Archived: Selborne Court

Selborne Court is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 20 older people in one adapted building. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. A registered manager was in post at the time of our inspection.

At our previous inspection on 24 October 2017 we found the provider was not meeting the required standards. The provider had not fully implemented systems and processes to monitor the quality and safety of the service to drive improvement within the home. People did not always receive care and support in accordance with their wishes and we identified risks to people’s safety. There was a breach of the legal requirements and improvements were needed across the service. We rated the three key questions of ‘Safe’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. During this inspection visit we checked action taken. Sufficient improvement had been made to address the breach in the regulations and the key questions of ‘Safe’ and ‘Responsive’. Action was in progress to fully address improvement within the key question of well led. We rated the service to be ‘Good’ overall.

Quality monitoring systems had been introduced or improved to gather people’s views and drive improvement of the home. The provider had undertaken some meetings with people and staff. Audit processes had improved following the last inspection but some records did not demonstrate risks were managed well. This included recruitment records, medicine records, accident and incident analysis and health and safety records.

People has access to some social activities which they enjoyed and their religious needs were supported as appropriate. In response to people's feedback a new staff member was being recruited to increase social activity opportunities.

Staff had completed training to make sure they knew how to support people safely and people felt safe were suitably trained. Staff felt confident in their roles and understood their responsibilities. They had regular supervision meetings with the registered manager to assess any ongoing training and development needs.

People felt safe living at Selbourne Court and the atmosphere was relaxed and homely. Staff knew how to recognise signs of abuse and understood their responsibilities to report any concerns. Staff knew people well and knew how to manage risks to keep people safe. No safeguarding incidents had occurred since our last inspection. People knew who to speak with if they had any concerns. When concerns had been raised, they had been investigated and responded to.

The home was clean, and staff understood what was required of them to maintain good infection control within the home.

People were happy living at Selborne Court and were happy with the staff, care, and support they received. People were encouraged to have choice and control of their lives and to make decisions about their care. Staff treated people with kindness and knew what was important and mattered to them including supporting them with their independence.

Staff gained consent before supporting people and respected people’s dignity and right to privacy. People enjoyed the meals provided.

People told us they could access a doctor if they needed one and records confirmed health professionals were contacted promptly when concerns were identified.

People received their medicines as prescribed by suitably trained staff.

The registered manager and staff understood their responsibilities in regard to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Appropriate applications had been made to deprive people of their liberty where this was in their best interests. People and staff described the registered manager as approachable and supportive. The registered manager knew people well.

Staff enjoyed working at the home and felt supported by the registered manager and the provider. Most staff had worked at the home for a number of years so people experienced a consistent staff team who knew people well. Staff referred to the service as being like ‘family’.

Selborne Court is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 20 older people in one adapted building. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. A registered manager was in post at the time of our inspection.

At our previous inspection on 16 and 24 August 2016 we found the provider was not meeting the required standards. The provider did not have systems to monitor the quality of service people received. Records were not sufficiently detailed to demonstrate the care and support required and provided to people. We identified a breach of the legal requirements and found improvements were needed across the service. We rated the three key questions of ‘Effective’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Responsive and Well Led. They sent us details of what actions they proposed to take to address the improvements required. During this inspection we found improvements had not been sufficient. This meant for a third time the key questions of Responsive and Well Led required improvement. In addition we also found improvement was needed to another key question, Safe. The registered manager told us further improvements were planned.

Staff felt they had good communication with people and systems and processes to support the effective running of the home continued to be developed. The provider had arranged and undertaken some meetings with staff and people to gain their views of the service. However, these had not taken place regularly to help continually drive improvement of the home. A quality questionnaire had been developed to assess people’s views of the service but this was to be implemented.

People were happy with the care they received and there was a relaxed and homely atmosphere within the home. People said they felt safe at the home and staff knew how to recognise signs of abuse and understood their responsibilities to report any concerns. There had been no safeguarding incidents of concern that had occurred in the home.

Some people felt more could be done to support their interests and social care needs. This included opportunities to go on outside visits from the home. People had a choice of meals and mealtimes had been made more flexible to meet people’s preferences.

Care plans had been reviewed to make them more person centred and they contained detailed information to support staff in meeting people’s needs. These included risks associated with people’s care.

Staff had completed essential training such as moving and handling people and first aid to support them in their role. Staff were required to complete training on a regular basis to ensure their skills and knowledge was updated.

All the people we spoke with told us they were able to access a doctor if they needed one and records confirmed health professionals were contacted promptly when concerns were identified.

People received their medicines as prescribed and regular checks were made to ensure these were managed safely. Medicines were administered by care staff who had completed medicines training.

The registered manager and staff understood their responsibilities in regards to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Appropriate applications had been made to deprive people of their liberty where this was considered to be in their best interests. Authorisations were still to be confirmed at the time of our visit.

Staff felt supported by the manager and provider and spoke positively of working at the home. There was a consistent staff team at the home and some had worked there for many years.

Selborne Court provides personal care and accommodation for up to 20 older people. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. A registered manager was in post at the time of our inspection but they were not available during our visit.

At our previous inspection on 8 September 2015, we found the provider was not meeting the required standards. This was because people did not receive person centred care, it was not clear what staff training had been completed and some of the management processes were not effective in monitoring the quality of the care and services provided. As a result of the required standards not being met, there were two breaches of legal requirements. The impact this had on people who lived at Selborne Court meant we rated the key question of ‘Effective’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

As the provider had not complied with the required standards, we asked them to take the necessary actions to improve. Following our last inspection the provider sent us an action plan telling us how they were going to do this. During this inspection we checked to see if sufficient action had been taken to improve and address the breaches in the regulations. We found some improvements had been made but these were not sufficient in regards to management processes. Therefore there was a continued breach of the legal requirements. You can see what action we told the provider to take at the back of the full version of the report.

The provider did not have sufficient systems and processes in place to assure themselves that people living at the home received a consistent good quality service that met their needs. Quality monitoring systems had not been fully developed. People were not given opportunities to provide their opinions of the service and share their experiences. There was a lack of effective audit processes to ensure improvements to the service were identified and acted upon in a timely manner, for the benefit of people who lived there. Communication systems across the home were not always effective to ensure staff were kept up to date with issues relating to the operation of the home. Care records were not always clear to demonstrate risks associated with people’s care were being address effectively.

Some work had been undertaken to develop person centred care plans so that staff had clear information about people’s interests and personal preferences about how they wished their care to be delivered. However, we found this information was not always being used to deliver person centred care. For example, ensuring people’s interests were pursued and opportunities were made available to them in relation to their social care needs. Sometimes information gathered about people was not used to enhance their daily lives.

Action had been taken to increase the choices made available to people at mealtimes and people were positive about the food provided. Further improvements were planned in regards to menus and choices.

People received their medicines as prescribed and these were administered by care staff who had completed medicines training.

Staff had completed essential training such as moving and handling people and first aid to support them in their role. Training was completed by staff on an ongoing basis and people felt their care needs were being met by suitably trained staff.

The provider had introduced a new training system that was computerised so that they could monitor staff training completed and ensure staff continued to develop their skills and knowledge. Staff understanding of the health and social care standards and regulations had improved. Staff had also completed training to increase their understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff felt supported by the manager and provider. There was a consistent staff team at the home with some that had worked there for many years. This ensured people were supported by staff who they were familiar with.

People were happy with the care they received and there was a relaxed and homely atmosphere within the home. People told us that staff respected their privacy and dignity when delivering care and we saw this happened. Staff took time to assist people with their personal care needs so that people did not feel rushed.

All the people we spoke with told us they felt safe at the home. Staff knew how to recognise abuse and told us they would report abuse if they observed this happening. There had been no safeguarding incidents that had occurred in the home.

All the people we spoke with told us they were able to access a doctor if they needed one. They told us staff would make an appointment for them. We records that confirmed health professionals visited the home to see people when needed. This included physiotherapists, chiropodists and opticians.

We found sufficient improvements had been made to record keeping. Care plan records contained more detailed information and were being regularly reviewed to make sure they were accurate and up-to-date.

During our visit to Selborne Court we spoke with five of the 17 people living at the home. We also spent time sitting in the lounge observing what daily life was like for people. We saw that people watched television or read the newspapers. Sometimes people talked with one another. People in the lounge looked well cared for. During the afternoon we saw staff arranging to play dominoes with people who had expressed an interest in this.

People told us: 'It's very good.' 'It's quite good, it's not perfect, but what is.' 'It's alright.' People told us their care needs were being sufficiently supported by staff and they felt safe living in the home. We saw that people felt at ease to approach staff and we saw staff were friendly in their approach to people.

We found people had a choice of meals and enjoyed the food provided.

Staff records showed appropriate recruitment checks had been carried out when they had been employed. This was to help ensure staff were deemed safe and suitable to work with vulnerable people living in the home.

The service had a complaints and safeguarding adult policy and procedure. People told us if they had any concerns about anything they would tell a member of staff or the manager. People told us they had no complaints.

We found that improvements were needed to record keeping.