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Despite the poor performance to deliver excellent care to the residents, it is apparent that residents were happy with the way staff interacted with them.

Residents described the staff as friendly and respectful and felt they were encouraged to be independent. Relatives were happy with the decision that their parents or other relatives were being cared for by St Theresa's Nursing Home. (CQC report, 2016).

The emergency bells were seen to immediately and response times to emergency situations were quick. Any residents needed emergency treatment were referred to in good time.

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Staff would receive training, however, it was done through E-Learning on the computer. Being trained through an online based resource suggests no evidence of the level of understanding taken from the training.

Staff were hardly supervised by their superiors and evidence from their training record cards shows that their refresher training was not up-to-date. Without the most recent training, members of staff may be providing a service that may not be completely correct.

Recruitment:
From 2014-2015, the nursing home was running without a registered manager. Five managers had been appointed until 2016, some were employed for a short period of time and others had left to work in other groups, demonstrating a lack of managerial stability.

DBS Checks:
When recruiting members of staff, some had not been trained or issued with satisfactory checks, such as the DBS check. Without these checks, it is unsure to know whether or not new employees are suitable to work with the residents that live there.

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Concerns had been raised regarding equipment either being faulty or not suitable. Things that were broken within the service, e.g. dishwashers and toilet seats, were not addressed or dealt with immediately - some of which had been outstanding since previous inspections. Although hoists and moving equipment had been serviced and was found to be working correctly, members of staff had voiced that they would benefit a great deal with an additional hoist so they wouldn't have to move equipment around.

During numerous inspections, there were never enough staff on duty meaning that it may have been hard to meet everyone's individual needs and care for them effectively.

Continence pads were unnamed and communally shared amongst residents. This demonstrates that the service was not respecting dignity and meant that residents may not have been 'getting the aid specifically prescribed for their size' (CQC report, 2016).

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St Theresa's was a registered nursing home located in Cornwall run by the Morleigh Group. Upon unannounced inspections commencing in 2013, the nursing home was issued inadequate ratings and placed in 'Special Measures' until its closure in 2016.

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Following inspection, the overall rating for the service that St Theresa's Nursing Home was rated inadequate.

From the 'St Theresa's Nursing Home Inspection Report, (November 2016)' published by CQC, shows that the service was questioned on how safe, effective, caring, responsive and well-lead it was. The findings were that improvements needed to be made or that it was inadequate.

Following the inspections over the years, St Theresa's Nursing Home wasn't performing as it should and consequently had to be shut down.

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St Theresa's Nursing Home's performance was measured by Care Quality Commissions.

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Residents needs in relation to their treatment was disregarded and the service failed to identify when residents needed treatment.

Staff were not providing clear guidance on how to minimize the risk of falling over in risk assessments. When residents were falling over, these incidents weren't consistently recorded and no action was taken to prevent it.

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St Theresa's Nursing Home had failed to comply with the law as some members of staff were working one-on-one with patients without a 'satisfactory Disclosure and Barring Service (DBS) check in place' (CQC report, 2016). Some patients were living with dementia therefore this could have caused potential harm to them as without satisfactory checks it's unsure to determine staff are suitable to work within the service.

No Registered Manager:
Since 2014, St Theresa's had been running without a registered manager. This is a requirement as they are legally accountable for meeting the requirements relating to the Health and Social Care Act 2008.

Medication:
Some medication that was held at St Theresa's had strict controls enforced by the law. Records failed to match with stock records, demonstrating either they were being incorrectly used or members of staff were not accounting for medication that was required to be controlled.

Breaches to the law:
During the inspections, the service was found to continuously breach the Health and Social Care Act 2008. Regulations 9, 10, 12, 15, 17 and 19 were breached. Many of these regulations had been continously breached over the years, demonstrating an 'inadequate response in meeting the requirements of legislation' (CQC report, 2016).

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St Theresa's Nursing Home was running without a registered manager since 2014 and following another inspection in 2015 it was found that the position was yet to be filled. However, up until 2016, 5 managers had been appointed, who had left to other groups or had short employment periods.

When the positioned had been appointed, the duties that the manager was supposed to overlook or carry out e.g. supervising, ensuring up-to-date training were not performed. Things reported to the manager, e.g. regarding medication, were ignored and not acted upon.