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Archived: Slate House Residential Home

Overall: Requires improvement read more about inspection ratings

26 Wellington Road, Sandhurst, Berkshire, GU47 9AN (01344) 773358

Provided and run by:
Mrs Liza Sabrina Khan & Mr Nasar Khan & Mr Ahmed Isaac Beeharry & Mrs Anne-Marie Antoinette Beeharry

All Inspections

27 October 2014

During a routine inspection

This was an unannounced inspection which took place 27 October 2014.

At the last inspection of Slate House Residential Home in October 2013 we found no concerns.

Slate House Residential Home is registered to provide accommodation for up to 13 people. The home specialises in the care of older people, some of whom may be living with dementia. At the time of the inspection 9 people were living at Slate House Residential Home.

The home has a registered manager. 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.

Although people and their relatives told us they felt safe and did not raise staffing levels as an issue in the day to day running of the home we found there were insufficient staff to ensure people’s safety. We looked at the provider’s duty rotas and found there were a number of shifts understaffed.

In their training and development policy the provider stated emergency first aid was a core module for all staff. We found that five out of eleven members of staff had either not completed the training or their training was out of date. There was a risk that people would not receive appropriate support in the event of a medical emergency.

Whilst medicines were stored and disposed of safely we saw that the care staff responsible for administering medication were also expected to manage a mealtime activity. There were seven people eating and minimal assistance was available from other care staff. There was a risk that the care worker would be distracted and a medication error could occur.

The provider had not reviewed the Statement of Purpose for Slate House since appointing the registered manager. Therefore we could not be assured current information was available for people and relatives.

Staff were knowledgeable about protecting people from harm and knew what they should do to report abuse or raise concerns if people were at risk of harm. The registered manager had a good understanding of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions for themselves. However, they were not aware of recent changes in practice following a Supreme Court ruling in regard to the Deprivation of Liberty Safeguards (DoLS). The DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty. The registered manager said they would make contact straight away with the local authority DoLS team to seek advice.

People and their relatives were positive about the staff and the care provided. One relative said: “staff are excellent” and another commented on staff consistency and low staff turnover. We saw staff supporting people in a kind and caring manner. We found staff were attentive to people’s needs. Relatives told us staff understood the needs of the people they supported. One relative commented: “Whenever you go, the staff are so kind and genuinely care" and another referred to Slate House as: “home from home.”

Staff received induction training when they began work. Core training was provided however, we saw some staff had not been provided with this training. Staff received regular supervision from the registered manager. They told us they found the registered manager supportive and approachable. However, there was no evidence of the provider conducting annual staff appraisals to provide an opportunity to discuss their work and development.

The décor of the home was tired and worn. We found there was a ‘musty’ smell in the entrance hall and some carpets were stained and in need of replacement. The environment of the home was not designed to be ‘dementia friendly’ and there had been no specific adjustments made for people living with dementia.

People enjoyed their food and relatives told us it was: “absolutely fabulous.” We saw food was fresh, plentiful and served attractively. Special diets were catered for and staff were knowledgeable about people’s nutritional needs.

People had their health risks assessed, these included pressure ulcers, malnutrition and falls. Identified risks were managed with such things as pressure relieving equipment, special diets and mobility aids. However, risks were not always managed appropriately due to insufficient staffing levels at night and people had developed moisture damage. Where necessary health and social care professionals were contacted for advice and support. Professionals were positive about the way staff responded to people’s changing needs.

People, and where appropriate their relatives were involved in planning and making decisions about their care. Staff were provided with guidance to meet people’s individual needs and preferences. People were treated with dignity and respect.

There were systems in place to encourage people to give feedback on the service. Residents meetings were held and satisfaction questionnaires had recently been sent. Relatives said they could post comments in the ‘comment box’ and everyone we spoke to said they would have no hesitation in talking to the registered manager or any of the staff if they had concerns. No-one had cause to make a complaint since the last inspection.

Regular health and safety checks were carried out as well as some audits of the service. However quality assurance systems were not always used effectively to identify areas of the service which may need improvement and there were no records of how the provider monitors the service or the registered manager.

Although a programme of activities was available to people at Slate House we were told activities could not always take place as planned due to staffing levels. One person and several relatives commented on the lack of activities outside of the home and said they would like to see more outings provided. However links to the community were maintained with visits from the mobile library, a minister of religion, the local primary school and a visiting ‘pat dog’.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

4 October 2013

During a routine inspection

On the day of our visit we were met by the registered manager who told us that there were currently ten people residing in the home. Most had varying degrees of dementia. Later on we were joined by the proprietor of the home.

We looked at consent to care and treatment and found that people were always being asked for their permission to have care and treatment provide to them, and had the right to refuse care and treatment. We also found that staff had a proper understanding of mental capacity issues.

We looked at the care and welfare of people who used the service and found they were generally happy with the level of care they were receiving. We also found that a proper system of care planning and management was in place.

We looked at how the provider ensured that people were protected from abuse and found that staff were properly trained in safeguarding, and would be able to identify and report any instances of abuse.

We found that there were appropriate staffing levels in the service and that care staff were qualified to fulfil their roles.

We looked at how the provider ensured a high quality of service, and found that they regularly sought feedback from people who used the service and from staff. We also found they conducted regularly reviews and audits on all aspects of the service, although not all of these were documented.

18 December 2012

During a routine inspection

As part of our inspection we spoke with three people whose relatives used the service.

All three people told us they were 'very happy' with the service and the level of care they provided.

They all told us they thought the staff were very good and very knowledgeable and kind.

They told us they had no concerns about the service but would feel very confident in raising concerns should they have any.

They also told us they believed their relatives to be safe within the home and that the staff would respond appropriately should there be an emergency.