26 September 2023
During a routine inspection
Summerfield House Nursing Home is a residential care home providing nursing and personal care for up to 107 people, some of whom may be living with dementia. The home is purpose built providing accommodation on three floors – Oak, Cedar and Maple. Each floor has separate adapted facilities. Oak provides residential care, Cedar specialises in providing care to people living with dementia and Maple provides nursing care. There were 84 people living at Summerfield House when we inspected.
People’s experience of using this service and what we found
Improvements had been made at Summerfield House since a new manager joined the service. An improvement plan was in place and the home acknowledged further changes and improvements were needed. New quality assurance systems had been introduced.
Risks to people were usually assessed and managed. However, we found examples where risk was not consistently assessed and managed. Accidents and incidents were not always recorded correctly and so could not be reviewed to reduce further occurrences.
The provider told us staff numbers were adjusted to ensure peoples needs were met all of the time. However, staff were observed to be busy, and task focused. We have made a recommendation to review staffing dependency for the home.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have made a recommendation for staff training and understanding of the best interest process and recording.
People's end of life plans were not always person-centred. We have made a recommendation to the information in the plans.
There were not many activities organised for people to take part in. The home was recruiting more activities coordinators and a full weekly plan for activities was being arranged. The home was being redecorated, with an art and craft room, sensory room and bar area.
Staff received training and support for their role. Staff were safely recruited and were kind and respectful. Staff told us morale had improved at the home and they felt they could raise any suggestions or issues with their seniors and unit managers.
People were supported to maintain their food and fluid. However, we found some issues with record keeping of meals eaten. People were supported to maintain their health. People received their medicines as prescribed.
Feedback from people and their relatives was positive, about the staff team and the changes being introduced at the home.
The local authority and safeguarding teams had worked closely with the home on improvements at the home and felt the home was moving in the right direction under the leadership of the new manager. Four visiting professionals were also positive about changes at the home, saying the staff were now more involved and knowledgeable about the people living at 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 and update
The last rating for this service was requires improvement (published 12 April 2023) and there were 3 breaches of regulation. The provider completed an action plan after the inspection to show what they would do to improve. They sent us a monthly update on their progress.
At this inspection we found improvements had been made. Further work was needed to implement all the improvements identified and embed them within the service. We found a continued breach in 1 regulation and have made 2 recommendations.
The last rating for this service was requires improvement (published 12 April 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last 5 consecutive inspections (since March 2020).
Why we inspected
The inspection was prompted in part due to concerns received about the management of the home, staffing, medicines, and falls. 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 service had an improvement plan in place to address these issues.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We have identified a breach in relation to risk management at this inspection. We have made recommendations in relation to staffing, best interest decisions and end of life care plans.
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 also request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.