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Inspection Summary

Overall summary & rating


Updated 21 November 2017

The inspection took place on the 19 and 21 September 2017 and was unannounced.

Shire House Care Home provides residential care without nursing for up to 22 older persons. There were 17 people living at the service when we visited some of whom were living with dementia.

A registered manager was employed to manage the service. 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.

We previously inspected the service in May 2016 and found breaches of regulation related to staffing, risk management and care being person centred. The provider wrote and told us about improvements they would make to meet the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. They told us they would make these improvements by the end of August 2016. At this inspection we found that these improvements had been made.

People were supported by staff that understood how to recognise signs of abuse and the actions they needed to take if they suspected abuse. The staff also put an emphasis on the need not to go to external authorities without talking to the management team first. The registered manager and nominated individual checked this understanding with the staff team and addressed the importance of whistleblowing during our inspection.

Healthcare professionals had been concerned about some aspects of risk management. The provider organisation had changed ownership in August 29017 and the new owner had discussed concerns with the district nurse team and plans were in place to ensure these issues were acted upon.

People received their medicines as prescribed. Records, however were not always accurate and stock levels of one medicine were unnecessarily high. The registered manager and nominated individual addressed these issues immediately and put measures in place to ensure they would not be repeated.

The risks people lived with had been assessed and were reviewed regularly. Staff understood the actions in place to minimise these risks. Staff had a good knowledge of the risks people lived with and their role in reducing these risks.

Where people needed to be deprived of their liberty to live in the home, applications for Deprivation of Liberty Safeguards (DoLS) had been made. One DoLs that had been authorised had expired. This was rectified during our inspection and a system put in place to ensure this would not be repeated.

Staff were supporting people in line with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People’s ability to make decisions about specific aspects of their life were regularly assessed and kept under review. When people could not make decisions for themselves this was done in line with the principles of the MCA.

People were supported by enough staff to meet their needs. Staff had been recruited safely which included checks that they were suitable to work with vulnerable people. Staff had the appropriate skills and training to support people safely and effectively. Staff felt supported and received regular supervision and an annual appraisal.

Staff understood people’s eating and drinking requirements, likes and dislikes. There were systems in place to ensure that risks associated with eating and drinking were managed effectively.

People had access to healthcare for ongoing and emergency treatment, This included GP’s, district nurses , dentists and opticians.

People were supported by staff who knew them well and understood their history , likes, dislikes and preferences. Staff were caring when they spent time with people and spoke about them with warmth and respect. People had their dignity and privacy respected and were supported in a way that reflected a person’s individuality.

People’s care and support plans had been written and reviewed regularly with people or appropriate representatives. Staff understood the actions they needed to take to support people with their care. People’s decisions about how they wanted to spend their time was respected and reflected past lifestyles and interests.

People felt listened to and told us they knew how to complain. They felt if they did raise any concerns they would be listened to and actions taken.

Audits and surveys were robust enough to identify any areas for improvement and included both the environment and people’s care and welfare. A quality assurance process was in place that ensured people had the opportunity to share their views about the service they received. When any actions were identified they were acted on to ensure people’s safety and wellbeing.

People and staff held the management and home in high regard. They all reflected an ethos of staff working to create a family feel. Staff were committed to supporting each other to achieve good quality care for people.

Inspection areas


Requires improvement

Updated 21 November 2017

The service was safe although we found some areas where improvements could be made. These were addressed during out inspection.

People’s medicines were administered safely. We noted a recording error and a stock control issue which were addressed quickly and comprehensively during our inspection.

Staff demonstrated they understood how to identify and keep people safe from abuse. They understood how to report abuse but emphasised internal measures. This may have put people at risk. The provider reinforced whistleblowing procedures with all staff during our inspection.

People had risk assessments in place which were updated regularly and staff understood how to support them to reduce these risks.

People were supported by enough safely recruited staff to meet their needs.

The home was clean. Staff had access to protective clothing and used it appropriately when supporting people with personal care and giving medicines.



Updated 21 November 2017

The service was effective.

People had enough to eat and drink and they told us the food was good.

People told us they saw their GP and health professionals when they needed to.

People were assessed to see if they could consent to their care. Where they could not do so staff understood how to ensure their rights were upheld.

People were supported by staff who felt well supported and had been trained to carry out their work.



Updated 21 November 2017

The service was caring. People told us the staff were caring and staff spoke of people with kindness and respect.

Staffing and care were planned to ensure people’s preferences and choices were respected.



Updated 21 November 2017

The service was responsive. People received care that reflected their needs and preferences.

Activities were provided to keep people active and these were being reviewed and developed when we visited. People had their faith needs met.

People were confident that they could raise concerns and complaints if they needed to.



Updated 21 November 2017

The service was well led.

People and staff told us the management team was approachable and they felt able to contribute to developments.

There were systems in place to monitor the safety and quality of the service people received.