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Yeovil - Sherborne House Care Home Requires improvement

Reports


Inspection carried out on 21 October 2019

During a routine inspection

About the service

Yeovil – Sherborne House Care Home is a care home and provides personal or nursing care for older people and those living with dementia. The home can accommodate a maximum of 38 people. Of the 38 bedrooms, 19 had a sink and a separate toilet, and there were three communal bathrooms spread over two floors. At the time of the inspection 35 people lived at the home. The home also had a separate pathway unit they called “The Wing.” The wing accommodated nine out of the 35 people. This unit was for people who had been discharged from hospital to be assessed prior to them either going home or moving into alternative accommodation. The wing was staffed by two NHS staff members, one occupational therapist, and one physiotherapist. The NHS staff carried out the needs assessments when people came to the home and Altogether Care provided the accommodation and care staff to deliver the regulated activity.

Some people we met at Sherborne House were not able to communicate with us verbally. We therefore used our observations of care, and our discussions with staff, relatives, and professionals to help form our judgements.

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

The service had a home manager but there was no manager registered with the Care Quality Commission. The home manager did not understand their role fully. Quality monitoring systems included audits and regular checks of the environment to ensure people received good care. These were not effective; the service did not have an effective governance system in place

Medicine management was not robust, staff did not follow the providers medicine management policy and people did not receive their medicines safely.

The service did not have a homely feel. Soft furnishings such as curtains were hanging off the rails and people’s rooms were sparse and looked clinical. One person’s room had large chairs in the middle of the room and was not safe. People were all issued with plastic cups and the dining room door was locked to prevent people accessing it during the day.

People were supported by staff that were caring and treated them with dignity and respect. Staff understood the needs of the people they supported and knew them well. All the feedback we received from people, their relatives and healthcare professionals was positive.

Risks of abuse to people were minimised. Assessments of people’s needs identified known risks and risk management guidance was produced for staff which they understood.

The provision of activities within the service was extensive and people could take part in multiple activities, but they did not always reflect personal hobbies and interests.

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 22 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the management of the service, and medicines management, at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 9 May 2017

During a routine inspection

Yeovil – Sherborne House Care Home is registered to provide nursing care and accommodation for 37 people. The home specialises in the care of older people living with dementia.

The home has been extended since the last inspection which has increased the number of beds available from 29 to 37. At the time of this inspection there were 23 people living at the home and no one had moved into the new extension.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good

People were cared for by adequate numbers of staff to meet their needs and maintain their safety. People looked very comfortable and relaxed with the staff who cared for them. People received their medicines safely from registered nurses. A visitor told us, “They are in safe hands.”

People received effective care and support from staff who had the skills and knowledge to meet their specialist needs. Food and drinks served to people were well presented and appeared appetising. One person said, “Food is very good.” People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and caring towards the people who lived at the home. One person said, “Staff are kind and happy.” Another person commented, “Staff are always kind. They look after you.” People or their representatives were involved in decisions about their care and support including the care they wished to receive at the end of their life.

The service was responsive to people’s needs and they were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation.

The home was well led by a registered manager who had an excellent knowledge of people using the service and staff. Staff morale was good which created a happy environment for people. The provider had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.

Further information is in the detailed findings below

Inspection carried out on 7 May 2015

During a routine inspection

This inspection was unannounced and took place on 7 May 2015.

Yeovil – Sherborne House provides accommodation and nursing care to up to 28 people. The home specialises in the care of older people living with dementia.

At our last inspection of the home in February 2014 we found the home needed to improve some areas of the premises to ensure they were safe. The provider sent an action plan outlining the work that had been undertaken to make sure all areas of the building were safe for people who used the service. At this inspection we saw the required work had been carried out.

There is a registered manager in post. 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.

Without exception the registered manager was described as open and approachable. Their office was located in the centre of the home which enabled people and staff to discuss issues with them at any time. The registered manager was very visible in the home and people looked very comfortable and relaxed with them.

People said they were supported by kind and caring staff. One person told us “There are very nice staff here and they are definitely kind.” Another person said “Staff are nice and we all get on.” Throughout the inspection visit staff interacted with people in a kind and friendly manner. Staff sat with people chatting and looking through books and photo albums. One person said “I think it’s a lovely place.”

There were sufficient numbers of staff to meet people’s needs in a relaxed manner. Staff received on-going training to make sure they had up to date knowledge to safely and effectively support people.

One to one and group activities were arranged to make sure people received social stimulation and were assisted to occupy their time. There was a weekly activity programme displayed outside the dining room to let people know what was going on. For people who did not wish to join in with organised activities there were objects around the home for them to interact with.

People received care that was responsive to their needs and personalised to their wishes and preferences. Staff told us there were no strict routines in the home and they liked people to please themselves. One member of staff said “We don’t make people get up or go to bed at a certain time It’s really up to them. We want people to feel they are at home.” People looked very comfortable with the staff who supported them and felt safe at the home. One person told us “The staff are lovely with you.” A visiting relative said “I think they are very safe and happy here.”

Staff respected people’s privacy and made sure people’s dignity was protected. Each person had a single room where they were able to spend time alone or see visitors in private.

People’s nutritional needs were assessed to make sure they received a diet in line with their needs and wishes. Where concerns were highlighted regarding people’s food or fluid intake the staff involved appropriate professionals such as GPs and speech and language therapists. There was always a choice of food and staff assisted people to choose their meal. People were complimentary about the food served at the home. Where people required a specialist diet to meet their needs this was provided.

There were always registered nurses on duty to monitor people’s well-being. People also had access to other healthcare professionals according to their individual needs.

There were annual satisfaction surveys for people who lived at the home and their representatives. The results of the last survey showed a high level of satisfaction with all aspects of the service.

Inspection carried out on 28 February 2014

During a routine inspection

During our visit we spoke we were unable to speak with most people who live in the home due to their complex communication needs. We spoke with the visiting relatives of three people who live in the home.

The relatives of people who live in the home told us that the home assisted them to understand the care choices available to their relatives. Relatives told us that people who live in the home could have their views taken into account in the way their care was delivered. A relative told us, "We have power of attorney. They discuss all their care with us."

We found that people's needs were assessed; and care was planned and delivered to meet people's needs. A person�s relative told us, "My (relative) has been here for three years. The care here has been very good; the staff are helpful, nothings been too much for them.�

We found that people were not fully protected against the risks of the unsuitable design and layout of the property.

People were supported by staff that were appropriately qualified and physically and mentally able to do their job.

People's comments and complaints were listened to and acted on effectively. People could be sure that they would not be discriminated against for making a complaint. A person�s relative told us, "I�ve never had any concerns. I know my (relative) is in safe hands." Another person�s relative told us, �I can�t fault it � I�ve never had any issues. But, if I had any, they would take notice, I�m sure.�

Inspection carried out on 24 January 2013

During a routine inspection

One relative said "When I first came to look around for my wife I was a bit worried that the staff were quite young. I can say now that they are a credit to their profession and I never worry about my wife's care."

The relatives of two people using the service were spoken with and they told us that the staff couldn't do enough for their relative.

The home had sufficient staff working the day we visited to look after people and we observed staff talking and discussing people's care in the staff room. One nurse we spoke with about care plan reviews said "Whilst we formally invite people's relatives to a review we are always chatting and letting them know about things when they visit."

The home had appropriate policies and procedures that staff could use for guidance. One staff member told us "We meet and talk about how we care for people regularly; the audits and documentation here supports that."

However whilst staff were clear about the action they would take if they suspected abuse there was no readily available guidance for them.

Inspection carried out on 8 March 2011

During a routine inspection

Sherborne House specialises in the care of people who have a dementia. The majority of people living at the home are unable to fully express their views verbally.

At the time of the visit there were 25 people living at the home. We spent time during our visit observing care practices, talking with staff, management and visiting relatives.

There is a very relaxed and happy atmosphere in the home. People observed appeared content and well cared for. Staff working at the home were very attentive and showed a good knowledge of the people they worked with. All requests for assistance were dealt with promptly and kindly. When someone became anxious staff were quick to offer reassurance and calm the person.

We saw the main meal of the day being served and this appeared to be enjoyed by most people. Visitors said that the food was always very good and that portions were always ample. We observed that people who required support with meals were helped in an unhurried manner and their dignity was protected.

During the day there was constant interaction between people living and working at the home. We saw that staff explained all actions to people and offered reassurance before any tasks were performed.

There are various activities, some on a one to one basis, and others in a group setting where people are able to participate or observe. During the visit a pancake race was held in the garden which some people took part in and others watched. This appeared to give people pleasure and amusement. Generally people appeared animated and responsive to the staff who supported them.

On the day of the visit the home was clean and fresh and one visitor commented �There are no smells, it�s always very clean.�

There is clear signage throughout the home and objects of reference to assist people to orientate themselves and retain as much independence as possible. People were seen to have unrestricted access to their personal rooms and all communal areas.

At the most recent satisfaction survey carried out by the home 92% of people answered YES to the question �Would you recommend this care home to your friends?� The remaining people responded MAYBE.