Whitstable Nursing Home

Whitstable Nursing Home, inspected by the CQC in January 2023, has had its overall rating changed to Requires Improvement following this visit. The report details findings across several key areas, highlighting both strengths and areas needing development to ensure consistent, high-quality care for residents. The inspection was prompted by concerns regarding the management of nursing care needs.

On safety, while residents felt safe, there were instances where detailed guidance for staff to manage risks was insufficient. Inaccurate care records were maintained, posing a risk to residents' well-being. Furthermore, care plans were not always followed precisely, leading to potential skin damage due to delayed repositioning, and inconsistent recording of catheter bag changes increased infection risk. There were also concerns about the accuracy of recorded insulin administration times for diabetic residents and a lack of documentation for oxygen concentrator maintenance and emergency preparedness. However, significant improvements have been made in safeguarding processes, with staff now better trained to report incidents quickly, and medicines are managed safely.

In terms of how effective the care is, the service requires improvement as best interest decisions were not always adequately recorded, impacting transparency on how choices were made for residents lacking capacity. While pre-admission assessments effectively inform care plans, and residents' needs are assessed using recognised tools, the documentation for decisions related to restrictive practices, like lap straps, and the reasoning behind crushing medication, needs to be more thorough. Residents are supported to eat well and access healthcare professionals, and the building is adapted to meet their needs.

Regarding how caring the service is, the report notes that residents were not always supported to have maximum choice and control in their lives, and staff did not always support them in the least restrictive way. Policies and systems did not always uphold this principle, and decisions potentially impacting liberty were not always clearly documented to show best interests. However, staff consistently asked residents about their preferences for daily activities and meals, respecting their choices.

In relation to how responsive the service is, improvements have been made based on resident and staff feedback, such as enhancements to the activities programme and menu. Residents are supported to visit with family safely. The home has a consistent supply of staff, utilising regular agency staff to fill gaps, and staff are recruited safely with appropriate checks in place.

On being well-led, while quality monitoring systems are in place, they were not always effective in identifying the shortfalls noted during this inspection. However, the registered manager has taken action following the inspection to address concerns, including updating care plans and holding staff meetings to discuss findings and reinforce best practices for record-keeping. Audits are conducted, and when issues are identified, action is taken to rectify them.