Sutherlands Nursing Home

Updated 9 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by 2 inspectors. An Expert by Experience supported with telephone calls to people and their families. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Sutherlands Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sutherlands Nursing Home is a care home with nursing care. At the time of our inspection the service was not providing any regulated nursing support. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 2 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

The first day of inspection was unannounced. The second day was announced.

Inspection activity started on 24 January 2023 and ended on 07 February 2023. We visited the service on 24 and 25 January 2023.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We reviewed information received from the provider, including their ongoing action plan. We used all this information to plan our inspection.

During the inspection

We spoke to 4 people receiving support and 7 family members of people receiving support. We spoke with 12 staff in total, this included care staff, home manager, operations director and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed care and medicine administration records (MAR) for 6 people and 2 staff personnel records. We also reviewed other records, including policies and procedures, relating to the safety and quality of the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 9 March 2023

About the service

Sutherlands nursing home provides personal care and support for up to 52 people in a purpose built

building. At the time of our inspection the service was not providing any regulated nursing support and there

were 16 people using the service, all residing on the ground floor.

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

Medicines were not well managed. We identified a number of concerns relating to the correct storage of medicated creams, in addition to required paperwork to ensure people received their medicines as intended.

Although governance at the service showed some signs of improvement since our last inspection, enough had not been done at this inspection and we were still concerned that full oversight had not been established.

Healthcare professionals gave mixed feedback on their experience of the service. Some identified failings that had occurred with seeking and following healthcare professionals direction to keep people safe, others felt improvements were now being made and this was supporting people to live safer, more fulfilling lives.

People and family members we spoke with were happy with the support now being offered. They felt staff were approachable and kind and that the manager was contactable if they required support.

Care records had improved since our last inspection. Daily recording evidenced the support people were receiving and sufficient detail was captured to ensure people could be supported consistently.

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 did not support this practice. We observed people being offered choice during both days of inspection, and people told us they were offered choice. However, we identified that capacity assessments themselves required further review and expansion to ensure correct processes were taken when assessing a person's capacity.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider has made some improvements but remains in breach of regulations.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced focused inspection of this service on 14 June 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safe care and treatment of people and the governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sutherlands Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and the governance of the service at this inspection.

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 from the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.