Archived: Shirwin Court Residential Care Home

Updated 1 March 2017

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.

This inspection took place on 13 December 2016 and was unannounced. The inspection team consisted of 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 service.

We asked the local authority and Health Watch if they had any information to share with us about the care provided by the service. As part of our inspection we also checked if the provider had sent us any notifications since our last visit. These are reports of events and incidents the provider is required to notify us about by law, including unexpected deaths and injuries occurring to people receiving care. We used this information to plan what areas we were going to focus on during our inspection visit.

During the inspection we met and spoke with four of the people who lived at the home. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us. We also spent time observing day to day life and the support people were offered. We spoke with three relatives of people and one visiting health professional during the inspection. In addition we spoke with the registered provider, the deputy manager and four members of care staff.

We sampled some records including four people’s care plans, the medicine management processes and the providers systems for staffing, training and for the monitoring and improving the quality of the service.

Updated 1 March 2017

This inspection took place on 13 December 2016 and was unannounced. The service was previously inspected in January 2016. During that inspection breaches of legal requirements were found. The issues identified that the registered provider did not have suitable arrangements to ensure the proper and safe management of medicines and did not have effective systems in place to assess, monitor and mitigate the risks to health, safety and welfare of people who used the service. In addition the registered provider did not ensure that the care and treatment of service users was always provided with the consent of the relevant person. There were ineffective systems in place to monitor the quality of the service. After the inspection, the registered provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. Whilst we found that some improvements had been in some areas, further improvements were needed to ensure compliance with regulations.

The registered manager was present during our inspection. 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.

The management of infection control and prevention and the cleanliness of the environment did not protect people from the risk of harm. Staff knew how to protect people and reduce risks associated with their specific conditions but this information was not always reflected in people’s care records. In some areas of the home the environment would be safer if the removal of clutter were improved. Staff were not consistent with their explanations of the fire procedure. People living at the home told us that they felt supported by staff to keep them safe. Staff had a good working knowledge of how to report any potential safeguarding concerns.

Staff told us that they had received most training required in order to meet the needs of the people they supported. People told us they were offered a choice of meals, but the menus provided were repetitive and lacked variety. People were supported to access healthcare professionals but some records lacked sufficient guidance to ensure people’s health needs were consistently met.

People spoke to us about how genuinely caring and kind staff were towards them. We observed some caring and compassionate practice and staff demonstrated a positive regard for the people they were supporting. People told us they felt involved in decisions about how they wanted their care and support provided and felt listened to. Assessments had been completed to determine people’s capacity to make certain decisions. People said that the staff who supported them maintained their privacy and dignity. People told us that they knew how to complain.

People told us that they were involved in the planning of their care but had not been involved in reviews. Some people and their relatives told us that activities at the home were limited and people were not supported to access their local communities as much as they wanted. There was little evidence to demonstrate how the provider ensured appropriate support and stimulation for people who lived with dementia. We recommend that the service explores the relevant guidance on how to make environments more ‘dementia friendly’ and how to provide meaningful stimulation to people who live with dementia.

We found that whilst there were some systems in place to monitor and improve the quality and safety of the service provided, these were not always effective in ensuring the service was consistently improving and compliant with the regulations. Feedback received had not been analysed to identify trends and to prevent re-occurrence of negative experiences for people. People spoke positively and with warmth about the caring and supportive nature of the registered provider.

You can see what action we told the provider to take at the back of the full version of the report.