Archived: Shaw Side Care Home

Updated 12 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The service met the regulations we inspected at our last inspection in October 2013.

The inspection took place on 14, 15 and 16 March 2016. Our visit on 14 March was unannounced. The inspection team consisted of four inspectors and a specialist advisor in tissue viability.

Prior to the inspection we reviewed information we held about the service, including the notifications the CQC had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also reviewed the inspection report from the previous inspection and contacted the Local Authority (LA), the local NHS Clinical Commissioning Group (CCG), two local General Practitioners (GPs), NHS Community Dieticians and NHS Tissue Viability Service for their comments about the service. Comments we received from them included concerns about poor communication and the provision of urgent medication. During our inspection we did not find evidence of poor communication. However we found that there were problems with the provision of urgent medication.

Some of the people living at the home were unable to give their verbal opinion about the care and support they received. Therefore we examined people’s care records and observed the care and support being provided to them in communal areas to capture their experiences.

During our inspection of the home we spoke with 20 people who used the service, six relatives, the management team, including the registered manager, 23 of the care staff, the cook, a house keeper and the maintenance worker.

We looked around the buildings, observed how staff cared for and supported people, reviewed records and looked at other information which helped us assess how people’s care needs were met. We spent time observing the lunchtime meals and watched the administration of medication to check that this was done safely.

As part of the inspection we reviewed the care records of 13 people living in the home. The records included their care plans and risk assessments. We looked at four staff files, which included their recruitment checks. We also reviewed other information about the service, such as quality assurance records, staff rotas, complaints and policies and procedures.

Updated 12 August 2016

This inspection took place on the 14, 15 and 16 March 2016. Our visit on the 14 March was unannounced.

We last inspected Shaw Side Residential and Nursing home in October 2013. At that inspection we found that the service was meeting all the regulations we assessed.

Shaw Side Residential and Nursing Home is a care home which provides residential and nursing care for up to 150 service users and is owned by Bupa Care Homes. Care is provided in five separate purpose- built houses, set within landscaped gardens. Each house can accommodate up to 30 people and caters for different needs: Miller House and Royton House both provide residential and nursing care, Oldham House provides nursing care for people with dementia and Beech House provides residential care for people with dementia. At the time of our inspection there were 131 people living at the home.

When we visited the service a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

In all the communal areas of the houses we found there were issues regarding the level of cleanliness and maintenance of some equipment. Some of the furnishings of the home were in need of repair or redecoration.

Some pressure relieving mattresses had not been maintained to an adequate standard to ensure that they functioned safely and protected people from the risk of infection.

Regular safety checks were carried out on the environment and equipment of the home but these had not identified the poor quality of some of the pressure relieving mattresses. There were on-going problems with the functioning of the nurse call bell system, which meant that when it was faulty people who used the service were not always able to summon assistance when needed. A new call bell system was scheduled to be installed later in the year.

Staff had an understanding of safeguarding procedures and what action they should take in order to protect vulnerable people in their care. Risk assessments had been completed to show how people should be supported with everyday risks, such as risks to their nutrition or mobility.

Recruitment checks had been carried out on all staff to ensure they were suitable to work in a care setting with vulnerable people.

We found that people who used the service and staff did not feel there were always sufficient staff available to provide high quality care.

Medicines were administered by staff who had received appropriate training. However, we observed that medicines were not always given at the correct time and that doses were not always evenly spaced. This meant that people might not receive the optimum benefit from their medication. In addition, there were problems with the delivery of some medication from the pharmacy used by the service, which meant that medication was not always delivered when required.

Staff had undertaken a variety of training to ensure they had the skills and knowledge required for their roles. Although staff received supervision to monitor the standard of their work and identify any problems they might have, this was not carried out in line with the Bupa supervision policy.

Staff understood the importance of encouraging people to make choices where they were able and sought consent before undertaking any care. We saw that overall staff were kind and patient with people who used the service. Care plans we looked at were ‘person-centred’ and had been reviewed regularly.

People were supported to eat and drink sufficient amounts to meet their needs and people told us the food was good.

Activity coordinators organised a variety of different activities for people who used the service, although staff told us that they did not always have time to participate in activities or spend time chatting to people due to the pressure of their work-load.

Members of staff we spoke with told us they found the registered manager to be supportive and approachable, but we found there was a negative ‘us and them’ attitude amongst staff in two of the houses. Carers expressed the view that the majority of ‘hands on’ care fell to them, as the nurses’ time was spent administering medication and completing paperwork.

Systems were in place to regularly monitor different aspects of the service, such as completion of medication records and care plans and the maintenance of equipment. However, these systems had not always identified where failings had occurred in the maintenance of equipment.

Complaints were investigated and responded to appropriately, although the complaints procedure was not adequately displayed in all five houses.