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Archived: Strathmore House

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Inspection report

Date of Inspection: 2 July 2013
Date of Publication: 11 July 2013
Inspection Report published 11 July 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 2 July 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff and talked with commissioners of services.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People’s needs were assessed and support, care and treatment were planned and delivered in line with their individual care plan. Support and care were planned and delivered in a way that was intended to ensure people’s safety and welfare.

People who we spoke with said that they were satisfied with the standard and quality of their support and care. One person told us that, “It is brilliant all round. I wish I knew about this place much earlier”. Other people who we spoke with told us that it was, “Okay” living at Strathmore House.

People’s health and welfare was maintained due the quality of engagement of staff when interacting with people who were living with dementia. During a 30 minute observation we noted that members of staff reminded and encouraged people to take their mid-morning drink. We also noted that were given time to reminisce, tell their stories and take part in recreational activities. These activities included playing a board game and stroking a piece of fabric, as part of their sensory stimulation activity.

From speaking with a member of staff and examination of our sample of people’s records, we noted that people were provided with opportunities to engage in other social and recreational activities. These included, but were not limited to, one-to-one and group discussions; visiting and attending to the home’s garden and going out on escorted trips, including to the seaside. Arrangements were in place for an entertainer to visit the home and perform on the 18 July 2013.

Our examination of the sample of people’s care reports indicated that health and safety risk assessments were carried out and measures were in place, and acted on, to minimise these risks. These risks included, but were not limited to, risk of developing pressure ulcers; malnutrition; choking and falls.

Where a person had developed a (low graded) pressure ulcer, we saw that remedial action had been taken to monitor and review the progression of this. This included the taking of photographs for monitoring purposes and consulting with the district nurses. In addition, the records demonstrated that the person was assisted to change their position to relieve the pressure and promote their comfort and healing of the pressure ulcer.

Records that we reviewed indicated other actions were taken to promote and maintain peoples’ health and wellbeing. These actions included monitoring and recording people’s nutritional and drink intake; providing them with soft food and thickened drinks (to minimise their risk of choking) and hourly monitoring of their safety following their experience of a fall.

We also noted people’s body weights were monitored and recorded, at least once a month or sooner if needed. The records demonstrated that action was taken when a person had experienced unintentional weight loss. This included supporting the person to access advice and treatment from the dietician, if required.

People’s health was maintained and supported. People who we spoke with confirmed that they were supported to access health care services. These included their GP; district nursing services and local hospital services. From our review of four out of 18 sets of people’s records we noted that people were also supported to access dieticians; chiropodists; physiotherapy and speech and language therapy services.

To ensure that people’s choices and decisions about their support, care and treatment were respected, there was a system in place to assess people’s mental capacity to make valid decisions. These decisions included, for instance, end-of-life care and treatment and receiving their yearly vaccination against influenza. Where people were assessed not to have this level of mental capacity, they were represented by their family members. This was so that the person’s health and wellbeing was protected, with appropriate care and treatment carried out and in the person’s best interest.