Stone Gables Care Home

Stone Gables is a care home without nursing care, providing accommodation for persons who require personal care for up to 40 people. The service provides support to older people, including people living with dementia. At the time of our inspection there were 23 people using the service. The care home accommodates people across 2 floors in 1 building.

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

The provider's oversight of the service was ineffective. Systems were not in place to support the monitoring and improvement of the service. Managers failed to provide evidential documents during the inspection process. There was a lack of measures in place to help drive improvements at the service.

Medicines were not managed safely. Guidance was not followed when changes were made to people’s medicines and time specific medicines were not given at the correct times. Risks were not being appropriately assessed and managed around challenging behaviours and people’s health. People’s risk assessments were not readily available for staff to read and follow. Referrals to the local authority safeguarding team had been made appropriately. However, follow up actions had not been completed by the provider.

People, staff and relatives did not feel there were enough staff on shift to meet people’s needs. We observed people at lunch time not receiving the support they required. Staff did not receive regular supervisions or appraisals. We were not assured that competency assessments were completed with staff. We observed staff to be kind and respectful to people, but they were very busy and task orientated.

We received positive feedback about the activities on offer and the activities coordinator. During the inspection, we observed people and their relatives participating in activities throughout the day. Relatives were complimentary about the care staff.

Assessments were completed with people before they moved in to Stone Gables and care plans included information on how to support people to meet their needs. People received health and social care support from a range of professionals including GP's, district nursing and social work teams.

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

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

Rating at last inspection

The last rating for this service was good (published 29 November 2019).

Why we inspected

The inspection was prompted due to concerns received about medicines and staffing. A decision was made for us to inspect and examine those risks.

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.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to risk management, management of medicines, staffing and quality assurance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

We found the following examples of good practice.

¿ Staff confidently demonstrated how they used personal protective equipment (PPE) and hand sanitising points were readily accessible before entering and in the home. One member of staff said, “We all wear masks, we have notice's all around the home. Anyone who comes into the home does. The registered manager is on the ball. It’s a lovely home.”

¿ The home was well ventilated and clean; regular cleaning procedures were in place to minimise the risk of infection.

¿ Infection control procedures were understood and implemented by staff.

¿ The service engaged with a regular testing programme and staff were positive in their approach to supporting people with this process.

¿ People were encouraged and supported to keep in contact with family through video links. Staff had supported people to send out personalised Christmas cards to their families.

Further information is in the detailed findings below.

Stone Gables is a residential care home providing personal care for up to 40 people in one building. There was 19 people at the time of the inspection.

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

The new registered manager was responsive to areas of improvements to the service and actively responded to these at the time of inspection.

On the whole we found medicines were managed well. We spoke to the registered manager about further improvements to the systems and processes to ensure this continued to be safe practice. We have made a recommendation in the ‘safe’ section of the full report about risk assessments for certain medication.

There were enough staff on duty to meet people's needs. Agency staff were being used at the service, However, these were consistently the same staff and we saw up to date profiles of these at the service.

Recruitment procedures continued to make sure staff employed were suitable to work with vulnerable people.

Staff supported people in a compassionate and caring way. They encouraged them to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. People we spoke with made positive comments about how staff delivered care. They told us they were happy living at the home and how things had improved since the new manager had come in.

People received safe care and treatment. Assessments had been completed to help make sure risks associated with people's care were identified and managed in a way which respected their choices. People were safeguarded from the risk of abuse. Accidents and incidents were monitored to identify and address any patterns or trends.

Staff had received training they needed to develop and update their skills and knowledge. This was ongoing at the time of inspection. Staff received support in the way of supervisions. The registered manager was looking to complete staff appraisals by the end of the year.

There was a range of social activities and events available for people to take part in if they wished to.

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

Rating at last inspection

This was the first inspection under this new provider which was registered in August 2019.

Why we inspected

This was a planned inspection.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.