Shottermill House

were living with a range of needs associated with the frailties of old age and some people were living with dementia.

We found the following examples of good practice.

There was clear communication to people who were visiting the service. Visiting was by appointment and there were different arrangements in place, to allow for individual preferences and weather conditions. Visitors used face masks and had temperature checks. Visits were risk assessed using a health questionnaire.

The layout of the service had allowed for isolation when needed and staff were working on separate floors.

The service was clean. Additional housekeeping staff had been employed and a robust cleaning

schedule was maintained. The layout of the service had been adjusted to give space between people when using communal areas.

One person had been unable to see their relative who lived overseas. Staff had supported contact with video calls and emails.

Shottermill House is a residential care home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can support up to 31 people.

Shottermill House accommodates people in one adapted building, spread across two floors. At the time of our inspection a refurbishment programme was in progress to improve the homes décor.

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

We have made a recommendation in relation to the recording of medicines. We have also made a recommendation in relation to the provision of a dementia friendly environment and to ensure mealtimes are person centred.

People received care in a safe and supportive environment. Potential risks were appropriately assessed to mitigate their reoccurrence. The premises were well maintained and monitored. The home was well kept and staff understood their responsibilities in relation to infection control. Staffing levels were reviewed to ensure they met people’s needs and staff were safely recruited.

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.

Staff received regular training, supervision and appraisal. When people needed to see healthcare professionals they were supported to do so. Although the meal time experience was task based, people enjoyed the food prepared for them.

People and relatives felt that staff were caring and supported them well. Staff knew how to respect people’s privacy and supported them to be as independent as they could be.

The care people received was personalised and reflected their preferences. Activities were in place to meet people’s needs. Complaints were appropriately responded to, and opportunities were in place to support people with end of life care.

Suitable interim management arrangements were in place to support people, relatives and staff. Quality assurance systems helped to identify areas of improvement. The provider worked alongside other agencies to enhance people’s wellbeing

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 30 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Shottermill House is a care home providing residential care for up to 31 older people, some of whom are living with dementia. The home is Christian home where worship and prayer are part of daily life. At the time of our inspection there were 27 people living at the service.

There was not a registered manager in post. 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. The registered manager had left the home on 31 March 2017. A new manager was due to start on 10 April 2017.

People and their relatives told us that they felt safe living at the service. Care records contained up to date risk assessments to keep people safe whilst encouraging independence. Risks to people were managed and staff followed guidance in relation to risk.

People were protected against the risks of potential abuse. Staff understood safeguarding adults procedures and what to do if they suspected any type of abuse.

People were supported by a sufficient number of staff to meet their individual needs. The provider had followed safe recruitment practices

Medicines were administered safely and on time. Medicines were stored securely and in an appropriate environment. Staff authorised to administer medicines had completed training in the safe management of medicines and had undertaken a competency assessment where their knowledge was checked.

There were appropriate plans in place in the event of fire. Each person had an up to date Personal Emergency Evacuation Plan (PEEP) which identified what support would be needed to evacuate the home in case of fire.

Staff worked in accordance with the Mental Capacity Act 2005 (MCA). People had their mental capacity assessed for specific decisions. DoLS applications had been made and staff had received MCA/DoLS training.

People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. Staff had undertaken induction training and on-going training as required.

People were supported by staff who had supervisions (one to one meetings) and an annual appraisal with their line manager. Staff received supervision three times a year.

People’s dietary needs and preferences were met. Staff monitored people’s food and fluid intake when required and made a GP appointment if they had any concerns about people. Records contained information on the food preferences of people and the kitchen staff were aware of these. People who needed support to eat were assisted by staff.

People’s health care needs were monitored and any changes in their health or well-being prompted a referral to their GP, mental health team or other health care professionals.

Staff treated people with dignity and respect and were caring. Staff knew people well. They were knowledgeable about people’s needs and backgrounds.

People were encouraged to be independent. Care records contained information on people’s strengths and what they could do for themselves. Observations on the day showed people were able to be independent as they used communal areas and facilities independently.

People were involved in the running of their home. Regular meetings happened where people could contribute. Relatives and friends were able to visit the home at any time.

Care plans were detailed and contained information on people’s lifestyles and preferences. Staff were very knowledgeable about people and what was in their care plans. People and their relatives were involved in developing their care plans. Annual reviews of people's care took place that included the person and their relatives.

People had a range of activities they could be involved in. People were able to choose what activities they took part in and suggest other activities they would like to complete. In addition to group activities people were able to maintain hobbies and interests, staff provided support as required.

People’s spiritual needs were met. The home is a Christian home where, ‘Collective Christian worship, prayer and support are core parts of daily life.’ Daily devotions take place and people are supported to go to places of worship.

People knew how to complain. The complaints procedure was available to people and visitors.

Audits were completed frequently and were thorough. These were carried out by the registered manager and the operations manager. They included cleanliness, records, health and safety, food, activities, consent to care, infection control and medicines. People and those important to them had opportunities to feedback their views about the home and quality of the service they received. An action plan was in place for 2017, this was created through actions identified in audits as well as feedback from people and relatives.

Falls were analysed so that staff could see where falls were occurring and what injuries were occurring. This was to help them identify how to avoid falls.

Staff were involved in the running of the home. Regular meetings took place where staff received important messages and shared good practice. Staff felt supported by management.

The service had a positive culture based on a Christian ethos. We observed this ethos to be present throughout the inspection and the findings from the inspection reflect this.