Stratton Court

Updated 12 July 2023

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

Three Inspectors and 2 Experts by Experience carried out the inspection. 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

Stratton Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

There was a registered manager in post at the time of our inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We considered the feedback from the local authority and professionals who work with the service. We used the information the provider sent us in December 2022 in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 12 people who lived or were staying at Stratton Court. We spoke with 12 people’s relatives about their experience of the care and support provided by the service.

We spoke with 18 staff including the registered manager, deputy manager, clinical lead, lifestyle coordinator, 4 unit leads, 8 care staff and 2 housekeeper staff. We also spoke with a representative of the provider and the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 8 people's care records. A variety of records relating to the management of the service, including policies and procedures were also reviewed. We reviewed 4 staff recruitment and personnel files.

We continued to seek clarification from the management team to validate the evidence found. We sought and received feedback from 4 healthcare professionals involved with the service.

Updated 12 July 2023

About the service

Stratton Court is a residential care home providing accommodation to persons who require nursing or personal care, for up to 84 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 48 people using the service. People are accommodated in 1 adapted building.

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

People were not always protected from the risk of harm as incidents had not always been appropriately investigated to ensure appropriate action had been taken. This meant the provider and registered manager had not always ensured lessons were learnt and changes were made to the service to protect people from the risk of avoidable harm.

People’s care plans and risk assessments had not always been updated following these incidents. However, care staff were taking action to protect people from the risks associated with their care. The provider had arranged for additional training for staff to assist them in managing the needs of people who can become anxious.

The provider and registered manager had not always informed CQC of notifiable events. The registered manager took immediate action to address this concern at the inspection.

People were at risk of not always receiving their medicines as prescribed. There were not always effective systems for staff to ensure people received their medicine as prescribed and to ensure people’s medicines were administered in accordance with manufacturers guidance.

The provider and registered manager did not always operate effective systems to monitor, assess and maintain the quality of service people received at Stratton Court. While some improvements had been made to good governance processes in relation to the environment, infection control and falls, there were not effective systems in relation to the concerns we identified at this inspection.

People and their relatives spoke positively about the level of engagement and support their loved ones received. People throughout the home enjoyed a range of activities and were being actively supported to be engaged in the community. Since the last inspection, action had been taken to provide a dementia friendly environment and tailored activities on Highgrove (dementia care unit). People enjoyed 1 to 1 and group activities which were tailored to their needs.

Improvements had been made to ensure people’s care plans were person centred, however additional improvements were required for people living on the Highgrove unit.

People and their relatives shared mixed feedback about the management of the service. Whilst the majority of relatives were positive, some relatives raised concerns in relation to communication and their loved one’s care. The registered manager was taking opportunities to engage with people, their relatives and seek their views.

Staff spoke positively about the support they received and discussed how the provider and registered manager were responsive to their ideas and requests. Staff told us they felt the service was improving, thanks to management support and a reduction in agency staff.

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 requires improvement (published 5 January 2023).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found while some improvements had been made in relation to some of these actions, there were additional shortfalls and the provider was not meeting all of the relevant regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 21,22 and 23 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care and good governance.

Prior to this inspection we received concerns in relation to people’s care and treatment and the service was involved in safeguarding processes with the local authority.

We undertook this focused inspection to check the safety of people’s care and to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance, safeguarding service users from abuse and improper treatment, safe care and treatment. We also identified breaches of Notification of other incidents and Notification of death of a service user of the Care Quality Commission (Registration) Regulations 2009.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety.