Solent Mead Care Home

Solent Mead is a residential care home providing personal care to up to 35 people. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection there were 20 people using the service.

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

Feedback we received from people, their relatives, and health professionals was positive. People were well treated and supported to express their views and be involved in making decisions about their care. Staff respected and promoted people’s privacy, dignity and independence. People’s care plans focused on them as individuals and provided care staff with the information to support them in providing personalised care. Relatives told us, “The staff are incredibly friendly” and, “They’re a very caring bunch.” A health professional told us, “I have always found the staff at Solent Mead to be incredibly caring, and sensitive to the needs of the residents.”

The provider and registered manager promoted a positive and inclusive culture that achieved good outcomes for people. Managers and staff were clear about their roles and responsibilities. The service sought and used feedback in order to learn and continuously improve care and worked well in partnership with others. A person told us, “Management couldn’t be better” and a relative said, "There is a lovely atmosphere in the home.” A health professional told us, “Overall, I would say that this service is very well-led, and the staff are very caring. This home is a pleasure to work with.”

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.

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 good (published 14 May 2019).

Why we inspected

We received concerns in relation to how the service was managed and this having an impact on people’s care. As a result, we undertook a focused inspection to review the key questions of caring and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service: Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect.

People told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

The service was responsive to people’s needs and staff listened to what people said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People and when appropriate their families or other representatives were involved in discussions about their care planning. People were encouraged to provide feedback on the service provided both informally and through an annual questionnaire.

People felt the service was well led and were positive about the registered manager who understood the responsibilities of their role.

The quality of the care and treatment people experienced was monitored and action taken to promote people's safety and welfare. Staff felt they would be supported by the management to raise any issues or concerns and spoke positively about the culture and management of the home.

Rating at last inspection: Good. Last report published 4 October 2016.

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection in August 2016.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good. If any concerning information is received, we may inspection sooner.

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

The inspection was unannounced and was carried out on 2 and 5 August 2016 by one inspector.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People and their families told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to respond to and meet people’s needs.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people, were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people in a patient and friendly manner.

The service was responsive to people’s needs and staff listened to what people said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People and, when appropriate, their families or other representatives were involved in discussions about their care planning. People were encouraged to provide feedback on the service provided both informally and through an annual questionnaire.

People and their relatives spoke positively about how the service was managed. Staff felt supported by the management to raise any issues or concerns. The quality of the care and treatment people experienced was monitored and action taken to promote people's safety and welfare. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

During this inspection we spoke with eight people who use the service, a visiting relative, the registered manager, deputy manager, nine staff, and the services manager. We observed support being given and looked at care and support records for four people who use the service.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found '

Is the service safe?

The service was safe because risks associated with the provision of care and support had been assessed, such as in relation to mobility and falls, nutrition and weight. The records showed that any concerns were followed up and appropriate action was taken. This meant that care was planned and delivered in a way that was intended to ensure people's safety and welfare. All eight of the people we spoke with said they felt safe. For example one person said 'I feel very safe and well looked after here'.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DOLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. The safeguards can only be used when there is no other way of supporting a person safely. We saw that the provider had followed the DOLS process in respect of three people who use the service. A copy of the restrictions that had been granted were kept in peoples' care plans, including details of when the DOLS authorisation was due to expire. Assessments involving the person's relatives and external professionals had been carried out to ensure that decisions taken were in the person's best interests.

Is the service effective?

The service was effective because staff were provided with training and relevant qualifications to support them in meeting people's needs. Staff we spoke with demonstrated a good understanding of people's needs and how they should be met. We observed they interacted well with people using the service, promoting a warm and inclusive atmosphere in the home. People who use the service were complimentary about the staff. For example, one person commented 'The staff are excellent. When I press the call bell I never have to wait'.

The service was effective in supporting people to be able to eat and drink sufficient amounts to meet their needs. At lunch time we observed the meal being served and staff providing support for people who use the service. We saw people who required special diets, such as soft, pureed or fortified meals, had their meals marked so that it was clear who it was for. Coloured plates were used, which would be of benefit to people with dementia, who may find it difficult to differentiate objects.

All of the people we spoke with told us the food was good. One person said 'I can get snacks and cakes at any time. You don't go hungry here, the food is very good'. Another person confirmed 'There is always plenty to drink'.

People were cared for in a clean, hygienic environment. We saw relevant policies and procedures were in place and audits were carried out to ensure procedures were effective and adhered to in practice. All areas of the home that we saw during the inspection were clean and there were no odours. We observed that staff washed their hands before serving food and wore plastic gloves and aprons when providing care. People who use the service who we spoke with said they thought the home was kept clean.

Is the service caring?

Throughout the inspection we saw staff were respectful, knocking on doors before entering, bending down to make eye contact with people and explaining what was happening. We observed a member of staff go and talk to a person who appeared confused and distressed. The member of staff sat with the person patiently, held their hand and spoke to them quietly until the person was calmer. People told us that the care staff spent time talking with them.

One person told us 'I am happy here. I am over 90 and can't do a lot but they involve me in the activities. We have lots of fun here and nothing is too much trouble'. Another person said 'I am very happy here, the staff are very kind'.

Is the service responsive?

We saw that people's health needs were monitored and referred to health professionals appropriately. People's care plans had been updated following reviews or when people's needs changed. This helped to ensure that the delivery of care was responsive to people's needs and based on up to date information and guidance.

There was a system in place to monitor and respond to any concerns or complaints about the service.

Is the service well led?

The service was well led because there was an effective system to regularly assess and monitor the quality of service that people receive. The registered manager also told us that she carried out a 'walk around', during which she would observe staff working practices and meet informally with people who use the service. We saw the registered manager kept a diary of these checks and observations, which included early and late shifts and weekends.

One person told us 'We are well looked after here. The manager comes and talks to us and asks if we are happy and feel looked after'. Another person commented 'The manager asks us if we are happy and we are'. We observed that the registered manager knew people's names and spent time talking with them.

Staff we spoke with during the inspection told us they thought the home was well led. One of the staff said 'If you have anything on your mind, you can talk about it. The managers listen to you'.

People told us that staff checked with them before providing any care or support to make sure they were happy with what was planned. We observed that staff supported people in ways that upheld their right to choice and independence. People confirmed that the service was meeting their needs. One person told us they were: 'Well cared for, couldn't be better'. Another person said: 'The care and support is very good'. We observed that staff spent time talking with people who lived in the home.

The service was taking action to ensure that all staff fully understood their responsibilities in relation to reporting safeguarding matters. Staff we spoke with demonstrated their understanding of the procedures for reporting any suspected abuse. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Staff we spoke with confirmed that the normal staffing levels enabled them to meet the assessed needs of people using the service. People living in the home told us that staff understood their needs and supported them appropriately. They said that when they used the call system staff responded quickly. For example one person said: 'I ring the bell and they're out straight away'.