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Stretton Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 December 2017

The inspection took place on 31 October and 8 November 2017. The first day of the inspection was unannounced.

Stretton Nursing Home provides accommodation, nursing and personal care for up to 50 people. At the time of our inspection, there were 42 people living at the home.

A registered manager was in post at the time of our inspection. 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 had been away from the service for a number of weeks at the time of our inspection visit. In their absence, we met with the managing director of the service. The nurses and senior staff team had overseen the day-to-day management of the service, during the registered manager's absence, with the support of the managing director.

Staff did not always fully understand, or fulfil, their individual responsibilities to protect people from abuse. The provider had, at times, been unable to maintain planned staffing levels over recent months, particularly on weekends. People’s rights under the Mental Capacity Act 2005 were not always fully promoted. The provider lacked a clear overview of the status of people’s DoLS authorisations and conditions on these were not always reviewed and complied with. Staff were not always invited to regular one-to-one meetings with senior staff or management, in accordance with the provider’s supervision policy. Staff did not have the time with people to provide personalised care that was responsive to people's needs. The management, leadership and line management structure of the service was not as effective as it needed to be. The provider had not always notified us of safeguarding issues involving people who lived at the home in a timely manner. The records maintained in relation to people’s care and support were not always accurate or complete. The provider’s quality assurance had not enabled them to identify and address significant shortfalls in the quality of the care and support provided.

The risks associated with people’s care and support needs had been assessed, recorded and plans put in place to manage these. People’s medicines were handled and administered in accordance with good practice guidelines by registered nurses.

Staff received an induction and ongoing training to help them fulfil their duties and meet people’s individual needs. People had enough to eat and drink, and any associated risks were assessed, recorded and managed. When people were unwell, they were supported to access professional medical advice and treatment.

Staff took a caring approach towards their work, and knew the people they supported well. People’s views about their care and support were welcomed and listened to. People were treated with dignity and respect.

People’s friends and relatives contributed to the assessment and planning of their care. People’s care files included details of their preferences and what was important to them. People had support to participate in one-to-one and group activities. People and their relatives understood how to raise concerns and complaints about the service, and felt comfortable doing so.

People and their relatives and friends were satisfied with the overall management of the service.

We found breaches of Regulations of the Health and Social Care 2008 (Regulated Activities) Regulations 2014 and a breach of the Care Quality Commission (Registration) Regulation 2009. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 9 December 2017

The service was not always Safe.

Staff were not always fully aware of, and did not always fulfil, their individual responsibilities to protect people from abuse. Agreed staffing levels were not always maintained, particularly on weekends. Staff helped people take their medicines safely and as prescribed.

Effective

Requires improvement

Updated 9 December 2017

The service was not always Effective.

People's rights under the Mental Capacity Act 2005 were not always fully promoted. Staff did not have the opportunity to attend regular one-to-one meetings with a supervisor or manager. Any complex needs or risks around people's eating and drinking were assessed, recorded and managed.

Caring

Good

Updated 9 December 2017

The service was Caring.

Staff approached their work with kindness and compassion. People's involvement in decisions that affected them was encouraged. People's rights to privacy and dignity were respected.

Responsive

Requires improvement

Updated 9 December 2017

The service was not always Responsive.

People did not always received personalised care and support that was responsive to their needs. People's care plans were individual to them and covered a range of needs. People and their relatives were clear how to complain about the service.

Well-led

Requires improvement

Updated 9 December 2017

The service was not always Well-led.

Staff did not always benefit from effective leadership and line management. The provider had not always submitted statutory notification in line with their registration with CQC. The records maintained in relation to people's care and support were not always accurate and complete. The provider's quality assurance activities had not enabled them to address significant shortfalls in the quality of the service.