We have made a recommendation about staff training on the subject of dementia.

People told us they felt safe. The registered manager had taken action to ensure there were enough suitable staff. Staff demonstrated that they were aware of signs which may indicate that someone was being abused and the action to take. The risks to people had been assessed and practices were in place to reduce the possibility of harm. There were process in place to ensure the premises and equipment were regularly checked so they remained safe and the risk of injury to people was reduced. The provider had taken action to ensure people received their medicines appropriately. People were protected from harm by the prevention and control of infection. There was a system to review incidences and learning when things went wrong.

People were supported by staff who had the skills and knowledge to do their job. Staff were aware of the provider’s policies to prevent discrimination and promote equality and diversity at the service. People received sufficient amounts of foods and drinks they enjoyed. People received continuing support from healthcare services and received ongoing healthcare support. Staff sought people’s consent before supporting them and respected their choices. Staff we spoke with were aware of the DoLS process and their responsibilities.

People told us that the staff were caring. We saw many positive interactions and staff spoke fondly about the people who used the service. People were supported by staff who respected their privacy and dignity and promoted their independence.

There were dedicated ‘activities co-ordinators’ to support some people engage in things they liked and maintain social contacts. People were confident staff would respond appropriately to any concerns. There were processes in place to ensure people would receive appropriate care at the end of their lives.

Processes to improve the quality of the service had not been effective at ensuring good practice was consistent across all the units. The registered manager had worked closely with other agencies to monitor and improve the quality of the service. People who used the service and staff expressed confidence in the leaders