Stafford Hall

Updated 7 December 2022

The inspection

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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Stafford Hall 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. Stafford Hall is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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.

Inspection activity started on 6 October 2022 and ended on 9 November 2022. We visited the location’s service on 10 October and 7 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service, one family member and had email feedback from 6 family members about their experience of the care provided. We used observation to understand people’s experience, especially those who could not talk with us.

We spoke with 10 members of staff including the registered manager, regional operations director, care staff, chef and housekeeping staff. A range of information including care plans, medicines records, staff files in relation to recruitment and records relating to the management of the service were looked at. The provider sent us further information after the site visit as requested.

On the second visit we spoke with 4 people who used the service and 6 staff including the registered manager, support manager and care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 7 December 2022

About the service

Stafford Hall is a residential care home providing personal care and support for up to 40 older people some of whom may be living with dementia. At the time of our inspection 26 people were using the service. The service is set in an adapted building over two floors.

People’s experience of using this service and what we found

There was not always enough staff on duty to meet people’s needs. Contingency plans for replacing staff when they were undertaking training had not been put in place. People did not always receive personalised care to access meaningful activities of their choice and to have a good mealtime experience.

The provider had made improvements to their processes for monitoring the quality and safety of the service since the last inspection. However, these systems were still not robust in addressing the staffing requirements to meet people’s needs.

Safeguarding systems were in place to protect people from harm. People were given their medicines in the right way and at the right time. They were well managed by staff who were competent in their role.

Infection prevention and control measures were in place to prevent the spread of infection. Some lessons had been learnt when things had gone wrong. Staff were safely recruited in line with legal requirements and the provider had completed the appropriate checks prior to them starting work.

Risks to people’s health and wellbeing had been assessed and were recorded and monitored. Care plans provided details of people’s care and support needs.

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.

The provider worked alongside other healthcare professionals in order to support people’s health needs, making referrals and seeking additional support where appropriate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was requires improvement (published 19 August 2021). The service remains rated requires improvement.

At this inspection, we found the provider remained in breach of the regulations.

Why we inspected:

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

We carried out this unannounced inspection on 10 October 2022 to review the key questions of safe and well led only. This was to follow up breaches of the regulations from the last inspection. We had also received concerns in relation to levels of staffing at the service.

At this inspection enough improvement had not been made and the provider was still in breach of the regulations. They sent us information to show improvements made to the service during the inspection.

We carried out a further unannounced inspection on 7 November 2022 to see if improvements the provider said they were taking had been made.

Some improvements had been made to mealtimes and activities, but the provider was still in breach of the regulations and staffing at the service had not been increased to ensure that peoples identified physical, social and emotional needs could be met.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stafford Hall on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staffing and oversight at the service. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.