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Archived: Jackman's Lodge Good

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Inspection carried out on 19 January 2017

During a routine inspection

This inspection took place on 19 January 2017 and was unannounced.

Stokefield Care Home provides care and accommodation for up to 30 older people, some of whom are living with dementia.

There was not a registered manager in place. The new manager was in the process of becoming registered. 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 our last inspection we found breaches of regulation. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

People’s medicines were administered safely by trained staff. People had access to a variety of healthcare professionals and staff worked alongside them to ensure people’s needs were met. Staff had undertaken training specific to the needs of the people that they were supporting.

People were given choices and involved in their care by staff. People were prepared food in line with their preferences and dietary requirements. People could engage in a variety of activities, events and outings. People’s cultural and religious needs were catered for by staff.

Staff demonstrated a good understanding of the Mental Capacity Act (2005). In most cases, the correct process was followed when placing restrictions upon people. We recommended that the provider reviews their MCA records to ensure that the correct legal process is always followed.

People were supported by staff that knew them well. Care plans were person centred and contained important information about people’s lifestyle, background and preferences. The manager undertook regular audits to ensure records were up to date and clear for staff.

People and staff got along well and caring interactions we observed were mostly positive. We observed one staff member speaking to someone in a way that was not considerate of their needs. We recommended that the provider ensures that all staff are considerate and respectful.

Staff understood their roles in protecting people from abuse. When recruiting staff, checks were undertaken to ensure that they were suitable for their roles. There were sufficient staff present to meet people’s needs.

Risks to people were assessed and measures were in place to protect people. Where incidents happened, actions were taken to keep people safe and prevent them from reoccurring.

People lived in an inclusive atmosphere in which they were involved in decisions about their home. Staff encouraged people to be independent and to make choices. The provider regularly sought people’s feedback and people were aware of how to make a complaint. Complaints were responded to appropriately by the manager.

Staff felt supported by management and could make suggestions to improve the lives of people living at the home. Staff provided support in a way that promoted people’s privacy and dignity.

Plans were in place to support people in the event of an emergency. Regular audits were undertaken to ensure the safety of the premises and equipment.

Inspection carried out on 31 July 2015

During a routine inspection

This was an unannounced inspection that took place on 31 July 2015.

Stokefield Care Home is owned by Galleon Care Homes Limited and is registered to provide accommodation with care for up to 30 people. At the time of our visit, there were 28 older people living at the service. Only a small number of people at the home are living with dementia, whereas others have complex needs. The accommodation is provided over two floors with annexes off each floor that were accessible by stairs and a lift.

Stokefield Care Home had 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.

People were at risk as the provider’s recruitment practices were not safe as not all of the relevant checks had been completed before staff commenced work.

People’s medicines were not always managed safely. There was not robust management of medicines to ensure there is a sufficient supply of medicines to meet people’s needs. Audits conducted on the management of medicines were not robust to stop poor practice.

People were protected from the risk of abuse because staff knew their roles and responsibilities should they suspect it was taking place. People told us they felt safe at the home. One person told us, I feel very safe here, the staff are lovely.” Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from abuse.

People were supported by a sufficient staff team, however there were times when staffing levels had an impact on the care provided. We made a recommendation that the provider reviews the staffing levels and deployment of staff to meet people’s care and support needs.

People were involved in how they were kept safe at the home. People’s risk assessments contained information regarding their behaviour, health and care needs were discussed with them. Any issues that arose would be discussed, along with the involvement of a healthcare professional, such as the speech and language therapist or falls team.

Staff had a clear understanding of what to do in the event of an emergency which would affect the home such as fire, adverse weather conditions, power cuts and flooding. The provider had identified alternative locations which would be used if the home was unable to be used.

People told us their freedom was not restricted. Staff told us they had received training on the Mental Capacity Act and Deprivation of Liberty Safeguards.

People’s care and support needs could be affected due to care records not being fully completed or kept up to date There were inconsistencies in the recording of people’s care records.

Quality assurance checks were not always effective to ensure that the systems in place were managed well. We made a recommendation the provider reviews people’s care plan in accordance to their needs.

People had mixed feelings about the quality and variety of food at the home. People had enough to eat and drink throughout the day and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and healthcare professional were involved in the regular monitoring of people’s health. The service worked effectively with health care professionals and referred people for treatment when necessary.

The décor of the home was painted in neutral colours. The walls and doors were painted in different colours, enabling people living with dementia or any impairment to move around the home independently. People’s bedrooms were personalised with pictures, photographs or items of personal interest.

Staff treated people with kindness and respect. People told us that staff treated them with respect and dignity when providing personal care. People felt that staff knew them well. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s relatives and friends were able to visit.

People had access to activities, but these did not always meet individual needs or interests.We made a recommendation that the provider reviews individual hobbies and interests and look at ways and means these could be implemented and people supported to participate.

People said that staff were attentive and responsive to their needs. People’s needs were assessed when they entered the service and reviewed regularly. Care records were updated by staff involved in their care. People had access to equipment to assist with their care and support to enable them to be independent.

The provider had sought, encouraged and supported people’s involvement in the improvement of the service.

People told us if they had any issues they would speak to the manager. People were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard.

People told us the staff were friendly, supportive and management were visible and approachable.

We found a number breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 23 September 2014

During an inspection to make sure that the improvements required had been made

People told us they were happy with the care they received. They said the staff were polite and spoke to them in a respectful manner. They told us, “There were enough staff on duty to meet our needs”.

We found the service had a staff duty rota which reflected the numbers of staff on duty over any twenty-four hour period. We saw that documentation of staff on duty had been recorded correctly.

Inspection carried out on 18 March 2014

During an inspection to make sure that the improvements required had been made

We visited Stokefield Care Centre to check if they had become compliant with the compliance action we made during our inspection in September 2013. This was in relation to ensuring that there were sufficient numbers of staff on duty. We also followed up on concerns that had been raised with the Care Quality Commission relating to the availability of staff and the administration of medicines.

During this visit we spoke with the manager and three members of staff. We had discussions with five people who used the service.

People told us that staff were not always visible in the home but that staff support was available if they needed it. All the people we spoke with carried portable call alarms and told us that staff arrived quickly if they used their call alarms. One person told us, “I can do most things for myself but they [staff] come and see to me if I need anything.”

Inspection carried out on 11 September 2013

During a routine inspection

This was a routine inspection which we brought forward due to concerns raised from relatives and carers about lack of staff and availability of equipment.

During our visit we spoke with spoke with six staff including the Registered Manager. We also spoke with seven people including relatives and made observations throughout our visit.

People told us that staff were very caring at Stokefield Care Home. We were told “Everyone is so nice” and “All the staff look after me very well.” Although some people commented that there were frequently delays in care due to staff being busy helping other people.

People told us that they generally enjoyed the meals. We saw that there was a choice of menus each day. We saw that lunch was a sociable occasion which was shared with people who were attending from the sheltered accommodation next door.

We found that there had been recent problems with equipment. The dishwasher was out of use and the washing machine was being repaired when we visited.

Most people, relatives and staff we spoke with told us that there were frequent shortages of staff which resulted in people waiting for care.

We found that staff had received appropriate training, although some formal supervision meetings were overdue.

Inspection carried out on 14 September 2012

During a routine inspection

People using the service told us that staff were available when they needed them and that they provided good care. They said that staff were polite, friendly and cheerful. One person told us that the staff were “all very good” and another said, “The staff have been superb to me – they’re absolutely wonderful.” The relatives we spoke with also provided positive feedback about the staff. They said that staff provided care in a professional but friendly manner and that they knew the needs of the people they supported well. One relative told us, “The staff are excellent.”

People told us that staff treated them with respect. One person described the staff as, “very polite” and another said, “They’re always very respectful.” People said that they were supported to make choices about their daily lives and how they spent their time. They said that their privacy was respected when care was being delivered or when they wished to spend time in their rooms. A visiting relative told us that their family member was always treated with dignity by staff and that their family member was encouraged to make decisions about their care.

People using the service told us that they felt safe and well cared for at the home. One person told us, “I like it here – I’ve never had a problem since the day I moved in” and another said, “To me, it couldn’t be any better - everything here is 100%.”