Haldane House Nursing Home

We identified two breaches of the regulations. The registered manager and provider did not always ensure safe and proper management of medicine. The completion of some of the medicine management records and checks needed reviewing and improving according to provider’s policy and current best practice guidance. The provider and the registered manager needed to improve recruitment processes to ensure staff employed in the service were suitable and people were not at risk of harm.

However, people were safe living at the service and relatives felt their family members were kept safe. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse and felt confident issues would be addressed appropriately. The registered manager and the staff team were working with the local authority to investigate safeguarding cases and provided support to address any issues. The registered manager and staff had guidance to support people in the right way and oversee the risks. The registered manager reviewed and improved staff deployment to ensure people received timely or effective support. We observed kind and friendly interactions between staff and people. Relatives made positive comments about the staff and the care they provided. We observed the staff were organised better to ensure people were not at risk of social isolation and provided gentle stimulation to people. The registered manager ensured incidents and accidents were reviewed, the actions taken, and any lessons learned noted with themes or trends identified. The dedicated staff team followed procedures and practices to control the spread of infection and keep the service clean. There was an emergency plan in place to respond to unexpected events and equipment was kept clean.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service were in place to support this practice. The registered manager worked with staff to ensure care plans and related documents had specific information about people, their needs and how to manage any conditions they had. Relatives were involved in planning their care and were informed of any changes in health or wellbeing. Relatives were positive about the staff and the service. People were able to access healthcare professionals such as their GP and other services specific to their needs. The service worked well with other health and social care professionals to provide care for people. Professionals noted to us a clear positive change and improvements in the service. Staff supported people to make decisions following best practice in decision-making and respected their rights to refuse support. People and relatives told us staff were caring, friendly and kind, and we observed this. Staff understood how to treat people with care, respect, and consideration.

We identified one breach of the legal regulations.

We found the registered manager did not always ensure all of the issues we found during this assessment that are described throughout the report, were identified through their own quality monitoring systems. Governance systems and audits had to be reviewed and improved to ensure it was more effective and consistent in identifying or addressing areas for improvement.

However, we also received positive feedback professionals, staff and relatives about the registered manager and the work they have been doing which had a positive effect on the service. The registered manager worked together with the staff team and proactively sought support and advice from external partners to ensure any improvements needed were identified and implemented swiftly. People's and relatives', and staff’s feedback were sought and used to make improvements to the service. Relatives said they could approach the registered manager and staff with any concerns. The registered manager appreciated staff contributions and efforts to ensure people received the care and support.