17 and 18 March 2015
During a routine inspection
This inspection took place on the 17 and 18 March 2015 and was unannounced. We previously inspected the service on the 10 October 2013. At that time the service was meeting the regulations inspected.
Saxby is a care home which provides accommodation and personal care for up to four people with learning and/or physical disabilities.
At the time of our inspection there were four people living in the home. There was a registered manager in post. 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.
People told us they felt safe. Relatives confirmed they felt their relatives were safe as staff supervision and support was provided for people. Systems were in place to safeguard people. However staff did not follow procedures to ensure changes in people were acted on, reported and medical advice sought where required to promote people’s safety and well-being. Staff did not work in line with infection control guidance either to prevent cross infection. We made a recommendation for the provider to address this.
The home was not suitably maintained which meant areas of the home were in need of updating and refurbishment.
Systems were in place to ensure people had their medicines safely. We saw some gaps in administration of medicines and auditing needed to be increased to address this.
Risks to people, staff and visitors were identified and managed. Care plans were in place which provided guidance for staff on how people were to be supported. We saw people were supported appropriately.
Safe recruitment procedures were in operation. The home had a number of staff vacancies and relied on agency staff to cover the vacancies. They were attempting to recruit into the vacancies and had been successful in filling a number of posts. Staff were suitably trained and supervised although agency staff did not have an induction or training in key areas to ensure they were effective in meeting people’s needs. We made a recommendation for the provider to address this. Staff recognised there had been issues within the staff team but felt these had been addressed and they had agreed a way forward. They were confident team work would improve.
Systems were in place to safeguard people who lacked capacity to make decisions on their care People had access to health professionals and guidance from professionals were followed. People were not weighed in line with the frequency outlined in their records. We made a recommendation for the provider to address this. Records were not available to evidence people had access to routine appointments such as dentists and opticians and this was addressed.
Staff were kind and caring. They had a good understanding of people’s needs. They used people’s means of communication to communicate with them and enable them to make choices and decisions. People were supported to be involved in activities and day to day life at the home. People told us “Staff were nice, they looked after them and took them out”. Relatives told us they were happy with the care provided. One relative described the staff as “wonderful, thoughtful and considerate”. They described Saxby as “a home from home”.
The provider had systems in place to monitor the home and gain feedback from people who used the service and relatives. The monitoring was not always effective as it failed to pick up issues we found in relation to gaps in medication administration, staff practice such as accident/ incident reporting and infection control. Relatives were generally happy with the way the home was run and found the registered manager to be approachable and accessible. One relative raised a number of issues about the management of the home, the support provided to staff and the lack of opportunity for their relative to get out regularly. This was fedback to the provider with the permission of the relative for the provider to act on.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which from the 1 April 2015 is the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.