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Angels (Stratton House) Limited Good

Inspection Summary

Overall summary & rating


Updated 23 December 2016

We carried out an unannounced comprehensive inspection on 1 December 2016. Angels (Stratton House) provides care and accommodation for up to 24 people. The majority of people at this service have dementia or mental health needs. There were 21 people using the service on the day of our inspection.

We last inspected the service in November 2014, at that inspection the service was meeting all of the regulations inspected. However we made two recommendations to the provider regarding reviewing the Mental Capacity Act 2005 to make sure best interests decisions were being carried out and recorded appropriately. Also to explore the relevant guidance on how to make communication systems used by people living with dementia more ‘dementia friendly’. At this inspection we found the provider had taken action to improve these areas significantly.

There was a registered manager. 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. The registered manager is also registered as the registered manager at a second location under a different legal entity. They delegated day to day clinical responsibility to two deputy managers who were nurses.

Relatives and staff gave us positive feedback about the management team. They said they were open, friendly and welcoming. They were happy to approach them if they had a concern and were confident that actions would be taken if required. The registered manager was very visible at the service and had an open door policy. They promoted a strong, caring and supportive approach to staff and put a high emphasis on staff training and increasing their knowledge.

The registered manager ensured there were sufficient numbers of suitable staff to keep people safe and meet their needs.

The provider demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (2005) (MCA). Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. They had made appropriate applications for people they had assessed that required to be deprived of their liberty to the local authority DoLS team.

People were supported by staff who had the required recruitment checks in place and were trained and had the skills and knowledge to meet their needs. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns.

People were supported to eat and drink enough and maintain a balanced diet. People and visitors were positive about the food at the service. People were seen to be enjoying the food they received during the inspection.

People received their prescribed medicines on time and in a safe way. Visitors said staff treated their relative with dignity and respect at all times in a caring and compassionate way.

People were supported to follow their interests and take part in social activities. A designated activities coordinator was employed by the provider. They ensured each person at the service had the opportunity to take part in activities and social events which were of an interest to them.

Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. Care plans were person centred and people where able and their families had been involved in their development. Staff were very good at ensuring people where able were involved in making decisions and planning their own care on a day to day basis. People were referred promptly to health care services when required and received on-going healthcare support.

The premises were well managed to keep people safe. There were emergency plans in place to protect people in the event of a fire or emergency.

The provider had a quality monitoring system at the service. The provider actively sought the views of people, their relatives and staff through staff and residents meetings, surveys and questionnaires to continuously improve the service. There was a complaints procedure in place. There had been no formal complaints received in 2016.

Inspection areas



Updated 23 December 2016

The service was safe.

Staffing levels were monitored to make sure there were always sufficient staff to meet people’s individual needs and to keep them safe.

People were kept safe by staff who could recognise signs of potential abuse and knew what to do when safeguarding concerns were raised.

The provider had robust recruitment processes in place.

People received their medicines in a safe way.

The premises and equipment were maintained to keep people safe.

Emergency personal evacuation plans were in place to protect people in the event of emergencies.



Updated 23 December 2016

The service was effective.

The registered manager and staff had an understanding of the principles of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards.

Staff had received effective inductions, training and appraisals. Staff were undertaking higher health and social care qualifications.

Staff recognised any deterioration in people’s health and sought medical advice appropriately.

People were supported to eat and drink and had adequate nutrition to meet their needs.



Updated 23 December 2016

The service was caring.

People, relatives and health and social care professionals gave us positive feedback. They said staff were compassionate, treated people as individuals and with dignity and respect. Staff knew the people they supported, about their personal histories and daily preferences.

Staff were kind and compassionate towards people and maintained their privacy and dignity. Staff were friendly in their approach and spoke pleasantly to people while undertaking tasks.

People were involved in making decisions and planning their own care on a day to day basis.



Updated 23 December 2016

The service was responsive.

Staff made referrals to health services promptly when they recognised people’s needs had changed.

Staff knew people well, understood their needs well and cared for them as individuals.

People’s care plans were person centred and provided a detailed account of how staff should support them. Their care needs were regularly reviewed, assessed and recorded.

The registered manager and deputy managers were available to deal with any concerns or complaints. People felt any concern would be dealt with effectively.

A designated member of staff supported people to undertake a range of activities.



Updated 23 December 2016

The service was well led.

The registered manager understood their responsibilities, and had support from two deputy managers who were registered nurses. They were also supported by the provider. Relatives and staff were positive about the registered manager and said she was fair and approachable and would challenge poor practice if required.

The provider had good quality monitoring systems in place. People, relatives and staff were asked their views and these were taken into account in how the service was run.

There was an effective audit program to monitor the safe running of the service.