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Inspection Summary


Overall summary & rating

Good

Updated 7 December 2017

Stewton House is registered to provide accommodation, nursing and personal care for 48 older people. There were 44 people living in the service at the time of our inspection visit.

The service was run by a company that was the registered provider. The company’s area manager was also managing the service and had applied to be registered by us in that role. 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. In this report when we speak about the company we refer to them as being, ‘the registered person’.

At our last comprehensive inspection on 6 September 2016 the overall rating of the service was, ‘Requires Improvement’. This summary rating was the result of us rating our domains ‘safe’, effective’, ‘responsive’ and ‘well led’ as, ‘Requires Improvement’. In relation to our domain ‘safe’, we found that there was a breach of regulations. This was because the registered person had not ensured that sufficient care staff were always deployed to enable people to promptly receive all of the care they needed. The other breach was in connection with our domain ‘effective’. This was because the registered person had not established suitable systems to plan and monitor the delivery of some parts of the care people needed to receive.

After this inspection the registered person wrote to us and explained what they intended to do to address the concerns we had raised. We completed a focused inspection on 11 April 2017 when we found that sufficient progress had been made to meet the two breaches of regulations. However, we did not change the ratings of the domains in question. This was because we needed to see that the improvements would be maintained. As a result the overall rating of the service remained as being, ‘Requires Improvement’.

At the present inspection the overall rating of the service was changed to, ‘Good’. We found that most of the improvements had been maintained and we rated each of our domains as being, ‘Good’.

In more detail, there were systems, processes and practices to safeguard people from situations in which they may experience abuse. Most risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, most of the necessary provision had been made to ensure that medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service to support people to stay safe and meet their needs. Background checks had been completed before new nurses and care staff had been appointed. People were protected by the prevention and control of infection and lessons had been learnt when things had gone wrong.

Nurses and care staff had been supported to deliver care in line with current best practice guidance. People enjoyed their meals and were supported to eat and drink enough to maintain a balanced diet. In addition, people had been enabled to receive coordinated and person-centred care when they used or moved between different services. As part of this people had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore, people had benefited from the accommodation being adapted, designed and decorated in a way that met their needs and expectations.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They were also supported to express their views and be actively involved in making decisions about their care as far as poss

Inspection areas

Safe

Good

Updated 7 December 2017

The service was safe.

Nurses and care staff knew how to keep people safe from the risk of abuse including financial mistreatment.

People had been supported to avoid preventable accidents and most untoward events.

Most of the necessary arrangements had been made to ensure that medicines were safely managed.

Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service to support people to stay safe and meet their needs.

Background checks had been completed before new nurses and care staff were appointed.

People were protected by the prevention and control of infection and lessons had been learnt when things had gone wrong.

Effective

Good

Updated 7 December 2017

The service was effective.

Care was delivered in line with current best practice guidance.

People enjoyed their meals and were helped to eat and drink enough to maintain a balanced diet.

People received coordinated care when they used different services and they had received on-going healthcare support.

The accommodation was adapted, designed and decorated to meet people’s needs and expectations.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

Caring

Good

Updated 7 December 2017

The service was caring.

People were treated with kindness, respect and compassion and they were given emotional support when needed.

People were supported to express their views and be actively involved in making decisions about their care as far as possible.

People's privacy, dignity and independence were respected and promoted.

Confidential information was kept private.

Responsive

Good

Updated 7 December 2017

The service was responsive.

People received personalised care that was responsive to their needs.

Positive outcomes were promoted for people who lived with dementia.

People told us that they were offered the opportunity to pursue their hobbies and interests and to take part in a range of social activities.

People’s concerns and complaints were listened and responded to in order to improve the quality of care.

Suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

Well-led

Good

Updated 7 December 2017

The service was well led.

There was an open culture and people benefited from staff understanding their responsibilities so that risks and regulatory requirements were met.

People who used the service, their relatives and staff were engaged and involved in making improvements.

There were suitable arrangements to enable the service to learn, innovate and maintain its sustainability.

Quality checks had been completed and the service worked in partnership with other agencies.