Archived: Sutton Court

Sutton Court is registered to provide accommodation for up to 59 people who require nursing or personal care. At the time of the inspection there were 46 people living at the service.

Accommodation is located over two floors. Part of the first floor provides accommodation for ‘Transfer to Assess’ (where people require assessment and support to return to their own home following hospital admission) which is managed Monday to Friday by the local CCG which is part of the NHS.

On the days of our inspection 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 told us that they felt safe. The risk of harm to people was reduced because staff knew how to recognise and report any incidents of harm. Staff were confident that the registered manager would deal with any concerns that they reported.

Medicines were safely administered and stored.

Staffing levels were adequate to meet people’s needs. Staff were recruited through safe recruitment practices. Staff received an induction, training and supervision. They felt supported by the management team.

People received sufficient to eat and drink although they did not always receive the necessary support during meal times.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and could describe how people were supported to make decisions. People were asked for their consent before care and support was provided and this was respected.

People’s healthcare needs had been assessed and were regularly monitored. Staff worked well with visiting healthcare professionals to ensure they provided effective care and support.

People told us staff were kind and caring but they did not always listen to them. Staff were aware of people's support needs and their personal preferences. People and/or their relatives were involved in the development and review of their care plans. People were encouraged to be independent.

People had the opportunity to take part in a variety of activities inside the service. Daily records were up to date and gave a good overview of what had occurred for that person. Complaints were dealt with in a timely manner.

The registered manager was supportive and approachable towards people, relatives, external professionals and staff. People were involved or had opportunities to be involved in the development of the service. There were systems in place to monitor and improve the quality of the service provided.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, the staff who supported them and from review of records. We also spoke with the registered manager and a senior service manager.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

During our visit we spoke with people who used the service and also observed how staff supported people in each part of the home. We saw examples of good care and support during this time. Everyone that we spoke with said they felt safe. One person who used the service said, 'I feel safe here. They do something about every bruise.'

We spoke with three relatives who told us that they were very satisfied with the service provided at the home. One relative told us, 'I don't have to worry.'

Is the service effective?

On the day of our inspection we saw that people received appropriate support. People told us that they were cared for in ways that they preferred. One person told us, 'They are looking after me very well. I get everything I need. I can't fault them.' Another person told us, 'They are brilliant. They understand me.' We saw evidence that people who used the service were involved and consulted in relation to how they were supported. One person told us, 'They ask us what we want or what we can do.' This meant that staff could provide effective support that met people's needs in ways that they preferred.

We found that the registered manager had effective systems in place to enable them to monitor and assess the quality of the service provided. We saw that care plans had been reviewed to ensure that they were still relevant and identified how people's needs should be met.

Is the service caring?

People were supported by staff who were kind and patient. We saw that, although staff were busy, they did not rush people and took time to explain what they were doing when offering personal care. People were reassured by this. One person told us, 'They treat people with respect. I always know what's happening.'

We saw how staff responded to requests for support in a timely manner. We saw records that showed how staff contacted family and health professionals when they had concerns about the health and welfare of people who used the service.The relatives we spoke with confirmed this. We saw that people were supported with their meals and encouraged to have drinks at regular intervals.

Is the service responsive?

We found that the registered manager actively sought the views and experiences of the people who used the service and their relatives. They organised regular residents' meetings and meetings for relatives and friends. Staff told us how the registered manager implemented suggestions for improvements. For example, the registered manager after feedback from people who used the service, made sure that puddings at lunch time were not served until people had finished their main meals and we saw staff implementing this on the day of our inspection. This showed that people who used the service were consulted and changes were made in response to their feedback and suggestions.

People who used the service told us how staff listened to them and acted in accordance with their wishes. We saw how the registered manager had worked closely with staff and health care professionals to ensure people remained safe. The registered manager had made improvements to the service since their recent appointment.

Is the service well-led?

We saw evidence that the registered manager carried out regular reviews and audits. For example, we saw that they had audited falls, health and safety and accidents and incidents. They told us that these processes reassured them that they provided a good service. The registered manager also told us how the service provider worked with them to monitor and assess the quality of the service and we saw that resources were made available to them to make improvements.

Staff told us that the registered manager offered effective leadership and worked alongside them to get to know the needs of the people who used the service. The registered manager confirmed that they did this. They also told us that as a result they had identified areas for improvement and acted upon them to improve the service. For example we saw that they had ordered equipment and reviewed existing support plans.

We looked at staffing rotas and spoke to the manager and some staff. We also spoke with people that used the service and observed staff attending to them. Two people told us that they had to wait for long periods of time for the assistance of two care staff. We observed people waiting and staff told us there were key times in every day when more staff were needed. The manager confirmed the staffing levels we reported in August 2013 had not been maintained on a regular basis, although they were on the morning we visited.

Following our visit, the manager confirmed that staffing levels would return to previously reported levels, but we have not seen evidence of dependency levels being used as the basis for deciding how many staff were needed so that people's needs could be met in a timely fashion.

We received a report from the provider and this stated that they were recruiting more care assistants. They told us they would make sure agreed staffing levels were maintained.

When we visited on this occasion, one of the care staff said, "It's much better than it used to be, now that we always have enough staff." We looked at the staffing rotas and these confirmed there were always at least five care assistants with a senior care worker on each day shift.

We found there was at least one care assistant in the main lounge throughout the time we were there. Two people that used the service told us there was always someone in the room to help people. We spoke with three other people in another lounge and one of them had access to a call bell should any of them need assistance.

We looked at the recruitment files for new staff and saw that suitably experienced people had been recruited.

We saw and heard care staff asking people for their consent as they provided them with assistance. One person told us, "They always ask me what I want to do." Another person told us, "When I first came here they asked me how I wanted them to help me. I don't have to do anything I don't want to."

We found that people experienced positive care and support to meet their basic needs. One person told us, "The best thing I ever did was to come in here. They helped me to start walking again."

We saw that staff took care to keep people safe when assisting people to transfer to wheelchairs and move around the home.

Regular visitors to the home told us the premises were always kept very clean and we found there were effective systems in place to reduce the risk and spread of infection.

Visiting relatives expressed concerns that there did not seem to be enough staff, especially at weekends, and we found the staff on duty were working continuously to meet people's basic needs. Some staff were on holiday and more staff were needed on the early shift each day in order to meet people's needs more effectively.

We found arrangements were in place to maintain accurate and appropriate records, which were all kept securely.