Archived: Shirwin Court Residential Care Home

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.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We found that care was provided in an environment that was safe, accessible, clean and adequately maintained. People were safe and their health and welfare needs were being met because there were sufficient numbers of staff on duty who had appropriate skills and experience.

We spoke to several people who lived at the home. People told us they felt safe at Shirwin Court. Comments included, ' We are all well looked after and kept safe, we have no worries' and 'Everything is fine, it's like a hotel really and we are kept safe.'

We found that the home's safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. We checked staff training records and saw that staff had received recent training in safeguarding vulnerable adults.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made under this legislation for any person living at Shirwin Court, we found that the provider understood their responsibilities in relation to the law.

We checked people's care plans and found them to be detailed, relevant and up to date. This meant that people were receiving safe and appropriate care.

Is the service effective?

People told us that they were happy with the care they received and the care staff who supported them. We found that most of the care staff had worked at this care home for many years and knew the people they supported very well. Care staff told us that they were well trained, competent and able to safely meet the needs of the people who used the service.

Staff training records showed that staff who prepared meals at the home had received appropriate training in a number of relevant topics including: food hygiene, obesity, diabetes and nutrition. This meant that staff had the appropriate skills and knowledge to ensure that people received nutritious and healthy food and drink.

People's needs were assessed and care and support was planned and delivered in line with their individual care plans. We saw that people had regular access to a range of health and social care professionals which included general practitioners, dentists, chiropodists and opticians

Is the service caring?

People were supported by kind and attentive staff. It was apparent to us during our observations that care staff were attentive, polite and sought consent before providing care and support. We saw that care staff were patient with the people they were supporting and treated them with respect and dignity. People commented, 'The manager and staff are all really good, very caring and considerate.'

We spoke to relatives of people who lived at the home. They were also very complimentary about the standards of care being delivered and the competence of staff delivering care and support. Comments included, 'My relative gets wonderful one to one care, he is content and happy there.'

Is the service responsive?

Records showed that meetings were held between staff and people using the service to discuss ongoing concerns and improvements at the home. We also noted that customer satisfaction questionnaires had been sent out and completed by some people living at the home. This provided useful information to the manager.

We found that care staff had regular meetings with the manager of the home and had the opportunity to discuss their training and development needs, welfare and any concerns they might have about the people they were caring for.

Is the service well-led?

We found that the manager of Shirwin Court and his wife worked at the home on a full time basis and were involved in delivering care and support to the people who lived there.

People who lived at the home and their relatives were very complimentary about the manager and his wife. Comments included, 'The owners are at the home most days providing care, they are really caring' and 'The home is really well run.' Care staff employed at the home told us that the manager and his wife were approachable and that they enjoyed working there.

A check of records showed that the provider had an effective system to regularly assess and monitor the quality of service that people received.

People told us that they were happy with the care they were receiving. Comments included, 'They are as good as gold to me, I wouldn't get any better than this' and 'I feel safe here, everyone is friendly and helpful."

Relatives of people using the service also made complimentary comments about the home. Comments included, 'The owners and staff have been wonderful and they provide excellent care and support.'

Our inspection confirmed much of the feedback we had received. We found the home to be clean, homely and adequately maintained. Our observations and conversations with people using the service confirmed that the staff were attentive, polite and respectful. It was clear that care staff had a good knowledge of all of the people who lived there and were familiar with their preferences and health conditions.

We found that care and support was planned to ensure people's safety. People were safe and their health and welfare needs were being met by care staff who were fit, appropriately qualified and competent.

People were protected from the risks of abuse or unsafe or inappropriate care and support because accurate and appropriate records were maintained and appropriate safeguards were put in place.

People told us, 'Well I love it here, it's really great', 'You couldn't put me in a better place' and 'You can ask for anything here and they will get it for you.'

Relatives of people using the service also made complimentary comments about the home. We were told, 'It is a lovely home, I can't fault it' and 'I know my relative is safe here.'

Our inspection confirmed much of the feedback we had received. We found the home to be clean, homely and well maintained. We found that care and treatment was planned and delivered in a way that ensured people's safety and welfare.

Our observations and conversations with people using the service confirmed that the staff were attentive, polite and that the manager and deputy were approachable and responsive to suggestions and feedback. It was clear that the staff had a good knowledge of all of the people who lived at Shirwin Court and were familiar with their preferences and health conditions.

We saw that people were safe and their health and welfare needs were being met because there were sufficient numbers of staff on duty who had appropriate skills and experience.

We also found that there were good quality checking systems and procedures in place to ensure that people remained safe and secure.