Archived: The Shires Care Centre

Updated 25 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 December 2016 and was unannounced. The inspection team consisted of two inspectors 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.

Before our inspection, we reviewed information we held about the service, which included notifications they had sent us. A notification is information about important events which the provider is required to send us by law.

We also contacted the commissioners of the service, and Healthwatch to obtain their views about the service provided.

On the day of the inspection we spoke with five people who used the service and one visiting relative for their feedback about the service provided. We also spoke with a visiting healthcare professional. We observed staff interacting with people to help us understand people's experience of the care and support they received. We spoke with the registered manager, the cook, activity staff member and five care staff. We looked at all or parts of the care records of six people along with other records relevant to the running of the service. This included policies and procedures, records of staff training and records of associated quality assurance processes.

Updated 25 January 2017

We carried out an unannounced inspection of the service on 12 December 2016.

The Shires Care Centre can accommodate up to 42 people with personal care and nursing needs. At the time of our inspection nursing care was not being provided at the service. 17 people with a range of needs including physical needs, mental health needs and people living with a learning disability were living at the service.

A registered manager was in post who had been registered since October 2016. 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.

During our previous inspection on 12 and 13 April 2016 we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to; how risks associated to people’s needs were assessed and planned for, how the principles of the Mental Capacity Act 2005 was adhered to, staff received insufficient training and support, people did not receive a personalised service and the systems in place to monitor safety and quality were insufficient.

During this inspection we checked to see whether improvements had been made. We found improvements had been made in all the breaches identified at our last inspection. A robust action plan was in place to fully complete the action required that would ensure sustainability. New systems and processes required further time to fully embed.

People told us they felt safe living at the service. Staff understood how to identify and report allegations of abuse. Risks associated to people’s needs had been in the main assessed for, but risk plans were variable in detail and guidance for staff. A new falls audit had been introduced but other incidents lacked detail and analysis. The internal and external environment people lived in was safe.

People’s emergency evacuations plans and the provider’s business continuity plan were being updated. This was to ensure staff had the required information in the event of an incident affecting the safe running of the service.

There was a system used to review and monitor people’s dependency needs. There were sufficient staff available to meet people’s needs and safety. Staff had been appropriately recruited; checks had been completed in relation to safety and suitability before they commenced their employment.

People received their prescribed medicines safely and their medicines were stored and managed appropriately.

Staff required additional support to fully understand and implement the principles of the Mental Capacity Act 2005. Some people experienced periods of heightened anxiety that could result in behaviours that were challenging to themselves and others. Staff had limited information and guidance available about how to support people effectively at these times.

Improvements had been made to the support and training offered to staff to enable them to carry out their role effectively and safely.

People’s nutritional needs had been assessed and planned for and people were supported to maintain their health. Staff worked well with external health professionals and followed recommendations made in supporting people with their health needs.

People were supported by kind, caring and compassionate staff that showed dignity and respect.

People did not have access to independent advocacy information should they have required this support. People were involved in regular reviews of their care to ensure the support provided met their needs.

People were supported by staff to participate in activities of interest to them. Information available for staff about people’s needs, routines and preferences was limited in parts. People reported that they had to wait to have their requests for assistance responded to.

Systems were in place for receiving, handling and responding appropriately to complaints. People had regular opportunities to provide feedback on the care and support they received in order to continue to drive forward improvements in the service.

Improvements had been made with regard to the quality assurance systems in place to ensure that people received high quality, safe and effective care and support. Whilst improvements had been made, further time was required for systems and processes to fully embed.