Archived: Simonsfield Residential Care Home

At the last inspection on the 16 November 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. The service was meeting all relevant fundamental standards. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Medication was recorded accurately and stored securely. Staff received training and regular competency checks to ensure safe administration.

Risk assessments were completed to consider any potential risk to people and accompanying support plans were evaluated regularly. Procedures were in place to monitor and analyse accidents and incidents for future learning and prevention.

Staffing numbers were maintained at a suitable level to support people in a timely manner according to their needs as assessed through a dependency tool. Some people told us they thought the service would benefit from more staff and we raised this with the registered manager at the time of our inspection.

The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely. Staff had received training in 'Safeguarding' to enable them to act if they felt anyone was at risk of harm or abuse and understood the reporting procedures.

Everyone we spoke with felt staff were competent. Staff received relevant training to equip them with the skills and knowledge to complete their job role effectively. Staff felt well supported with their learning and development and felt they could raise any issues both formally and informally.

We spoke to two health professionals during our site visit who spoke positively about the care offered at the home. One visiting health professional approached us to commend staff on their intervention with one person whose well-being had markedly improved since being admitted to the home.

Most people we spoke with were happy with the food served at the home and a variety of drinks was served throughout the day to ensure their hydration needs were met. The dining experience was pleasurable with beautifully laid tables and background music.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were complimentary about staff and told us that staff treated them with dignity and respect. Comments included, “The staff are marvellous” and “They’re always polite and courteous, they treat me very well.” We observed a variety of kind and caring interactions between staff and people who lived at the home. People told us they could have a laugh with staff and this was evident during our inspection.

Care was planned and delivered in way that responded to people's assessed needs. Care plans contained important information on people's personal preferences and monthly evaluations were completed to ensure the service remained responsive to people’s evolving needs.

People enjoyed a range of activities, including days out in the local community using the service’s minibus and theatre trips. The activities co-ordinators catered the activity programme to meet people’s individual preferences and people spoke positively about them. One person commented, “The activities co-ordinator is very good, I like the activities.”

The registered manager had been employed at the home for over 10 years and maintained an active and visible presence at the service. People told us they were approachable and dealt with problems quickly. One commented, “She’s brilliant, everyone loves her. I could talk to her without a doubt. She’ll say, ‘I’ll have a look right now’ and gets things sorted.” Staff also echoed this positive feedback. One commented, “[Registered manager] gets stuck in, they aren’t scared to get their hands dirty, they interact with residents, they are fantastic.”

Opportunities were available for people and their relatives to provide feedback and contribute to service delivery through the use of quality assurance surveys and regular ‘resident and relative’ meetings.

There was a series of audit systems and processes to monitor the quality of the care and improve service delivery. These included a variety of self-assessment tools and an electronic reporting system to ensure managerial oversight of areas such as care plans, medication, accident and incidents and untoward events.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with our statutory requirements.

Further information is in the detailed findings below.

For people who did not have the capacity to make decisions for themselves, staff told us they were able to recognise an individual's facial expressions and body language as a means of understanding what the person wanted, or liked or disliked. This enabled staff to judge if people who used the service were happy with the choices they were given. Care records were written in a way which enabled staff to provide an individual service that met the specific needs of each person. Risks had been assessed and managed appropriately.

People told us that they felt safe living in the home. The 'resident satisfaction' surveys completed gave positive comments about the care and support provided. During our visit people told us that the care they received was good. Visiting healthcare professionals also praised the care provided to people living in the home. The provider listened to people's views and took action to improve the service where possible.

The people who lived at Simonsfield were cared for by staff who were appropriately recruited, well trained and experienced at supporting them. We found that staff were happy working at the home and that they had received relevant training for their role.

We saw that there were appropriate systems in place to monitor the quality of care that people received at the home and we were told that the manager was approachable and responded to comments and suggestions made by people, their relatives and members of staff.

Five people living in the home told us that they were able to make choices and express preferences about their care and support. They told us they could choose what they did with their time each day

For people who did not have the capacity to make decisions for themselves, two care staff told us they had developed skills in recognising individual's facial expressions and body language as a means to understanding what the person liked or disliked. This helped staff to understand if people were happy with the care options they were being presented with.

Care plans were written in a person centred manner to enable care staff to provide a personalised service that met the specific needs of each individual. Risks to the safe delivery of care had been assessed and managed appropriately. Seven people told us that they felt safe living in the home.

Satisfaction surveys completed by people using the service gave positive comments about the care and support provided and during our visit a person told us that the care they received was good. A district nurse and diabetic nurse we spoke with also praised the care provided to people living in the home.

The provider listened to people's views and took action to improve the service where possible.