Carisbrooke Nursing Home

People's needs in relation to their emotional and social care needs, were not met. Although people told us they were supported well with their physical care needs, people said they did not have the opportunity to take part in activities and they were left to entertain themselves.

Risks to people's safety and welfare were identified and plans were in place to help minimise risks. Checks were carried out on the facilities and equipment, to ensure they were safe. Whilst some fire safety checks were completed, records did not demonstrate all fire safety checks and safety practices were completed as they should. We made a recommendation about this.

Processes were in place to prevent and control infection. However, we were not fully assured that staff were always using PPE in line with best practice guidance. We made a recommendation to the provider to take action to update staffs' practice accordingly.

The registered manager was not present during the inspection and people and staff told us the registered manager had not worked at the service since the beginning of the year. The provider had not notified CQC about this, as required.

The services quality assurance systems and processes in place had not always been effective at identifying areas for improvement and ensuring action was taken in a timely manner.

During the inspection we observed there were enough staff to provide safe care and support. However, people's feedback was varied with some people reporting staff were "rushed off their feet" and did not have any time to spend with them. Relevant checks were completed to ensure staff were suitable to work in a care setting.

People told us staff were well trained and they knew how to care for them. New staff received an induction, and all staff were enrolled on the providers online training programme.

Although staff had opportunities to discuss work performance, staff supervisions had not been completed consistently. We made a recommendation the provider review their systems in place, making sure staff

received on-going support and supervisions.

Staff told us that communication from the management was not always good and meetings had not taken place consistently since the provider had taken over the running of the service.

Recent improvements had been made to ensure that people were engaged with and consulted about the care they received. Surveys had been sent out to people and changes to the service provision had been made to meet people's needs and requests.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they enjoyed the food and had enough to eat. People's care plans contained information about their dietary needs and preferences. People were protected from the risk of malnutrition and from the risk of choking. People's food and fluid intake was monitored, and people received a modified diet following assessments by health professionals.

People were supported to access healthcare services. Records showed staff made referrals to health care professionals in response to people's changing needs.

People made decisions about how they wanted to receive care and support and were involved in planning their care. Person-centred care plans and risk assessments were in place to guide staff about how people liked their support to be provided.

People told us they felt able to raise concerns. The provider had systems in place to log, investigate and respond to complaints.

Systems and processes were in place to support people at the end of their life to have a comfortable, dignified and pain-free death. Staff worked closely with the local doctor and hospice services to ensure people had access to the care and support they needed.