Summerhill Residential Home

We found the following examples of good practice.

At the time of our visit the home had never had a resident that had contracted Covid-19 and 100% of residents had received their first vaccine for Covid-19.

The home was clutter free and visibly clean. Cleaning schedules were in place for day to day cleaning.

All visitors’ temperatures were screened prior to visitors entering the premises and an IPC checklist was completed for all visitors. All visitors including contractors were required to complete a Covid-19 lateral flow test and wait 30 minutes prior to entering the premises. Staff always answered the door to visitors and prompted them to follow IPC procedures. Visitors and contractors were emailed visitor guidelines prior to pre-booked visits.

The home was having closed windows visits at the time of inspection. Staff had spoken with families about the visiting arrangements and all families were happy with them. In addition, residents could use the home’s tablet computers to have virtual visits with families by appointment. If a resident was receiving end of life care (EOLC) they would be facilitated with visits in their rooms.

Handovers during shift took place in the lounge or dining room. Staff took breaks at different times and socially distanced during breaks in the home’s garden or dining room. There were posters at the nursing station and around the home to remind staff of social distancing. There could not be more than one staff member at the station at a time.

Residents were supported with a range of socially distanced activities to promote their wellbeing. Staff told us they had not had any issues with residents’ mental health in response to the pandemic and residents had managed social distancing and IPC control measures well.

With the exception of one resident with safeguards in place, the home did not have any residents that had asked to go out or leave the home during lockdown. Staff told us residents were supported to use the garden to access outside space.

Staff always wore face masks and personal protective equipment (PPE) when providing personal care. PPE was donned in residents’ rooms and doffed in the room. PPE was disposed of immediately in clinical waste bins. Staff told us this was to minimize the risk of cross-contamination.

All new residents or residents returning from hospital must have had a Covid-19 test prior to entry from hospital or if they were a new resident they would be tested on arrival at the home. All new residents or residents returning from hospital were isolated for 14 days in their own room.

PPE used in the home was CE marked in accordance with current regulations. Posters around the home explained to residents why staff wore PPE. Staff told us the home did not have any residents with anxiety in regards to staff wearing PPE.

The CCG had trained all staff to recognise signs of deteriorating physical health and to identify when people were at risk of deterioration. As part of this training 20 staff were trained on the use of pulse oximeters. All staff had up to date IPC mandatory training. All staff completed online Covid-19 training via e-learning.

Staff underwent polymerase chain reaction (PCR) Covid-19 testing weekly, this was supplemented by twice weekly lateral flow testing. Residents had whole home PCR testing every 28 days.

The home had never had a resident test positive for Covid-19. Staff told us if a resident tested positive, they would immediately isolate the resident, the same policy applied for residents with symptoms. The manager said the home had never had a staff member refuse a test and staff would not be allowed to work if they refused a test. If a resident declined a test staff would closely monitor them for symptoms.

The home had an IPC policy which was in date. The providers operations team had audited IPC policies and created new policies in response to the pandemic.

The home did monthly IPC audits. The audits included extra measures the home had put in place due to Covid-19. The most recent IPC audit was on 28 January 2021. The audit was a checklist which identified actions staff had taken in response to the audit questions. All audit questions had answers recorded.

All staff had Covid-19 risk assessments in place. The risk assessments included measures the provider had taken to risk assess staff that may be disproportionately affected by the virus.

Summerhill Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Summerhill Residential Home is registered to accommodate 15 older people. The home is split over two floors with the first floor having access via stairs or a lift. On the ground floor there is a large lounge and a separate dining room. There was level access to the outside patio area at the rear. There were 15 people living at the home at the time of inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse. Staff told us who they would report this to both internally and externally.

Staffing levels were sufficient to provide safe care and recruitment checks had ensured staff were suitable to work with vulnerable adults. Staff had received an induction and continual learning that enabled them to carry out their role effectively. Staff received regular supervision and felt supported, appreciated and confident in their work.

When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with monthly audits to ensure safety with medicines.

Staff were clear on their responsibilities with regards to infection prevention and control and this contributed to keeping people safe. The service had hand sanitiser in the corridors along with hand washing guidance.

Accident and incidents were recorded and analysed. Lessons learnt were shared with staff by letter and during monthly meetings.

People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required.

The service worked well with professionals such as doctors, nurses and social workers.

People had their eating and drinking needs understood and were being met. People told us they enjoyed the food and thought the variety and quantity was 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.

The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service.

People, their relatives and professionals described the staff as caring, kind and approachable. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs. Their life histories were detailed and relatives had been consulted.

The home had an effective complaints process and people were aware of it and knew how to make a complaint. The home actively encouraged feedback from people, their relatives and professionals.

People’s end of life needs were included in their care and support plans. Feedback received by the service showed that end of life care provided was of a good standard.

Activities were provided and these included staff, people and their relatives. Individual activities were provided for those that preferred them.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone.

Leadership was visible within the home. Staff spoke positively about the management team and felt supported.

There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were carried out and lessons learnt.

The service understood their legal responsibilities for reporting and sharing information with other services.

Summer Hill Residential Home provided personal care with accommodation to 15 elderly people. The service was a two story house with eight bedrooms on the ground floor and seven on the first floor all of which were en suite. There was a large communal living area and separate dining room which both led off the hallway. People accessed the first floor using a lift or the stair way. There was a large enclosed level access garden and patio area which was from French doors in the living area.

The service had a registered manager in place. 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.

People, relatives, a health professional and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had a care file which also included guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and accurate.

Medicines were managed safely, were securely stored, correctly recorded and only administered by staff that were trained to give medicines.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training in response to people’s changing needs for example one person was displaying behaviour which challenged the service and staff were being trained to support them safely.

Staff told us they received regular supervisions which were carried out by the manager. We reviewed records which confirmed this. Staff told us that they found these useful.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. Capacity assessments were completed and best interest decisions recorded as and when appropriate. Summerhill had a set of Aims and Values which put people in the centre of the care they received. These reflected giving people who use the service control over their daily life, safety and dignity. Staff and management demonstrated these using person centred approaches by acknowledging them, promoting choice and talking them through the support they were providing in an empowering way.

People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. We saw that food was regularly discussed in resident meetings and people’s likes and dislikes recorded in their care plans. The chef told us that the majority of meals are home cooked.

People were supported to access healthcare appointments as and when required and staff followed professional’s advice when supporting people with ongoing care needs. Records we reviewed showed that people had recently seen the GP, District nurse, mental health team and a chiropodist.

People told us that staff were caring. We observed positive interactions between staff, managers and people. This showed us that people felt comfortable with staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes and interests. This meant that people were supported by staff who knew them well.

People had their care and support needs assessed before being admitted to the service and care packages reflected needs identified in these. We saw that these were regularly reviewed by the service with people, families and health professionals when available.

People, staff and relatives were encouraged to give feedback about the care and support provided in the home. We reviewed the people satisfaction survey report for 2016 which contained mainly positive feedback. This report reflected results from feedback questionnaires sent to people. The results had been analysed and actions were set for the registered and service manager to follow up. We saw that the actions identified from this were being addressed.

There was an active system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints in place. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.

People and staff felt that the service was well led. The registered and service manager both encouraged an open working environment. A staff member told us, “The service manager keeps the team motivated, we look forward to working here”.

The service understood its reporting responsibilities to CQC and other regulatory bodies they provided information in a timely way.

Quality monitoring audits were completed by the service manager and monthly management reports were sent to the registered manager. The registered manager analysed the detail and identified trends, actions and learning which was then shared as appropriate. This showed that there were good monitoring systems in place to ensure the service improved. Safe quality care and support was provided to people.