We carried out this unannounced inspection on 22 and 24 October 2014.
Sovereign House is a large detached property set in its own grounds. It is a privately owned service providing personal care and support to up to ten older people some of whom are living with dementia. There were nine people receiving support and care at the time of the inspection. People spoke highly of the registered manager and the staff throughout the day, with comments such as “I have no worries about living here, the people are very nice”; “It is a lovely home, they are so nice here” and “I feel safe living here, there is always someone around”. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff interacted well with people, and supported them when they needed it.
The provider organisation is a partnership and one of the partners is the registered manager. 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 and associated Regulations about how the service is run. The registered manager was present for part of the inspection on the 22 October 2014 and for the completion of the inspection on the 24 October 2014.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Seven of the people in the home had been assessed as lacking mental capacity, and there were clear records to show who their representatives were, in order to act on their behalf if complex decisions were needed about their care and treatment.
There were enough staff to make sure that people’s needs were met. Staff had been trained in how to protect people, and discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.
People and their relatives told us that they were involved in their care planning, and that staff supported them in making arrangements to meet their health needs. Visitors said they felt able to talk to staff if there were any problems and people said if they wanted something or were unsure about anything they would ask “one of the lovely girls”.
There were risk assessments in place for the environment, and for each individual person who received care, although not all risk assessments had been updated. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.
People were provided with a nutritious diet. Comments from people included “I have always been a bit fussy with food, but it is really good and plenty of it” and “The food is very good and if you don’t like it, you leave it and they will give you something else”.
Medicines were managed and administered safely. People received their medicines on time.
People were given individual support to take part in their preferred hobbies and interests, such as playing cards and knitting. One person talked about going out to the local shops. The premises included a garden which was accessible and was used for summer events and relaxation.
There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; questionnaires; and daily contact with the registered manager and staff. People said that the registered manager was “Friendly and approachable.”
Recruitment checks were completed and staff files contained the required recruitment information. New staff were taken through a staff induction programme which included basic training subjects. They worked alongside other staff until they had been assessed as being able to work on their own. There were systems in place for ongoing staff training; and for staff one to one meetings and support.
Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or meals were being served.
There were formal processes for actively involving people in making decisions about their care and treatment. The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People felt able to raise any concerns with staff or the management.
The quality of the service was regularly reviewed. Meetings held regularly gave people the opportunity to comment on the quality of the service. People were listened to and their views were taken into account in the way the service was run.