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Inspection carried out on 7 June 2018

During a routine inspection

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 an

Inspection carried out on 19 January 2016

During a routine inspection

We inspected Stanbridge House on 19 January 2016. This was an unannounced inspection. Stanbridge House is a residential care home that provides accommodation and support for up to 27 people. The people living there are older people with a range of physical, mental health needs and some people living with dementia. On the day of our inspection there were 26 people living at the home. Stanbridge House does not provide nursing care. Stanbridge House is a large detached House with an attached ground floor wing. People’s bedrooms were situated on the ground and first floor. The house is set within a large landscaped garden with accessible pathways.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. On the day of our inspection the registered manger was on holiday but the deputy manager was available to provide the information we needed.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care

tasks before they proceeded. However there was no formal specific recording where someone may lack capacity to make day to day decisions regarding their care and support. This is an area that needs improvement.

Staff were appropriately trained holding a Diploma in Health and Social Care and had received all essential training. Although staff said that in general they felt supported to carry out their roles they identified that there were few formal supervision sessions with a manager and no formal staff meetings. We confirmed this via looking at records and identified this as an area that needs improvement.

People who lived at Stanbridge House told us they were safe. One person said “I feel safe, I’ve got people around me”. A relative said “My [family member is safe, they can ring their bells, they are answered very quickly, if you ask for help they always come and are always checking on them”. People said they felt safe as they were cared for by staff that knew them well and were aware of the risks associated with their care needs. There were sufficient numbers of staff in place to keep people safe and staff were recruited in line with safe recruitment practices. Medicines were ordered, administered, recorded and disposed of safely. Staff had received training in safeguarding adults.

People could choose what they wanted to eat from a daily menu or request an alternative if wanted. People were asked for their views about the food and were involved in planning the menu. They were encouraged and supported to eat and drink enough to maintain a balanced diet. One person said “The food is excellent and always homemade, staff are always offering you a cup

of tea”.

People were cared for by kind and compassionate staff. People told us how well the staff knew them. One person said “Every carer here is kind”. Another person said “Staff are caring in every way. I have no complaints. People told us that they were offered choices daily and their privacy and dignity was respected.

Care plans provided detailed information about people and were personalised to reflect how they wanted to be cared for. Staff followed clinical guidance and ensured that best practice was followed in care delivery. Daily records showed how people had been cared for and what assistance had been given with their personal care. There was a range of social activities on offer at the home, which people could participate in if they chose. The home had a complaints policy in place and a procedure that ensured people’s complaints were acknowledged and investigated promptly.

The home was well-led by the registered manager and deputy manager.  A positive culture was promoted. People and staff told us that first and foremost Stanbridge House was a home where people were put first. The registered manager told us “We try to make it as homely as possible and to personalise it, it’s all about the client”.  There was a range of audit tools and processes in place to monitor the care that was delivered, ensuring a high quality of care. These included monthly reviews of care. People could be involved in developing the home if they wished through questionnaires and residents meetings. 

Inspection carried out on 20 November 2013

During a routine inspection

We spoke with three people who lived at the home and two visitors. They were all satisfied with the care and support they received and were happy living at Stanbridge House. One person told us, "This feels like a home from home". Another said, "I love it here. They (staff) are like family". A visitor told us, "This is a terrific home without doubt". We noted that the home provided a wide variety of social events in both group and individual settings; the people we spoke with were happy with the number and types of activities on offer.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

Inspection carried out on 26 February 2013

During a routine inspection

We spoke with six people, one visitor, three visiting health professionals and five members of staff. People told us that they were well cared for and that they knew who to raise any concerns with. They felt the staff were attentive and responded well to their needs but at the same time maintained their independence. They told us that the staff treated them with respect and nothing was too much trouble.

People were able to make choices about the support they needed and their privacy and dignity were respected and promoted. Consent to care and treatment was recorded appropriately. People experienced care, treatment and support that met their needs and protected their rights. They were protected from the risks of inadequate nutrition and dehydration. People were cared for by staff who were well informed about what constitutes abuse and how to report any concerns. Staff administering medicines were appropriately trained.

The service had effective recruitment and selection processes in place, with enough staff to care for people. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The provider had an effective system to regularly assess and monitor the quality of service that people received. There was an effective complaints system available. People had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint.

Reports under our old system of regulation (including those from before CQC was created)