Archived: Summerfields Residential Home for the Elderly

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is it safe?

The delivery of care did not ensure people's safety. Staff action when people experienced a fall was not consistent and placed people at risk of further injury. Staff did not always follow the direction of health care professionals, and did not to seek medical assistance when this was required. Care plans did not reflect people's current needs and failed to include detailed instructions to staff on how to support people in a safe manner. Risks to staff and people using the service were not identified, assessed and managed due to no auditing system. Fire evacuation plans were not in place for all people living in the home, and where they did exist these contradicted information in the person's care plan.

The home was not clean and staff practice did not ensure people were protected against the risk of infection. Medicines were not managed and administered safely. Recruitment processes were not sufficiently robust to ensure staff employed in the home were suitable to work with vulnerable adults. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to recruitment. We have also asked them what they are doing to meet the requirements of the law in relation to ensuring care is delivered safely, people are protected from risk of infection, and medication is managed safely.

Staff were aware of what constitutes abuse and the signs that this may be happening. They were aware of how to report concerns and how to escalate these if they were not dealt with appropriately. People we spoke with told us they felt safe living in the home. One person told us, 'I have no problem at all with any of [the staff]'.

Is it effective?

Care plan reviews had not identified where assessments were out of date, contradictory, or information was missing. Care plans for two people could not be located.

Staff completed training but did not put this into practice in the home. Staff had received training in infection control. However, we observed poor practice in the home which placed people at risk of infection. Staff did not complete a competency assessment following training in the administration of medication.

Is it caring?

Staff talked to people in a friendly manner. One person said of the staff, 'they are lovely, very kind'. However, the provider and staff did not always act in a way that protected people's right to privacy and dignity. People, and their relatives, were not involved in the planning of their care. Staff appeared to communicate well with some people and not with others.

Is it responsive?

The service was not responsive. The provider failed to ensure people with specific needs were cared for appropriately. The diet of people with low Body Mass Index (BMI) or diabetes, for example, was not effectively monitored and provided according to specific dietary needs. There were insufficient staff to provide people with the support they required to eat sufficient amounts.

Is it well-led?

The service is not well-led. The provider had not taken action following the serious concerns we found during our inspection in June 2014. Issues with food and nutrition, care and welfare, infection control and quality assurance, staffing levels and staff training had not been addressed adequately. No audits or monitoring of the quality of the service provided was carried out.

A clear management structure was not in place and staff did not receive effective supervision. The provider appeared to be unfamiliar with the requirements of the regulations governing the provision of the regulated activity. The responsibilities of the provider and manager were not clearly defined and therefore concerns that had been identified had not been addressed.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to assessing and monitoring the quality of the service they provide.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

Risks to people's health, safety and welfare had not been assessed and remedial action had therefore not been taken. Some people did not have access to assistance from care staff, because their call bells were out of reach in their room.

Staff were employed within the home without the necessary checks on their suitability. The provider failed to ensure that Deprivation of Liberty Safeguards were applied for appropriately. Incidents of abuse had not been reported to the local safeguarding authority or to the Commission. People's safety was therefore placed at risk.

Is the service effective?

People we spoke with said they were satisfied with their care. However, we found staff were not familiar with people's needs and did not know how to assist people to manage their medical conditions. People's care needs were reviewed regularly but their care records were not updated. Staff failed to seek medical assistance when people required it. Staff training was not up to date and we observed poor care practice by staff who had received training recently.

No procedures were in place to ensure the home was kept clean. Care staff told us they were too busy to clean as well as providing care to people. We found some parts of the home were dirty and there was an offensive odour throughout the home. People were given assistance to eat however, they were not provided with a choice of main meal and snacks were not available to people.

Is the service caring?

People told us staff cared for them in a kind manner and we observed staff showing a caring attitude towards people living in the home. One person said, 'they are more like angels than staff'. However, staff often left people unattended for long periods and therefore could not respond to people's requests for assistance.

Is the service responsive?

People's care plans did not reflect their most current needs, and staff failed to take appropriate action when people's health deteriorated. We spoke with three relatives who told us they had not received an adequate response when they had made a complaint or comment about the care their relative had received.

The provider failed to respond to requests from staff for improvements to the care provided at the home. Staff supervisions were not carried out and poor staff practice was not addressed in order to ensure improvements were made to the provision of care. The provider had not ensured that commitments made at the registration of the manager of the home had been carried out.

Is the service well-led?

The service failed to consult staff about care provision and only half the people living in the home had been given an opportunity to give feedback about the service. There were no quality assurance processes in place and audits were not carried out to identify areas where improvement could be made.

In this report the name of a registered manager, Mrs Patricia Jannaway, appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. This was because they were still a registered manager on our register at the time of this inspection.

Everyone told us that they were happy with the care and support they received. One person told us, "Staff here are extremely pleasant and helpful, they are very willing and cant do enough for you. The staff here are real sweeties".

Another person said, "They really respect me and help me to feel that I have my dignity despite the help that I need". We asked the person what staff did to help them to maintain their dignity and they told us, "They always cover me up with towels and blankets when they are giving me care so I never feel exposed. They always knock on my door before they come in, and they always talk to me politely and care about my responses. In a nutshell I feel cared for".

People also told us that staff treated them with respect and promoted their privacy. They told us that they felt safe from harm living at the home and that they would be listened to if they raised any concerns. Our evidence gathered during this inspection supports the comments made by people who were receiving a service.