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Stowford House Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 August 2019

About the service

Stowford House is a care home that was providing personal and nursing care to 47 people aged 65 and over at the time of the inspection. The care home accommodates up to 51 people across two separate floors. One floor provides nursing care and the other floor provides care to people living with dementia.

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

There were not always enough staff deployed to ensure people’s needs were met. People were at risk of not receiving medicines as prescribed because medicines were not always administered safely. People and staff told us there were not always enough staff to support them in a timely way. The registered manager and provider did not ensure they were meeting all the requirements of their registration as they did not ensure there were enough staff deployed to meet people's needs.

The provider’s systems to ensure compliance with the regulations were not always robust. This included assessing, monitoring and mitigating all risks relating to the health, safety and welfare of people in the service. Staff told us they felt listened to, however they did not always feel action was taken to address issues. This included having enough staff to meet peoples’ assessed and changing needs.

The registered manager continually looked for ways to improve the service. There were links with the local community and there were plans in place to improve those links. There were systems in place to engage people, relatives and staff. The provider had effective recruitment processes in place which enabled them to make safer recruitment decisions. This included pre-employment checks to ensure potential staff were of good character.

People were supported by staff who understood how to report concerns relating to harm and abuse.

Rating at last inspection: The last rating for this service was Good (published 21 June 2018).

Why we inspected:

We received concerns in relation to the safe management of medicines and staffing levels. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. As well as the concerns raised, CQC was also aware of an incident where concerns had been raised in relation to the conduct of agency staff. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident. However, we considered this information in assessing any ongoing regulatory risks to other people in the service.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were regulation 18 (Staffing) as systems were not robust in demonstrating staffing levels were adequate to meet people’s changing needs. Regulation 17 (Good governance) failing to effectively evaluate the safety and wellbeing of service users and use this information to improve practice.

Details of action we have asked the provider to take can be found at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safe

Inspection areas

Safe

Requires improvement

Updated 9 August 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 21 June 2018

The service was effective.

People’s needs were assessed before moving to the home and reviewed on an ongoing basis.

Staff were supported and received training to ensure they had the skills and knowledge to meet people's needs

People received food and drink to meet their dietary needs.

People were supported to access healthcare services.

People were supported in line with the principles of the Mental Capacity Act 2005 (MCA) and their rights were protected. The registered manager took immediate action to ensure the Deprivation of Liberty Safeguards were all in place.

Caring

Good

Updated 21 June 2018

The service was caring.

Staff showed kindness and compassion towards the people they supported and their families.

Staff knew people well and took time to build relationships with them.

People were treated with dignity and respect and their privacy protected.

Responsive

Good

Updated 21 June 2018

The service was responsive.

People's care plans reflected their personal preferences and recognised them as unique individuals. Ongoing action was needed to ensure people’s social needs were met.

Staff responded to people's changing needs in a timely and effective manner.

People had access to the complaints procedures.

People were supported with compassion at the end of their life.

Well-led

Requires improvement

Updated 9 August 2019

The service was not always well-led.

Details are in our safe findings below.