Archived: Smyth House

Updated 28 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Smyth House is a care home for older people, the majority of whom were living with dementia. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager who was also one of the providers. They and the other provider are legally responsible for how the service is run and for the quality and safety of the care provided in line with the Health and Social Care Act 2008 and associated Regulations.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service to ask about their experience of the care provided.

We spoke with the two providers, the cook and two care staff. We looked at three care records in relation to people who used the service. We also looked at staff files and records relating to the management of the service, recruitment, policies, training and systems for monitoring quality.

Updated 28 March 2020

About the service:

Smyth House provides accommodation and personal care for up to 18 older people, some of whom were living with dementia. At the time of our visit 12 people were using the service.

What life is like for people using this service:

Risks in the environment had not been identified and acted on. For example, window restrictors were not in place and checks were not carried out to ensure safe water quality. Risk assessments had not been carried out for the staircases in the property. The temperature of the water coming from taps was too hot and posed the risk of scalding.

The service had not identified shortfalls we found and acted upon these, which meant people had been placed at the risk of potential harm. The management had not made themselves aware of Health and Safety regulations and ensured that the service was compliant with these.

Mental capacity assessments had not been carried out and Deprivation of Liberty Safeguards (DoLS) applications had not been made where these would be appropriate.

Risk assessments were in place which set out the measures staff should take to reduce risks such as pressure ulcers, falls or malnutrition. Care planning contained sufficient information about the care people required so staff knew how to meet their needs.

Care records were personalised and contained sufficient information about people’s preferences, specific routines, their life history and interests. People were provided with individualised support to follow their particular hobbies and interests. People made positive comments about the activities.

Improvements were required to end of life care planning to meet best practice guidance such as that provided by the Gold Standards Framework.

People who live at Smyth House have their needs met by sufficient numbers of suitably trained staff.

Staff and the management team were kind, caring and compassionate. People told us that the staff were kind to them and this confirmed our observations.

People were offered a choice of meals which met their nutritional requirements. The risk of people becoming malnourished was identified, monitored and managed.

People and their representatives were involved in the planning of their care and given opportunities to feedback on the service they received. People’s views were acted upon.

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

Rating at last inspection (and update):

At the last inspection the service was rated Good. (Report published 7 July 2017)

At this inspection we found there were shortfalls that had not been identified and addressed. This included breaches of regulations 11, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.