The inspection took place on 13 and 14 May 2015 and was unannounced.
Stroud House provides accommodation and care for up to 25 older people, some of whom may also be living with dementia. The home is in a rural location, near Petersfield. There is access to gardens.
Stroud House has 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 said they felt safe. Staff had received safeguarding training and were able to explain how to protect people from abuse and how to report suspected abuse.
People’s individual risks were appropriately assessed and care plans were in plan to mitigate against known risks. The service used good communication methods to ensure that staff were knowledgeable about risks to people and what actions needed to be taken to keep people safe.
There were sufficient staff on duty. People’s needs were met whether they were in communal areas or being cared for in bed.
Staff recruitment and induction practices were safe. Relevant checks were carried out to ensure that suitable staff were recruited.
Medicines were stored and administered safely. Records in relation to medicines were accurate and staff had received training in medicines administration, and had their competency checked regularly.
Staff had received appropriate training to meet people’s needs. Records showed that staff had received training in key areas such as infection control, fire training, moving and handling, food hygiene and health and safety. Staff were supported to study for health and social care vocational qualifications. Staff told us they felt supported in their role.
Staff were knowledgeable about people’s needs and how to support them. Staff said they knew about people’s needs from handovers, care plans, risk assessments, people themselves and their families. We saw that staff interacted with people appropriately and kindly, appearing to know them well as individuals, and treating them accordingly.
People were asked for their consent before care or treatment was provided and the provider acted in accordance with the Mental Capacity Act 2005 (MCA). People made their own decisions where they had the capacity to do this, and their decision was respected.
People were supported to have sufficient to eat and drink and maintain a balanced diet. Drinks were readily available throughout the day and staff encouraged people to drink. For lunch a main meal was offered, with a second choice and a vegetarian option. The chef was knowledgeable about people’s individual requirements such as those people who required a pureed diet, a soft diet or a diabetic diet. We saw that staff maintained a presence in the dining room during lunch, checking that everyone was managing and offering support if needed.
People were supported to maintain good health through access to ongoing health support. Records showed that district nurses, speech and language therapists and the community psychiatric team had been involved in people’s care and referrals were made where appropriate.
Staff were kind and patient with people, using gentle persuasion and encouragement to support them. They took time to listen to people and understand how they were feeling. People’s dignity was respected, staff took time to make sure that little things which were important to people were respected. For example staff checked that hairbrushes were kept clean and people’s clothes were named. Staff had an understanding of people’s abilities and supported independence as much as possible.
People were involved in decisions about their care and were offered choices in all aspects of their daily life. Where they had capacity, people had signed their care plans showing that they agreed with the plan of care.
Staff were able to respond appropriately to people’s needs because they knew them well and understood their care needs. Staff had taken the trouble to get to know people personally so they could respond to their preferences, likes and dislikes providing personalised care. Care plans were reviewed monthly and updated where necessary to ensure that staff were always aware of people’s needs.
The home had been recently renovated and people appreciated and commented on the new décor. A wall had been knocked down to create a large living space which suited people’s needs more effectively. The provider had responded to the need to improve the environment within the home and this had had a positive outcome.
People were able to engage in different activities, such as scrabble, bingo or arts and crafts. Harp therapy was available for people as a soothing activity.
The provider had a complaints procedure which detailed how complaints should be dealt with. There were a small number of complaints and all had been dealt with appropriately.
The atmosphere in the home was friendly and easy going. The registered manager was passionate about the home and keen to make improvements. There was a family feeling amongst staff who were united and keen to ensure people were happy and well cared for. Staff felt valued and involved in decision-making and this reflected in the care delivered.
Feedback was sought regularly from people, staff and relatives and was responded to, ensuring continuous improvement to the home.
The registered manager demonstrated good management and leadership. She ensured she was visible ‘on the floor’ on a daily basis. People knew and trusted her.
Policies and management arrangements meant there was a clear structure within the home which ensured the service was effectively run and closely monitored.
The quality of the service was closely monitored through a series of audits of care plans, the kitchen, infection control, health and safety, falls and medicines.