Background to this inspection
Updated
2 December 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health & Social Care Act 2008 Regulated Activities Regulations 2014, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We also reviewed information we received since the last inspection, including information we received from the local authority safeguarding team and information received from whistleblowers in the home.
We spoke with the interim manager, the area manager, a company quality assurance manager, a community nurse, nine people that lived in the service, four relatives, two nursing staff and four care staff. The registered manager was currently unavailable and the provider had employed an interim manager in the meantime until their return. The interim manager is referred to as the ‘manager’ within this report.
We observed how staff spoke with and supported people living at the service and we reviewed people's care records. We reviewed other records relating to the care people received. This included the audits on the running of the home, staff training, staff recruitment records and medicine administration records.
Updated
2 December 2015
Shelton Lock Nursing Home provides accommodation and nursing care for up to 40 people accommodated over two floors. This includes care of people with mental health and physical health needs. On the day of the inspection 31 people were living at the home.
This inspection took place on 14,18 and 21 September 2015. The inspection was unannounced.
Two breaches of legal requirements were found on this inspection. The registered person had not ensured that people were protected from risks to their safety and that people's consent to care had not always been properly ascertained.
A registered manager was in place. 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 and associated Regulations about how the service is run. The registered manager was not managing the service at the time of the inspection. The registered manager was currently unavailable and the provider had employed an interim manager in the meantime until their return. The interim manager is referred to as the ‘manager’ within this report.
Since our previous inspection in June 2014, we had received information from whistleblowers which had stated that people had not been properly cared for or treated with dignity by some staff and proper action had not been taken to deal with these issues. We followed up these concerns by focusing on the issues raised.
People using the service and the relative we spoke with said they thought the home was safe. Staff were trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.
Staff told us that on occasions they thought there were not enough staff on duty to meet people’s needs promptly. Some people’s risk assessments were in need of improvement to help ensure staff understood how to support them safely and keep people safe.
People using the service and a relative told us they thought medicines were given safely and on time. Some improvements were needed to the way medicines were stored and recorded to evidence that medicines were properly supplied to people to protect their house.
Staff were generally safety recruited to help ensure they were appropriate to work with the people who used the service to protect people from unsuitable staff supplying care to them.
Staff needed more training to ensure they had the skills and knowledge to be able to fully meet people's needs to ensure people's needs are met at all times.
Not all staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives and the service had not obtained legal approval for limiting people's choices.
People had plenty to eat and drink and everyone, except one person, told us they liked the food served to them.
People's health care needs had not been fully protected by timely referrals to health care professionals when necessary.
Most of the people we spoke with told us they liked the staff and got on well with them, and we saw many examples of staff working with people in a friendly and caring way which appeared to make people happy and relaxed when staff spoke with them.
People were not always actively involved in making decisions about their care, treatment and support.
Care plans were not fully individual to the people using the service and did not fully cover their health and social care needs.
People were generally satisfied with the activities provided.
People and a relative told us they would tell staff if they had any concerns. Records showed that complaints were not always been comprehensively followed up to meet people's needs.
Not all staff were satisfied with how the home was run. People only had infrequent opportunities to share their views about the service at meetings so this limited their participation in the way the home was run.