Archived: Shaw Side Care Home

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.

We looked at seven peoples' care plans. One person living at the home told us "Everything is satisfactory here. I am involved with my care plans and if I needed to complain I would talk to [the house manager]". Another person said "I've been living here for five years. Yes I have an input to my care plan".

Care plans were person centred and took account of individual choice and preference. Where risks were identified assessments were in place to eliminate or minimise the risk of harm occurring. One person told us "I am quite happy here. I feel very safe and the staff are very nice and helpful". Another said "I enjoy it here. I get involved with all that is going on".

We asked healthcare professionals about their experience of visiting the home. People told us the quality of their experience "varied greatly" depending upon the house they visited. People consistently gave us positive feedback about three of the houses. The feedback was less positive with regard to the other two.

There were sufficient numbers of suitably qualified, skilled and experienced staff employed for the purpose of carrying on the regulated activity. The provider had arrangements in place to support staff with training, supervision and appraisal.

We spoke with three people staying at the home and with visiting relatives of three people. One person said 'I am fine here'. Another person said 'The staff do listen to you. I get up and go to bed when I want'. A visiting relative told us 'I can't fault it here' and another visitor said 'I think the care is very good'.

People told us that they were involved in their care [as far as they were able] and visitors told us that they were kept up to date about their relative's welfare. People told us that they felt confident to raise any concerns or complaints with staff and the manager.

People told us that 'The food was very good'. We saw that people were offered a range of choices at each meal times and appropriate records were maintained.

We saw that there were sufficient staff to meet people's needs in a timely manner. Care records showed that people's health and social care needs were assessed and reviewed regularly.

Staff demonstrated a good understanding of how to meet the specific care needs of people and they confirmed that they received regular training.