Archived: Sabourn Court Care Home

We found the following examples of good practice.

• Visitors had to sign a COVID-19 risk assessment and declaration before entering the building and the pens used were disposed of. There was a supply of ready made PPE packs for visitors if they did not have PPE with them.

• The home completed hand hygiene competency checks on all staff to ensure they were competent in handwashing techniques.

• The home had turned the disused salon into a testing station for staff and service users. Staff nurses and nurse assistants had been trained to perform COVID-19 tests and staff who wanted to self-test were provided with guidance and supported to do so.

• Staff who tested positive and were self isolating would be paid for shifts missed to ensure they complied with testing and self isolation guidance. Staff who tested positive were referred to human resources who would conduct wellbeing calls.

Sabourn Court Care Home is a residential care home providing personal care to 34 older people, some of whom were living with dementia. The service can accommodate 49 people in two buildings.

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

At our last inspection the provider had failed to manage medicines safely and to operate an effective quality assurance system. This resulted in breaches of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we found enough improvement had been made and the provider was no longer in breach of these regulations. Medicines were managed safely; people received their prescribed medicines when they were due. There was a structured approach to quality assurance which was effective in identifying areas for improvement.

People and staff said the home was safe. Staff were aware of the safeguarding and whistle blowing procedures and knew how to report concerns. Previous safeguarding concerns had been dealt with effectively. There were enough staff to meet people’s individual needs. New staff were recruited safely. Incidents and accidents were monitored to help ensure people were safe and to prevent them from happening again. Health and safety checks and risk assessments were completed; these helped maintain a safe environment.

Staff confirmed they were well supported. Most training was up to date with systems in place to ensure training was updated periodically. 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 received good care from considerate staff. Care records guided staff about people’s preferences.

People's needs had been fully assessed; this was used as the basis for developing care plans. A small number of care plans required additional information. Care plans were evaluated regularly to reflect people’s changing needs. People could participate in activities if they wanted.

The registered manager was supportive and approachable. People and staff had good opportunities to provide feedback.

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 30 May 2018). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected.

This was a planned inspection based on the previous rating.

Sabourn Court Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sabourn Court Care Home is registered for 49 places for older people some of whom were living with dementia. The home is comprised of two buildings. Oakwood House dates back to the 19th Century and Park House is a purpose built building. At the time of inspection the service supported 36 people. The service had a new provider since our last inspection and this was the new provider’s first inspection.

The home had a registered manager. 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.

At the last inspection in January 2017 we found the service required improvement. At this inspection we found the service had improved but the overall rating remained ‘Requires Improvement’.

Medicines were not always stored, recorded or administered in a safe way. Stocks of medicines were sometimes excessive and time sensitive medication could not always be evidenced as to what time it was administered.

People received good quality care from staff who were kind and compassionate. There were enough staff working in the home to meet people's needs and preferences, however the allocation of staff could be improved so people’s need could be met promptly. We have made a recommendation about the allocation of staff and use of agency staff.

Staff were polite, thoughtful and treated people with dignity and respect. Staff were recruited in a safe way and supported in their role through meetings and supervision.

The registered manager was not able to evidence up to date training completed by all staff. We have made a recommendation about retaining evidence of the training staff have completed.

There was not a robust system in place to identify and fix short falls in the service, such as the medication practices.

People were able to make choices about their care and they were encouraged to maintain their hobbies and interests to enhance their wellbeing.

Systems were in place to protect people from the risk of abuse and avoidable harm. Risks to people's safety had been assessed and actions taken to reduce these risks as much as possible.

Accident‘s and incidents were recorded and monitored to reduce future risks to people. Staff completed health and safety checks on the building and equipment to keep people safe.

Care plans were written in a person centred way and promoted independence. We observed staff promoting people’s independence. People were given choice and had their decisions respected. Staff worked in line with the principles of the Mental Capacity Act (2005).

Complaints were recorded and acted on in line with the provider’s policy.

People received enough to eat and drink to meet their needs and were supported to maintain their health. Their consent was sought and where people could not consent to their care themselves, any decisions made for them by the staff were done in the person's best interests.

There was an open culture within the home. People and staff were involved in the running of the home and were able to contribute their ideas on how to improve the quality of care people received. These were listened to and implemented. People and staff could raise concerns without hesitation and these were listened to and dealt with quickly for the safety and satisfaction of the people living there.

The registered manager and staff understood their roles and responsibilities.

Sabourn Court Care Home is registered for 49 places for older people. The home is comprised of two buildings. Oakwood House dates back to the 19th Century and Park House is a purpose built building. It is located close to local amenities and is accessible by public transport.

At the time of our inspection the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. We found there was a manager in post who was in the process of registering with the CQC.

Risks to people had been assessed, managed and reviewed. Recruitment checks had been completed and relevant professional qualifications had also been checked and were regularly monitored.

The registered provider planned staffing levels using a dependency tool to ensure there were enough staff to meet people’s needs and provided in excess of these assessed staffing hours. However, people and staff said there wasn’t enough staff. People did not always feel safe during the night for this reason.

Although people were complimentary about staff, we observed several occasions when staff did not communicate with people and provide reassurance. We discussed this with the regional director. We found the atmosphere in the lounge was quiet and observed staff had limited time to chat with people between their daily routines. Privacy and dignity was being respected.

People and staff were not complimentary about the manager who they felt needed to have a stronger presence in the home. Quality management systems were found to be effective through a system of audits which had been regularly carried out. Feedback was actively sought from people and relatives.

Codes for keypads which provided access to sluice areas were written above these doors which meant people and visitors were able to access these areas. Building maintenance was up-to-date and fire safety checks had been regularly completed.

Medicines were mostly well managed as staff had received this training and had their competency checked.

Staff received supervisions and appraisals, although this was not as often as stated in the registered provider’s supervision policy. Staff training records showed high levels of completion and staff received an appropriate induction.

Staff understood the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards although recording of consent and best interests decisions needed to be clearer. Records we looked at showed people had access to a range of healthcare services.

People were satisfied with the food and drink and we saw most people had a positive mealtime experience. People gave mixed feedback about activities. Additional staff hours for activities had been approved by the registered provider and were beginning the recruitment process for this.

Care plans provided sufficient guidance for staff to follow in order to provide effective care. However, there was little evidence of involvement from people and relatives in reviews. Audits and action plans showed this had been identified by the registered provider as an area for improvement.

Complaints were appropriately managed as information on how to complain was on display and people knew how to complain if they were dissatisfied. Complaints were investigated and responded to. The service had received a high volume of compliments from relatives.