Stoneleigh Residential Care Home Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager and nominated individual led by example. They fostered a culture of learning at the home and a passion to get it right for people and staff. Accidents and incidents were investigated and learning from these was used to support staff to continually improve their practice, reduce risk and keep people safe. The provider had systems to support staff to report and record safety concerns and events. Staff told us how they recorded accidents and incidents on the provider’s electronic care system. They said the registered manager asked for more information if needed and any learning would be fed back to them.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and their relatives described robust processes to support their move to the care home. This included assessments, meetings, and visits to the home before admission. One relative told us, “Oh God yes, they did a great assessment tailored to him. There are lovely staff, they look after him well, he is happy now adjusted to being there, it has been an absolute godsend, I know he is safe, looked after as staff are all brilliant.” Where people’s health declined and they needed specialist care, this transition was considered and planned with people, their families and staff. The registered manager informed us 1 person’s health needs had changed. Following discussions with the person’s relative, it was agreed they would remain at the care home. Health professionals were engaged to provide an air mattress and detailed guidance to ensure their comfort. This collaborative approach supported continuity of care and enabled the person to remain with a consistent staff team.

The service had processes to share information about people if they had to be admitted to hospital in the event of an emergency. A staff member always travelled with people which ensured other healthcare professionals had the information they needed to respond to any risks associated with people’s care. People were re-assessed in hospital before being discharged back to the care home. The registered manager explained, “Before discharge from hospital, we assess each person to ensure we put in place everything they need to return safely to Stoneleigh.” A diary system ensured external routine healthcare appointments were attended and planned for. Staff accompanied people to healthcare appointments or visited them in hospital even if they were being supported by a family member. This was demonstrated during the assessment when the owner excused herself to go to the hospital and support a resident in meeting the occupational therapist. The registered manager told us this promoted continuity of care because, "It is reassuring to our residents during distressing times, and we get to be part of continuous treatment of the person.”

External healthcare professionals expressed confidence in the provider’s processes to ensure good transitions between healthcare providers. One healthcare professional told us, “The manager is attentive and is a frequent attendee at the care home managers meeting, keen to learn about new initiatives and be involved in ensuring her team are kept up to date.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The registered manager and staff understood the different types of abuse and how to safeguard people. Staff consistently explained they would report any concerns to the management team and were confident these would be addressed. A comprehensive safeguarding file recorded incidents and actions taken to reduce risks, including sharing information with the local authority and updating care plans. The registered manager audited these records to ensure appropriate action was taken. The provider notified CQC of all allegations of abuse in line with legislation.

People and relatives told us Stoneleigh residential care home was a safe place to live. One relative said, “I watch the staff with the residents who show an abundance of patience and kindness, no sign of abuse or bad treatment.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. 2 people were under Dols, and an application had been made for 1 person. We found the service was working within the principles of the Mental Capacity Act (MCA) and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. These were kept under review and monitored. People’s capacity and the Deprivation of Liberty Safeguards (DoLS) in place were included in people’s care plans, including what the DoLS meant when supporting people. Where people required support to make decisions this was documented, including how decisions were made in people’s best interests.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The service used robust systems to manage risks to people. This included assessing people’s individual risks and other generic risks at the home.

The registered manager and staff worked proactively to reduce the risk of falls for people. The Manager reviewed falls prevention monthly and annually.Staff worked closely with the health professionals’ team to assess and make recommendations about walking aids and equipment, to minimise the risks of falls. Staff monitored people and remained available in case people required their assistance. A relative commented, “We love how the staff are with mum, and so helpful. No accidents or falls.”

People’s care records contained up to date and accurate information, which ensured staff had access to the guidance they needed to prevent or appropriately manage risks to people, to keep them safe. Staff felt confident they had access to sufficient information to keep people safe. For example, they knew where to access people’s eating and drinking support plans if a person had been assessed as at risk of choking

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Since our last inspection, new areas of the service were built and some existing parts refurbished to include ensuite bathrooms. Areas of the service were decorated to support people living with dementia. The provider told us there were plans to update older areas and we observed refurbishment works in progress. The service was clean, well maintained, and included a well presented, accessible outdoor space. One relative said, “It’s a well maintained and clean building, security is excellent.”

There were dedicated staff responsible for overseeing the premises and a system for staff to report any maintenance issues. Building safety and equipment checks were carried out to ensure the safety of people living within the service, including fire, gas, and electrical checks. A staff member said, “We report everything, they get it fixed right away. They like the residents to be safe.” People using the service, their relatives and staff told us they were satisfied with the environment. One person said, “I can walk around safely in here, I can take myself outside without a bother,” One relative said, “Mum uses a stick, zimmer frame and a wheelchair if out, there are no hazards around, very safe and well-maintained environment.

The provider ensured enough qualified, skilled, and experienced staff were available and gave them effective support, supervision, and development. Staff worked together to deliver safe care that met people’s individual needs. We observed sufficient staff on duty to meet people’s needs.

The registered manager confirmed they had a full staff team and did not use agency staff. “Keeping the same staff is key for continuity of care and building relationships with residents.”People and their relatives spoke warmly about the support they received, praising the care and attention provided. The service used a dependency tool to assess safe staffing levels, and existing staff covered any gaps in the rota. The nominated individual said, “We staff above the dependency tool, which enables us to respond effectively to residents’ needs. For example, residents never wait long for anything, because someone is always available to support them.” Staffing records, we reviewed confirmed there were enough staff. We observed staff being kind and courteous, taking time to gain consent and never appearing rushed.

Staff reported feeling supported and said they received regular supervision. They confirmed completing an induction that included shadowing a colleague and undertaking the provider’s mandatory training. Training records confirmed this. A member of staff told us, “I did not start working alone until I had completed my induction, which included training and shadowing. I was paired with experienced staff until I got to know people and was confident to work alone. They worked at my pace. Always giving me support and showing me what I needed to do.”

Staff had access to sufficient training opportunities, and records showed training was refreshed in line with the provider’s procedure. Overall, staff were competent; we observed appropriate support being provided when people showed signs of distress. A relative said, “Enough staff? yes, a load of them, which is lovely, good ratio, very impressed with the staff so far.” Another relative said, “Same staff always around, enough of them to care for the residents.”

The provider recruited staff safely, completing relevant checks before they started work, including criminal record and employment history checks to ensure suitability for the role. All required documents were in place, such as satisfactory references, and any gaps in employment were explored.Staff received a mix of e-learning and in-person practical and theoretical training, which was regularly refreshed, including competency-based assessments. Staff told us they received regular training relevant to their role. The provider’s training records confirmed this.One member of staff told us they had undertaken training to understand what living with dementia feels like and how much they learned from it. A relative confirmed this, they said,” Staff are well trained, good with dementia”. All staff completed fire warden training, enabling any team member to respond promptly to protect people if required

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service was clean, well maintained and free of malodours. People and their relatives told us the service was regularly cleaned, and staff used personal protective equipment (PPE) appropriately. Relatives said, “Yes, they always were their gloves and aprons.”

Staff told us that spot checks were carried out to ensure PPE was used correctly. They also said they consistently followed PPE guidance and confirmed there was sufficient stock of gloves and aprons for personal care, commenting, “We always use PPE and have enough gloves and aprons to use for personal care.”

The provider’s infection prevention and control policy reflected national guidance. Where the service had recently experienced an outbreak of covid, staff and leaders were able to explain the additional measures they took to ensure this was safely managed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People and their relatives were positive about the management of medicines. A relative told us, “No concerns around her medication, always given correctly at the right time.”

They told us people’s prescribed medicines were regularly reviewed, and staff were responsive when people required pain relief. Records demonstrated people received their medicines as prescribed. Medicines administration records (MARs) were completed accurately, with no unexplained gaps or omissions identified. Medicines were ordered, stored and disposed of safely.

Some people were prescribed medicines on an ‘as required’ basis (PRN). PRN protocols were completed in a person-centred manner, reflecting the GP or the health professionals’ recommendations. Staff demonstrated confidence in administering PRN medication and confirmed they had received appropriate training. People received their medicines from competent, well-trained staff who prioritised safety and reassurance. Staff observed during medication rounds were confident, professional, and patient, allowing people adequate time to take their medicines. Staff administering medication demonstrated a clear understanding of how to report medication errors and escalate incidents appropriately. Records confirmed people’s medicines were reviewed regularly with healthcare professionals. A relative confirmed, “A district nurse visits daily to give [person] Insulin as she is diabetic”.