Background to this inspection
Updated
11 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 15 December 2015 and was unannounced. The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed information we held about the service. This included statutory notifications the registered manager had sent us. We looked at information received from people that used the service and their relatives, from the local authority commissioners and the statutory notifications the registered manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority. On this occasion we had not asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt relevant with us.
We spoke with nine people living in the home, four relatives, four members of the care staff, and the manager. We did this to gain views about the care and to ensure that the required standards were being met.
We spent time observing care in the communal areas to see how the staff interacted with the people living in the home. Most people were able to speak with us about the care and support they received. However, for people who were unable to speak to us, we used our short observational framework tool (SOFI) to help us understand their experience of care.
We looked at the care records for three people to see if they accurately reflected the way people were cared for. We also looked at records relating to the management of the service, including quality checks, training records and staff rotas.
Updated
11 February 2016
This inspection took place on 15 December 2015 and was unannounced. Our last inspection took place on 26 March 2015 and at the time we found the service was not meeting the regulations associated with the consent to care and treatment. At this inspection, we found that the required improvements had been made
Shenstone Hall provides accommodation and nursing care for up to 36 people. At the time of the inspection, 19 people were using the service. There was a registered manager at the service. 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.
Improvements had been made to ensure the manager and staff sought people’s consent and made decisions that were in their best interest. People told us they were able to make choices about their care and support.
The provider determined staffing levels on the number of people living in the home instead of on an assessment of people’s needs. This meant people sometimes waited longer for support when they needed the assistance of two members of staff. The provider ensured staff were suitable to work with people and staff recognised their responsibilities to keep people same from harm. People received their medicines as prescribed but improvements were needed to the management of medicines .
Further improvements were needed to ensure the systems to assess and monitor the quality and safety of the service were effective in identifying shortfalls and driving continuous improvement.
Staff received an induction and ongoing support which enabled them to meet the needs of the people they were caring for. We saw that staff were kind and caring and respected people’s privacy and dignity and promoted their independence. Staff told us they felt supported by the manager and we saw they took action to address concerns.
People received food and drink that met their nutritional needs and received support from other healthcare professionals to maintain their day to day health. Staff knew people’s needs and preferences and people received personalised support. People were offered opportunities to take part in social activities both in the home and in the wider community. People were supported to maintain the relationships which were important to them.
People and their relatives knew how to make a complaint and were encouraged to express their views about the service and where appropriate, changes were made in response to their feedback.