Sutton House

About the service

Sutton House is a residential care home providing accommodation and personal care for up to 5 people. The service provides support to people with a learning disability, and autistic people.

Sutton House is a residential house with some adaptions. At the time of our inspection there were 5 people using the service.

People’s experience of using this service and what we found

Right Support:

When incidents occurred the systems were not always effective at ensuring learning took place, and people's care records were updated to reflect any changes.

Sutton House is a small, ordinary home forming part of a local community. The property does not appear to be a care home and mirrors the other properties on the road. Some reasonable adjustments were needed to bathroom facilities to ensure people's changing needs continue to be met.

People were supported by staff to take part in activities and pursue their interest in the local and wider community. Staff supported people to achieve their aspirations and goals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People were supported by caring staff and people's privacy and dignity was respected. Staff had received appropriate training. Staff worked in partnership with other agencies to promote people's health and wellbeing.

Right Culture:

Governance systems were in place but the oversight of these was not always effective. The oversight of risk management was not always effective and some incidents where people had been harmed or put at risk of harm, had not been reported as required.

A system for formally asking relatives and professionals about their views, was not yet fully implemented.

The registered manager promoted a positive culture and led by example. They responded positively to feedback and showed a commitment to improve things at the home. People were at the forefront of the service and staff supported people well in doing things they enjoyed, and also trying new things.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service was good (published 23 August 2017).

Why we inspected

This inspection was prompted by a review of information we held about the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified 3 breaches in relation to safe care, safeguarding and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection in November 2015, the service was rated as Good. At this inspection we found the service remained Good.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

People continued to receive care and support from staff who understood how to keep them safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. Staff were available to meet people’s needs and understood how to best support people and the risks to their well-being. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately.

People continued to receive effective care and support from staff that had the skills to meet their individual needs. Staff were supported by the management team through regular supervisions and staff meetings. Staff understood they could only care for and support people who consented to being cared for and throughout the inspection we saw people supported to communicate their choices. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice

People enjoyed mealtimes, menus were planned at the beginning of each week with the input of people living in the home and we saw people were encouraged to be involved in the preparation of food and drinks. Staff responded when people were unwell and arranged appropriate healthcare appointments in support of people’s well-being.

People continued to receive support from caring staff who treated them with dignity and respect. We saw people were happy in the company of staff, who they looked to for support and reassurance when needed. People were involved in how their care and support was received and their choices were respected by staff.

The service remained responsive. Staff provided care that took account of people’s individual needs and preferences. People and their relatives were listened to and felt confident they could raise any issues should the need arise and action would be taken.

The service was well led. At the last inspection of November 2015 a new manager was in place but they had not registered with CQC. At this inspection we found that there was a registered manager in place who, with the support of the project manager had taken action to introduce new checks and processes to assure themselves of the quality of care being delivered.

Relatives and staff spoke highly of the management team and positively about the teamwork of the staff group within the service. Staff were supported through supervisions, team meetings and training to provide care and support in line with people needs and wishes. The quality of service provision and care was monitored and actions taken where required to improve people’s experience of living at the home.

Further information is in the detailed findings below.

We spoke with the service manager who was responsible for the running of the home and four members of staff.

Risk assessments were in place to support people's needs. However, the lack of appropriate care plans for people's health meant that people may not always receive care in a consistent manner.

Systems were in place to ensure that people received medication that they needed to maintain their health.

Recruitment processes were adequate which gave people who used the service some assurance that only suitable staff had been employed.

People were cared for by staff who were supported, supervised and trained to deliver care to an appropriate standard. One person told us, "The staff are nice I get on with them".

Systems were in place to regularly assess and monitor the quality of service that people received. A relative told us," The service is fantastic".

As people had complex needs and were not all able to tell us about the service they received we used different methods to help us understand their experiences, including observation. We observed good interactions between staff and people living there.

We found that people were treated with respect and dignity and that they were given choices about how they wanted to live their lives.

We saw that care plans lacked instruction on how staff should care for people with specific health conditions to keep them in good health.

We identified that medication systems were not as robust and as safe as they should be to prevent people being placed at risk of ill health.

Recruitment processes had not been as thorough and safe as they should have been to give assurance that only suitable staff had been employed.

Records and staff both confirmed that systems had been used to monitor how the home had been run to benefit the people who lived there.