Background to this inspection
Updated
11 November 2020
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 Care Act 2014.
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
Two inspectors visited the service on 24 September 2020 and a medicines inspector visited on 25 September 2020. An Expert by Experience made telephone calls to relatives of people living at the service on 23 September 2020. 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
Steeton Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because we wanted the registered manager to send us some documentation prior to the visit. We also needed to check the infection status of the home in relation to COVID-19.
Inspection activity started on 23 September 2020 and ended on 2 October 2020. We visited the location on 24 September 2020.
What we did before inspection
We had not asked the provider to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. To reduce the amount of time we spent in the service due to the current pandemic, we requested information and documentation about the service prior to our visit. We used all of this information to plan our inspection.
During the inspection
We spoke on the telephone with ten people’s relatives about their experience of the care provided. None of the people living at the home at the time of our inspection were able to, or did not wish to, tell us about their experiences over the telephone. We spoke with seven members of staff including the provider, registered manager, deputy manager, nurses and care workers. This inspection was completed in line with current infection control guidelines.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and other records relating to the service.
Updated
11 November 2020
About the service
Steeton Court is a care home providing personal and nursing care to older people and people living with dementia or physical disabilities. At the time of the inspection there were 19 people using the service which can accommodate up to 65 people in this purpose built two storey home.
Rating at last inspection and update: The last rating for this service was inadequate (published 6 December 2019) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since December 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Steeton Court Nursing Home on our website at www.cqc.org.uk.
People’s experience of using this service and what we found
People received safe care and support because systems for assessing and managing risk were robust and staff knew how to safeguard people. Care plans included up to date and comprehensive individual risk assessments which gave staff the information they needed to maintain people’s safety.
New and emerging risks including the effects of COVID-19 had been assessed. Improvements had been made to the systems for managing medicines and regular auditing meant these systems remained safe.
Clear processes were in place to prevent and control infection within the home. The provider had been proactive in following government and local guidance in relation to managing the COVID-19 pandemic.
Systems for recruitment of new staff were safe. Staffing was well organised and was appropriate to the needs of people using the service. Staff received the training and support they needed to care for and support people safely and effectively.
People’s nutritional needs and preferences were assessed, and plans put in place to make sure they were met.
People were supported to have maximum choice and control of their lives and the provider had made improvements in systems for assessing people’s capacity to make decisions. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider assessed peoples’ needs before they began to use the service and regular reviews took place to make sure care plans reflected people’s current needs. People were supported by a range of health and social care professionals to maintain their overall health and wellbeing.
People were supported to make decisions about their care and care plans reflected a person- centred approach.
People were treated with kindness and consideration and care was delivered in way which met people’s dignity and independence needs.
People were supported to maintain relationships to avoid social isolation during the pandemic. Complaints about the service were managed effectively.
Changes in management systems had been effective in improving quality assurance systems. Analysis of accidents and incidents enabled the provider to learn lessons from previous events and implement positive change.
People were unanimous in their feedback in relation to the improvements made at the service. One relative said “I can’t praise enough the improvements. There has been a very noticeable change in the home.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.