Surbiton Care Home

Surbiton Care Home is a residential care home providing personal care to up to 26 people. The service provides support to older people and those with dementia. At the time of our inspection there were 17 people using the service.

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

Risk management was not always clearly recorded to ensure staff had guidance to mitigate the likelihood of risk occurrence. Where potential incidents had occurred, these had not always been identified, reported or investigated. Management and oversight of the service required some improvement to ensure audits were effective in driving improvements.

There were enough staff to meet people’s needs, and despite the lack of written guidance staff knew how to respond to people’s needs. People received their medicines when they needed them. Staff understood how to safeguard people from the risk of abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People, relatives and staff were complimentary of the registered manager and the support and passion they brought to the role. The service worked in partnership with other agencies to meet people’s needs.

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 this service was good (published 30 January 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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 good governance at this inspection.

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

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.

We found the following examples of good practice

• Thorough screening procedures were utilised upon entry into the home. This included testing, temperature checks, screening forms and use of personal protective equipment (PPE).

• Quarantine boxes were in place to cover all infection control needs should a person test positive. This enabled easy access to all PPE for staff and ensured people were supported to isolate safely.

• There were sufficient levels of PPE available across the home for staff to use throughout their shift. We saw that this was in plentiful supply and contingency plans were in place to ensure stock was available.

• People were supported to see their loved ones through the use of screened visits or video calls where necessary.

• People and staff were subject to regular testing in line with government guidelines.

• All staff were up to date with infection prevention and control (IPC) training and the providers IPC policy was up to date.

• The home was clean and hygienic throughout with regular cleaning schedules in place to stop the spread of infection.

This new care home was registered by the CQC in January 2017 and this will be the first time they have been rated by the CQC. Following this inaugural inspection we have rated Surbiton Care Home ‘Good’ overall and for the five key questions ‘Is the service safe, effective, caring, responsive and well-led?’

The service had a new registered manager who had been in post since August 2017. A registered manager is a person who has registered with the Care Quality Commission (CQC). Registered managers like registered providers 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. The registered manager was also responsible for managing another of the provider's care homes for older people (known as ‘The Summers’) in Surrey.

People and their relatives told us they were happy with the standard of care provided at the home. We saw staff looked after people in a way which was kind and caring. Staff had built up caring and friendly relationships with people and their relatives. Our discussions with people living in the care home, their relatives and community health and social care professionals supported this.

There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. There were enough staff to keep people safe. The premises and equipment were safe for people to use because managers and staff routinely carried out health and safety checks. Manager’s ensured the environment continued to be hygienically clean for people and staff demonstrated good awareness of their role and responsibilities in relation to infection control and food hygiene. Medicines were managed safely and people received them as prescribed.

Staff received appropriate training to ensure they had the knowledge and skills needed to perform their roles effectively. People were supported to eat and drink enough to meet their dietary needs and preferences. Managers and staff were aware of their duties under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff sought people's consent before providing any care and support and followed legal requirements when people did not have the capacity to do so. They also received the support they needed to stay healthy and to access health care services. People said the care home was a homely and comfortable place to live.

Staff were caring, treated people with dignity and respect, and ensured their privacy was maintained, particularly when being supported with their personal care needs. Staff communicated with people using their preferred methods of communication. This helped them to develop good awareness and understanding of people's needs, preferences and wishes. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were nearing the end of their life, they received compassionate and supportive care.

People received person centred care and support that was tailored to their individual needs. Each person had an up to date and personalised care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. This meant people were supported by staff who knew them well and understood their needs, preferences and choices. Staff encouraged people to actively participate in meaningful leisure activities that reflected their social interests and to maintain relationships with people that mattered to them.

The registered manager had a positive impact at the care home in a relatively short period of time and was highly regarded by people and staff. Manager’s used well-established quality assurance systems to ensure all aspects of the care home were regularly monitored. This helped them to check that people were consistently experiencing good quality care and support. Any shortfalls or gaps identified through these checks were addressed promptly. People felt comfortable raising any issues they might have about the home with manager’s and staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately. The provider also routinely gathered feedback from people living in the home, their relatives and staff.