17 January 2023
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.
One inspector carried out this inspection.
Service and service type
Stroud House 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. Stroud House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We used all this information to plan our inspection.
During the inspection
We spoke with five people, nine relatives and two professionals to get their feedback about the quality of care and support people received. We spoke with eight members of staff including the registered manager, head of care, senior care assistants, care assistants and a housekeeper. We reviewed a range of records. This included support planning documentation for five people and multiple medicines records. We looked at six staff files in relation to recruitment. We also reviewed a variety of records relating to the management of the service, including risk assessments, quality assurance records, training data and policies and procedures.
17 January 2023
About the service
Stroud House is a residential care home providing accommodation and personal care to up to 25 people. The service provides support to adults over 65 years who may also be living with dementia. At the time of our inspection there were 20 people using the service.
People’s experience of using this service and what we found
We had received concerns relating to unsafe staffing levels. We inspected the service unannounced. Staffing levels had been determined by assessing people’s level of dependency. During the inspection we observed safe staffing levels and staff appeared unhurried and available to meet people’s support needs. Feedback from people and relatives confirmed they felt people received safe care. Staff told us care plans contained accurate information about people’s needs and care related risks. People received their medicines safely in line with their preferences and by staff who knew them well.
People and their relatives were positive about the quality of care and support people received. People experienced care that was personalised. We saw a warm and caring approach by staff with positive and kind interactions between staff and people. Relatives consistently told us people were treated with respect. The home provided a range of activities and relatives were encouraged to join in. The provider had developed an approach which optimised the opportunities for engagement in activities.
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 supported this practice. People's needs were assessed, regularly reviewed and included their physical, mental health and social needs. We saw evidence of people's and relative's involvement in care assessments and reviews. People were supported to have choices of meals and were able to make personalised requests.
People and relatives felt staff were well trained. There was a strong emphasis on the importance of training and induction. Training was regularly refreshed and updated. Staff were able to access specialised training courses. The service worked with other organisations to ensure they delivered joined-up care and support and people had access to healthcare services when they needed it.
Relatives told us they felt the home was homely and we saw the environment was designed to support people to move around safely. People could freely access the shared spaces and corridors and go out into the grounds and gardens without any restrictions when they wanted to. Staff were knowledgeable about the MCA and how to protect people's human rights.
The registered manager was pro-active in ensuring they were visible within the home and operated an open-door policy. The feedback we received from people and relatives was positive, expressing confidence in management, leadership and care delivery. The registered manager got to know staff and staff were encouraged to make suggestions and were listened to. The service was well-led by a registered manager and senior team whose passion and drive to deliver a good service, leading by example, was evident.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 31 January 2018).
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stroud House on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.