Archived: Sharmway Private & Residential Home

Sharmway is a small residential care home providing personal care to 11 older people aged 65 and over at the time of the inspection. The service is registered to support up to 11 people.

Sharmway accommodates people in one large, traditional detached house over three floors. Each floor is accessible by stairs only with no lift available. People living at the home share communal bathroom facilities and there are shared bedrooms.

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

People were not consistently safe from the risk of cross infection because the systems and procedures at Sharmway Private & Residential Home were ineffective in identifying improvements needed in maintaining a clean home environment.

People remained at risk of developing contractible illnesses because infection prevention and control practices were not maintained.

The provider's quality monitoring procedures were ineffective in identifying the improvements needed to sustain a clean and safe environment.

Rating at last inspection and update

The last rating for this service was requires improvement (published 02 October 2019) and there were multiple breaches of regulation. We issued a warning notice to the provider to make the necessary improvements. At this inspection we found although there had been improvements made to safeguard the premises against the risk of fire; there were several issues identified around infection control, therefore the provider had remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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

Enforcement

We have identified continued breaches in relation to infection control and how the service is managed at this inspection. In normal circumstances, positive conditions to drive improvement would have been applied to the provider’s registration. However, due to the unprecedented circumstances created by the Covid 19 virus and Government guidelines to CQC, it has been agreed, on this occasion only, we will request updates and evidence from the provider to assure us they have completed the necessary repairs and implemented improvements to maintain the standards of quality and safety. We will work alongside the provider and local authority to monitor their progress.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Sharmway Private & Residential Home provides accommodation and nursing care for up to 11 people some of whom were living with dementia. At the time of our inspection 10 people were living there.

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

People were not safe as the systems and procedures at Sharmway Private & Residential Home were ineffective in identifying improvements needed in safety.

People did not always have individual assessments of risk associated with their care and support.

People were at risk of developing contractible illnesses as effective infection prevention and control practices were not followed.

Not all parts of Sharmway Private & Residential Home were safely maintained.

People did not always have their personal and private information kept confidential.

The provider did not always follow their own procedures for ensuring those they employed continued to be suitable employees.

The provider’s quality monitoring procedures were ineffective in identifying the improvements which were needed to drive good care and support.

People received safe support with their medicines.

People were protected from harm and abuse as the staff team had been trained to recognise potential signs of abuse and understood what to do.

People had information on how to raise concerns and were confident any issues would be addressed correctly.

People were supported to have choice and control of their lives and staff supported them in their best interests; the policies and systems in the service supported this practice.

The provider supported staff through one-to-one supervision.

People had access to additional healthcare services when required.

People were supported to maintain a healthy diet by a staff team which knew their individual likes and dislikes.

People received help and support from a kind and compassionate staff team with whom they had developed positive relationships.

People were supported by staff members who were aware of their individual protected characteristics like age, gender, disability and religion.

People were provided with information in a way they could understand. The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.

The provider, and management team, had good links with the local communities in which people lived.

Rating at last inspection

The last rating for this service was ‘Good’ overall with requires improvement for the ‘Well-Led” domain (published 24 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified two breaches in relation to safety and the overall governance at Sharmway Private & Residential Home.

Please see the action we have told the provider to take at the end of this report.

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.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Sharmway Private and Residential Home provides accommodation and personal care for up to 11 older adults who may have dementia and/or other health conditions. At the time of our inspection ten people lived at the home.

The provider was also the registered manager and was present during our visit. 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.

At our last inspection in November 2015, we found the quality management systems the provider had in place to assess and monitor the quality of the service provided to people required improvement. At this inspection, although there had been some improvement further improvement was required.

The provider reduced the risk of people being harmed and from potential abuse because the safety of people who used the service was taken seriously. Staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Staff understood the various types of abuse, what signs to look for and knew how and who to report any concerns to. Staff also knew what action they needed to take to minimise any potential risk of harm caused through an injury or accident to keep people safe. There were appropriate arrangements in place to ensure peoples’ medicines were obtained and, where appropriate, people were supported to take their medicines safely.

People were supported by staff that had the skills and knowledge to meet people’s individual needs. Suitable staff were recruited and employment checks were completed before they started to work for the service, although the provider did not always follow their recruitment policy. There were sufficient staff numbers on duty to meet the support needs of people living at the home. Staff received training and supervision and staff were happy with the quality of the training and were keen to learn and improve their knowledge base in order to provide effective care.

People had been involved in decisions about their care and received support in line with their care plan. Relatives were also involved in how their family member’s care was planned and delivered. People were encouraged to make choices in the support they received. Staff understood that people have the right to refuse care and that they should not be unlawfully restricted. The provider knew what appropriate action should be taken to protect people’s legal rights.

Staff supported people with snacks and drinks throughout the day. People were offered a choice of meals that they enjoyed. Peoples’ needs were being met because the service worked in partnership with health and social care professionals to meet those needs. People were supported by staff that was caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs. People were involved in group or individual social activities to prevent them from being isolated. People, relatives and staff felt they could speak with the provider about their worries or concerns and felt they would be listened to and were confident the provider would take appropriate action where required.

All the people we spoke with told us positive things about the service they had received. One

person told us "She is good looking after us". All the relatives we spoke with were complimentary about the service. One person told us, 'The care is such good quality. So good and do a wonderful job.' This meant people were happy with the care provided.

Records showed that people needs had been assessed and planned so that people received individualised care. We saw that staff treated people with respect and dignity and people were given choices. Health needs were met by a range of health professionals. One relative told us, 'Can't fault the care.' One person was heard arranging a visit to the doctor the following day with the manager. This meant that people's needs were met.

Recruitment processes ensured that people were protected from

unsuitable staff working at the home. All the staff we spoke with had the skills and knowledge to protect people from harm. We saw that people were comfortable in the presence of staff.

Systems were in place to ensure that staff received the support they needed to care for people safely.

We saw that all the required records were maintained and stored safely.

People we spoke with told us positive things about the service they had received. One person told us "There is not a bad thing about this place, we are well looked after'. Another person said "This is my home now and I love it here". A staff member told us that in their view the home was very good. They said "People are very well cared for, they are happy and safe".

We saw that staff had treated people with respect and dignity. People told us that choices had been offered and their views had been taken into consideration.

People's needs had been assessed by a range of health professionals including doctors and the optician. This meant that people's health care needs had been monitored and met.

We found that people engaged in activities that they enjoyed and were able to observe their chosen religion.

Recruitment processes were robust which meant that people were protected from unsuitable staff working at the home. We saw that staff had received training on a number of subjects which meant that they had up to date knowledge to support the people who lived at the home.

We found that systems had been used to monitor how the home had been run.