The Care Quality Commission

Archived: Shenstone Hall Nursing Home

13 Birmingham Road, Shenstone, Lichfield, Staffordshire, WS14 0JS (01543) 480222

Provided and run by:
Dr. Dhiraj Mahanta

Important: The provider of this service changed. See new profile

All Inspections

19 August 2013

During an inspection in response to concerns

In order to target our inspections effectively we continually gather information about services. This may include information from people who use services, family members, health professionals or staff. We had received some information of concern which prompted us to visit the home to ensure people were receiving care and treatment that was appropriate and supported their needs. The information directed us to review the care and welfare of people living at the home and staffing levels.

The visit to Shenstone Hall was unannounced this meant the provider; registered manager and staff did not know we were coming. During the inspection process we spoke with two people living at the home, four visiting relatives, five members of care staff, three nurses and the provider.

People living at the home were not receiving appropriate and consistent care delivered in a timely manner.

We found that people were not protected against the risk of receiving care or treatment that was inappropriate or unsafe as there were insufficient numbers of staff who had the appropriate knowledge and skills to provide individual care needs

29 July 2013

During an inspection in response to concerns

In order to target our inspections effectively we continually gather information about services. This may include information from people who use services, family members, health professionals or staff. Prior to this inspection we had received some information of concern. The information directed us to review the care and welfare of people living at the home; staff recruitment and staff training, support and supervisions.

The visit to Shenstone Hall was unannounced this meant the provider; registered manager and staff did not know we were coming. During the inspection process we spoke with two people living at the home, six members of care staff, one nurse, the registered manager and the provider.

We found that people were not protected against the risk of receiving care or treatment that was inappropriate or unsafe as appropriate assessments of need had not been completed.

There was not an effective system in place for recruitment. The provider had not taken suitable steps to ensure that people were suitable to work with this group of people.

The care staff we spoke with had not received appropriate mandatory training, or updates to their training. Staff had not had an annual appraisal nor was there a system in place for staff to have regular supervisions or one to one meetings with the manager.

26 February 2013

During an inspection looking at part of the service

We carried out the inspection to update the information we hold and to check the service had made improvements since our last inspection. The provider sent an action plan detailing what they had done to improve the service. We looked at improvements that were required to ensure people using the service were receiving the care they required. The inspection was unannounced which meant the provider and the staff did not know we were coming.

There was a new manager in post who was in the process of registering with us, the manager had been in post for two days. This meant they were still in the process of understanding how the service needed to improve

We spoke with staff about the care delivered to people at the home. The staff we spoke with were knowledgeable about the care requirements for people using the service. The manager said they thought the care was very good delivered by staff who were, 'Very committed'. A staff member said, 'There have been extreme improvements at the home'. A person living at the home told us, 'They have talked to me about what's important. I think they talk nicely and you can have a bit of fun too'. This meant people were satisfied with the care and treatment they received.

We had previously identified improvements were needed in relation to the quality monitoring of the service. We found that quality monitoring systems were now in place. We saw further development was still required regarding the safe handling of medication.

28 June 2012

During an inspection looking at part of the service

We carried out this review to see if action had been taken by the provider to improve outcomes for people. Two compliance inspectors visited the home unannounced; this meant no one knew we were visiting.

The provider had sent an action plan to us detailing what they had done to meet the regulations, and to ensure people using the service were receiving the care they required. We used the information in the action plan to check if the provider had implemented what was required.

The provider has used consultants to support them in meeting the legal requirements. A manager had also been recruited and had been in post for four weeks.

We found that people's needs were assessed and care and treatment had been planned and delivered in line with their individual care plan. The home was warm, clean and well maintained with no malodours. We saw people had the necessary equipment in place to ensure they received the necessary support.

People using the service spoke well of the home. One person told us, 'If you have to be anywhere, here is as good as anywhere can be.' Another person using the service said, 'There has been a change to the staff team, but they all seem to know what they are doing.'

People we spoke with told us that staff were helpful and kind. We heard staff speak respectfully and it was clear from our observations that people reacted positively when the staff engaged with them. We observed staff providing support and saw people were treated with respect. Personal care issues were discussed sensitively and discreetly. We saw the staff listened to people and did not rush them.

We looked at how the home kept people safe; the people that we spoke with told us they were happy in the home. A questionnaire recorded, 'My relative tells me she is happy and feels safe at Shenstone Hall, that's so comforting to me and my family.'

We looked at medication management and saw it had improved. However, improvements were still required because the home did not have suitable monitoring and auditing procedures in place regarding medication coming into or out of the home. We found a number of miscalculations and errors, in relation to the quantity of tablets held at the home. This meant we people could not be confident that they were receiving their medication as prescribed.

We looked to see if the staff were trained and supported. We saw that suitable systems were in place. The staff we spoke with were happy and felt they were providing a good level of care. One comment included, 'There have been so many changes, all to the good. We have designated teams who feed information up and down so we all know people are getting the care they need. Everything is better.'

30 January 2012

During an inspection looking at part of the service

We carried out this review to check compliance with a warning notice that we served in November 2011. A warning notice is served when the home is not meeting the required standards and people using the service could be at risk. We were concerned that there might be continuing breaches of the regulations.

We served two other warning notices in November 2011 and we still have serious concerns regarding the care and welfare of people who used services.

We also checked to see if improvements were evident where the provider had been told action was necessary to meet essential standards and regulations.

Shenstone Hall is under a multi agency investigation which is coordinated by the local authority. This was to look at concerns raised about the home in July 2011. The investigation is presently ongoing and CQC have liaised with other professionals including the local authority and the primary care trust (PCT) throughout this process.

We spoke with people who used the service, their relatives and talked with the staff. We checked some of the provider's records, and looked at some records for people who used the service. We asked for updates and information from the local authority, primary care trust (PCT), joint commissioning unit and social workers before our visit. Their comments are included within this report.

We have received information from some relatives confirming they were happy with the care being provided at the home. We also spoke with relatives during this visit who confirmed they were satisfied with the care provided. One visitor said, 'I think it is nice here they cater for my relatives needs.'

Although some improvements were noted during our visit and recognised within this report, some basic care needs were still not being met. People using the service were not always receiving the care they required and their dignity was compromised. Medication management was not satisfactory and quality monitoring and management systems still needed improvements.

12 December 2011

During an inspection looking at part of the service

We carried out this review to check compliance with a warning notice that we served. We were concerned that there might be continuing breaches of the regulations.

Shenstone Hall is also under a multi agency investigation which is coordinated by the local authority. The investigation is presently ongoing.

We only looked at specific areas on this visit that were in connection with the warning notice we served on 22 November 2011.

We arrived unannounced at Shenstone Hall at 06:45, this meant people did not know we were coming. We spoke with the night and day staff about the care provided to people at Shenstone Hall.

Some of the staff told us there had been improvements and said they were more aware of talking to people who used the service. They told us there was more paperwork and there were charts to fill in regarding what they did and when. One staff member thought there had been improvements in the last seven months. They told us there was more support and training available.

Some of the staff told us there still needed to be better communication and improved leadership.

People using the service were happy with the care staff and the meals they received. They told us they felt they made day to day choices about their lives. Some people said they would like more to interest them and three people told us they wished their bedrooms and the conservatory were warmer.

On the day we visited the newly appointed activities coordinator was being introduced to people living at the home.

7 November 2011

During a routine inspection

We carried out this review to see if action had been taken by the provider to improve outcomes for people. Three compliance inspectors and one expert by experience visited the home unannounced, this meant no one knew we were visiting.

We visited the service in August 2011 because the provider had not registered with CQC as required. When we did our registration visit we had a number of concerns and asked the provider to complete an action plan. We were concerned about the equipment in the home, the minimal training provided to the staff and the lack of knowledge regarding safe guarding. The primary care trust and the local authority also had concerns and stopped placing people at Shenstone Hall Nursing Home.

The service was registered with us in September 2011. The primary care trust and the local authority have been supporting the provider since August 2011 and we visited in November 2011 to see what improvements the provider had made.

We involve people who use services and family carers to help us improve the way we inspect and write our inspection reports. Because of their unique knowledge and experience of using health and care services, we have called them experts by experience. Our experts by experience are people of all ages, from diverse cultural backgrounds who have used a range of health and/or social care services. An expert by experience took part in this inspection and talked to the people who used the service and their visitors. They looked at what it was like to live at Shenstone Hall. They took some notes and wrote a report about what they found and details are included in this report.

Due to the needs of some of the people living at the home not everyone was able to share their experiences of what it was like to live at Shenstone Hall Nursing Home so we spent time observing people being supported by the staff on duty during our visit.

We asked people who used the service, if they felt safe in the presence of staff. All commented that they felt safe and told us the staff treated them well and were kind.

We saw some people were left without support for long periods of time. We observed and were informed by people using the service that not everybody was always treated with dignity and respect. We saw people were not always involved in decision making and were not always consulted.

We saw that people did not always receive safe or appropriate support.

Information regarding support and care in the future, or if people become ill, were not recorded meaning people's wishes were not clear and may not be followed through. Plans of care did not focus upon what each person wanted to do.

Visitors told us that when important things happened the communication between them and the home was good.

The staff were not receiving supervision and have not received all the necessary training.