Stoneyford Care Home

Updated 9 April 2024

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

The inspection was carried out by 2 inspectors, a specialist advisor who was a registered nurse and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Stoneyford Care Home 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. Stoneyford Care Home 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. However, this person had tendered their resignation, and a new manager was being inducted to the service.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 28 November 2023 and ended on 6 December 2023. We visited the service on 28 November 2023 and again on the 5 December following receipt of further concerns.

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 the local integrated care board. We contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people living at the home and 9 relatives about their experiences of the care provided. We reviewed in part, 8 people’s care records and multiple medicine records.

We spoke with 18 members of staff including care staff, senior care staff, domestics, maintenance person, activity co-ordinator, administrator, manager, director, and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two visiting external health professionals who visited the service to gather feedback on the care provided.

Following our visit we continued to seek further information related to people’s care records, policies and procedures, staff training, quality monitoring and auditing processes as part of the inspection.

Updated 9 April 2024

About the service

Stoneyford Care Home is a residential care home providing accommodation and personal care to up to 58 people. The service provides support to adults, some of whom were living with dementia. At the time of our inspection there were 33 people living the service. The home had 2 floors and was divided into separate 3 sections. There was a communal garden to the rear of the home.

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

People and staff at the home raised concerns about the care and support they were receiving. People told us they did not feel safe at the home as their care was not delivered safely, timely or in line with their wishes.

People described excessive wait times in response to call bells and a lack of support with personal care such as showering and toileting.

There was a shortage of trained staff which had impacted on the care they were able to offer people. Staff stated they had raised this repeatedly with the registered manager, but no action had been taken.

Care plans were not person centred and did not reflect people’s needs. Risk assessments had failed to fully identify or mitigate risk. This meant that staff did not have the required information to support people in a safe manner nor in line with their wishes. Where risks had been identified, such as pressure care, there was no evidence to show people received support in line with the recommendations which meant that people were at increased risk of ongoing harm.

The home had recently undergone some renovations and people and staff were positive about these changes. However, the cleanliness of the home did not meet standards to control and prevent the spread of infections. Domestic staff were employed but they were often asked to support in other areas of the home due to staffing issues.

People and relatives told us they had raised incidents and complaints with the registered manager and the provider, but limited action had been taken and their concerns had not been fully addressed or formally responded to.

Staff told us there was a blame culture within the home which had hindered their ability to raise concerns. Staff described incidents of being ‘shouted at’ and ‘talked down to’ by the provider. Relatives and a professional working with the service supported these comments.

People were not supported to have maximum choice and control of their lives. While staff were knowledgeable about people’s needs they were not able support them in the least restrictive way possible and in their best interests as the systems and care plans in the service did not support this practice.

Staff we spoke with told us the home had changed since the new provider had taken over and this had adversely impacted the care people received. Relatives supported this and commented that communication and updates were lacking and there was a visible absence of management within the home.

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

Rating at last inspection

The last rating for the service under the previous provider was good, published on 26 September 2020.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and person centred care planning and delivery. A decision was made for us to inspect and examine those risks.

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

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

Enforcement

We have identified breaches in relation to, staffing, safeguarding people from avoidable harm, safe care and treatment, personalised care, consent to care, complaint handling and governance at this inspection.

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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.