Swarthmore Housing Society Limited

About the service

Swarthmore Housing Society Limited is a residential care home it is registered to provide personal and nursing care for up to 40 people. At the time of the inspection 29 older adults were being supported. Accommodation is located over two floors in one adapted building. People had access to extensive well-maintained gardens.

People’s experience of using this service and what we found

Medicines were not always being managed in line with current best practice.

Systems of governance and oversight were not sufficiently robust to have identified the issues we found in relation to managing risks and the management of medicines.

Risk management was not always comprehensive and up to date. People who had been identified at risk did not always have documentation in place to guide staff.

Several people did not have current and up to date Deprivation of Liberty Safeguards in place. However, we were aware this had been applied for within the specified time to the local authority.

Records were not always completed correctly to document the support people were given.

People’s care plans did not always reflect their support needs. Some care plans had conflicting information recorded.

People were supported to follow their interests and take part in activities that were socially relevant to them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had a choice of food and specific dietary requirements were catered for.

The management was aware of the culture of the service. We were aware there were ongoing issues relating to a member of staff. Where performance of staff was an issue this was dealt with accordingly. The service promoted and supported fairness and an open culture for staff to air their views and concerns.

Staff received safeguarding training when they first joined the service. Staff we spoke with told us they knew what abuse was and they would report any concerns following the correct procedure.

Staff were caring and respected people as individuals. Staff ensured people’s privacy and dignity needs were respected during personal care. People could be as independent as they wanted to be.

People and relatives spoke highly about the service and said Swarthmore was … “A great place to live” One person commented, “I am as happy as I would be anywhere.”

There was a wide range of activities for people to engage in and to follow their hobbies. The service encouraged people to take active roles in their community.

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

Rating at last inspection

The last rating for this service was Good (published10 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This residential home is registered to accommodate up to 40 older people. At the time of the inspection there were 31 people living in the home. There was a registered manager in place.

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.

Just prior to this inspection the home had an outbreak of diarrhoea and vomiting. This affected both the people living in the home and staff members. The infection was dealt with quickly and effectively but had an impact on the number of regular staff working in the home. Agency staff were used to cover for staff absences. The home had infection control policies available and these were effective throughout the outbreak. Staff had received training in infection control and how to prevent cross contamination.

Where people required assistance with medicines, these were administered by trained staff. The home had a medicine policy and this was adhered to. Medicines were stored securely, and only appropriately trained staff had access to them. We found some gaps in the guidance information for staff for “As required” medicines.

People’s safety and well-being had been considered by the service and steps had been taken to ensure that any risk of harm had been assessed. Environmental risk assessments were in place alongside risk assessments related to the care provided for people.

Staff knew how to report concerns of abuse. They had received training in how to safeguard people. Staff knew how to whistle blow and had no reservations about doing so if they had concerns. Learning had taken place from safeguarding concerns, complaints, accidents and incidents to improve the service to people. We saw actions had been taken following a safeguarding concern and staff were fully engaged with the learning from this incident.

Recruitment systems were in place to ensure people were protected as far as possible from unsuitable staff.

There were mixed responses regarding the food on offer in the home. People were involved in the planning of the menus and were satisfied they were provided with an additional option if they did not like the food on offer on any particular day.

We observed poor practice with regards to people’s choice, dignity and comfort during meal times. We observed one person was not given any choice about how their food was presented to them, for example the food was mixed together on the plate. People were not always seated in a good position to eat their food safely and comfortably. We have made a recommendation to the provider about person centred care. However, most people appeared to enjoy their food and drinks were readily available throughout the day.

Staff received support through training, induction and supervision. Staff told us they felt supported in their role and from our observations we could see the registered manager had a good rapport with staff and people. Staff felt the registered manager was approachable and staff were confident to raise concerns or issues.

Staff were knowledgeable about the Mental Capacity Act 2005 (MCA) and the deprivation of liberty Safeguards. (DoLS). They understood how this applied to their work and the lives of the people they cared for. The home was working within the principles of the Act.

People told us and we observed staff were caring and kind. Their interactions were positive with people, they showed patience and spoke respectfully to people.

Activities were available to people. Some people enjoyed the activities whilst others preferred to spend time on their own. Where people could not join in activities they were visited in their rooms by staff. This protected people from the risk of social isolation.

Care records were comprehensive. Care and support was planned and delivered in a way that ensured people’s safety and welfare. Risk assessments were completed in all the files we looked at. This ensured people received appropriate care.

The provider had in place a complaints procedure, which enabled people to raise complaints or concerns. Staff knew how to respond to complaints. People were able to raise complaints through the residents meetings or directly to staff or the registered manager.

We observed a team of staff who worked well together and supported each other. The registered manager was accessible and staff were confident in their abilities to manage the service.

An improvement plan was in place in the home. The registered manager and staff had engaged well with professionals who had come into the home to suggest how they could improve the quality of the care and ensure people’s safety and wellbeing.

We found there was good regard for people's care and welfare. Each person had a care plan which outlined their needs and the support they required. Risk assessments were in place to identify and help minimise risks associated with providing personal care and support. We saw people had access to a range of external professionals to help meet their healthcare needs.

There were systems in place to manage people's medication safely. We observed a medication round and found staff followed the home's procedures. People we spoke with said they received their medicines appropriately.

We looked at how staff were supported. We saw new staff undertook a detailed induction. Training was provided to ensure staff had the skills and knowledge they needed for their roles. We found supervision sessions had not taken place as frequently as the provider expected. However, work was underway to ensure improvements were made in this area.

Care plans were in place to document people's individual needs. Risk assessments had been written to identify and reduce the likelihood of injury or harm. We found people had access to healthcare professionals to help keep them healthy and well. Medicines were managed safely.

Staff undertook a thorough induction. There were on-going training opportunities to update their skills and knowledge. Systems were in place to supervise and appraise staff to make sure their performance was satisfactory.

The home had a statement of purpose in place. It contained all required information. This information is useful to people looking for care services, to help them decide if it can meet their needs.