The inspection took place on 7 June 2018, and was unannounced.
Stanbridge House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can provide accommodation and personal care for 27 people in one detached building that is adapted for the current use. The home provides support for people living with a range of physical, sensory and mental health needs, including people living with dementia. There were 22 people living at the home at the time of our inspection. One person who had been staying at the service for respite left the home during the morning of the inspection.
The service had a registered provider. A registered provider is a person who has registered with the Care Quality Commission to manage the service. Like registered managers, 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.
At the last inspection on 19 January 2016, the service was rated Good. At this inspection we found the service remained Good overall.
The provider’s quality assurance systems and processes were not consistently robust in relation to the recording of medicines guidance to inform staff practice. For example, staff did not always have access to detailed records or guidance to support the safe administration of people’s prescribed or ‘as required’ medicines. However, this did not impact on people’s wellbeing.
People’s capacity was considered in line with the Mental Capacity Act 2005 (MCA) guidance. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies in the service supported this. However, the provider’s quality assurance systems did not consistently ensure people’s capacity to make specific decisions had been fully recorded including; for example, where their capacity may fluctuate. People were supported to have choice and control in their lives by staff that aimed to support them in the least restrictive way. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).
People and relatives told us they felt the service was safe. One person told us, “Since I’ve been here, I’ve never seen any abuse” and “I’m not frightened living here. My family know I’m safe and can come as much as they can and want to.” People remained protected from the risk of abuse because staff understood how to identify and report it.
Staff felt well supported to carry out their roles, and were appropriately trained. The registered provider was open to staff developing their skills and the home further through additional training and discussions in staff meetings.
Staff supported people to eat and drink and their nutritional needs, food preferences and ethical choices were met. One person told us, “The food’s pretty good, and when there is something on the menu I don’t like, they will do something else.” Where special dietary needs were required in relation to people being at risk of malnutrition staff followed guidance given by care plans and the health professionals.
People’s relatives told us and we saw that the staff were attentive, kind and respectful. One person told us, “They are a happy lot of girls here and are very caring.” Care and support provided was personalised and met peoples’ diverse needs. People and their relatives were included in the assessment of their needs and development of care plans that promoted their independence. One person told us, “Staff do sometimes ask about things in my care plan,” and “Yes, I do feel involved in decisions.”
A range of meaningful social activities were offered to people daily. One person told us, “There seems to be enough to do and I enjoy what they put on.” People were also supported to have access to activities with and in their local communities.
Care plans provided information about people and were personalised to reflect how they wanted to be cared for. Daily records showed how people had been cared for and what assistance had been given with their personal care. Health professionals told us that they were very proactive in ensuring people’s health needs were addressed and that treatment plans were followed to ensure their health and wellbeing was maintained.
People when needed received ‘end of life care’ that was responsive to their individual health care needs and respected their wishes. People’s individuality and important relationships were respected.
Feedback received showed people and their relatives were satisfied, and felt that the home was well led and that staff provided good care. People and relatives felt listened to and any concerns or issues they raised were addressed suitably and dealt with in a timely way.