Archived: Stinchcombe Manor

This was an unannounced inspection and was carried out by an inspector from the Adult Social Care (ASC) directorate. We spoke with a person who used the service, the registered manager, a clinical nurse, two cleaners, staff who had lead roles in infection control and staff training. The staff provided us with additional information which included the cleaning schedule, staff training records and cleaning audits. We toured the premises to observe whether suitable cleanliness and infection control practices had been applied throughout the service.

At our inspection in April 2014 we found that poor attention had been paid to cleanliness and infection control practices and procedures within the home. This placed people at risk of infection.

The purpose of this inspection was to answer one of our five key questions, is the service safe?

Is the service safe?

We reviewed cleanliness and found infection and control practices had improved which enhanced people's safety throughout the service. We found these practices and procedures were consistent with the provider's policies and procedures and people were no longer at risk of transmittable diseases. As a result suitable practices had been implemented throughout to protect people from outbreaks of infection and increase their safety thus transforming the service into a safe place for these who live and visit the service.

' Is the service caring?

We saw that care workers showed patience and gave encouragement when supporting people. Relatives told us that 'The care is good and my family member is well looked after'. One member of staff told us, 'We have a violinist' and 'once a month we have Holy Communion to meet the needs of people who are Roman Catholics and of Christian faith'. People were supported by staff that provided support when they needed. Staff told us that 'care provided is exceptional'. One person told us they were 'Happy with the care'. We noted during the mealtime that people's meals were served on red crockery plates and people were provided with multi coloured solid handled cutlery to help people maintain their independence at mealtimes. Relatives told us 'My [family member] is well cared for here'. Another relative told us 'My [family member] still has their daily newspaper'.

' Is the service responsive?

During our visit we noted that there was a call bell system and people's calls were responded to promptly by staff ensuring that people were not left waiting too long. One relative told us that, 'due to the rapid change in my [family member's] condition the staff responded promptly'. Assessments were planned and the care was provided according to the assessments. For example 'My [family member] now needed 2:1 care'. This meant that the person needed two care workers to assist with their personal care and treatment and this was recorded in their care plan. This meant the staff had responded to the changing needs of the person in their care.

' Is the service safe?

We saw that the home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards; the outcomes of people's mental capacity assessments were seen in their care plans. Relatives told us of their involvement with their family member's mental capacity assessment and we noted saw that the staff home provided care according to individual need.

Relatives told us they felt their family members were safe. Safeguarding procedures were maintained; however we found that some staff required training updates in this area. Staff understood how to safeguard the people they supported and were aware of the reporting and recording practices and procedures. No safeguarding concerns had been raised since the previous inspection.

' Is the service effective?

People's health and care needs were assessed and family involvement was encouraged. People coming to live in the home were given the opportunity to spend a day at the service. We reviewed the care records of a person who had recently been admitted into the care home and saw these contained relevant assessments. Relatives told us that they were 'involved in the planning of their [family member's] personal treatment and care'.

The registered manager ensured that the staff team were supported with regular training, supervision and appraisal sessions. The staff files confirmed that these took place on a frequent basis. New members of staff participated in an organised induction and were required to work through an induction workbook to further enhance their skill and knowledge in health and social care.

' Is the service well-led?

We saw that the service had a registered manager in place to manage the daily administration of the service. The service had qualified nurses to provide general nursing care to meet people's needs. The staff team were clear about their roles under the direction of the registered manager. We found that regular audits were conducted to address any identified gaps in the quality of the service. One relative told us, 'We were given a questionnaire which asks for feedback on the service'.

We observed assisted eating which was calm and the staff were seen to be engaged with the people who used the service. The staff were seen to be wearing gloves whilst supporting people with their lunchtime meal and we felt this compromised people's dignity.

The shortcomings from the previous inspection in March 2013 concerning hygiene and infection control had been addressed. We observed that there were hand dispenser gels placed in the hallway of the home.

Improvements had been made to the environment that were highlighted from the previous inspection in March 2013. We saw an on-going work plan for continued improvements and repairs to the home. The home was a Grade II listed building and the maintenance person told us that 'they have to make repairs and restorations in keeping with the architecture of the building'.

We observed that the permanent and bank staff, who had been employed for a number of years, had positive relationships with the people who used the service. One member of staff told us 'I enjoy working here'.

We saw from the staff work sheet there were inconsistencies and the frequency of staff supervision and appraisal had not been maintained throughout the year for the staff team providing care.

People said that they felt safe at the home. There were procedures in place which helped to ensure that people were protected from abuse. Staff told us that they felt able to report any concerns that they may have about people's well being.

People were being asked for their views about the home. Regular meetings had taken place during the last year with the people who used the service and with their relatives. The quality of service that people received was also being checked through audits. Overall, the arrangements being made for quality assurance had improved since our last inspection. However there were shortcomings, which meant that good standards in relation to hygiene and infection control were not being maintained.