Archived: Stadium Court Care Home

Stadium Court is a care home that was providing personal and nursing care to 65 people across three separate units at the time of inspection; these were called Wedgwood, Spode and Wade units. Each unit had their own adapted facilities. There were five units in total, but two were closed. The service can support up to 110 people. People who used the service were over 65 who had mental health needs such as dementia and physical disabilities.

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

Quality assurance systems had not been fully embedded, but the registered manager had been making improvements. Medicines were not always managed safely as there were some stock discrepancies, and medications that had expired but had not been disposed of. Although we did not find anyone having come to harm as a result of this, action was taken to address immediately by the registered manager and nursing staff.

Staff recruitment was on-going and some agency staff were being used to meet people’s needs.

Risks to people were not always assessed and planned for, and some care plans needed reviewing. Staff did not always understand people’s needs. This was being addressed by the registered manager.

Staff were trained to recognise and respond to concerns of abuse. There were adequate infection prevention and control measures in place.

Lessons were learned when things went wrong. Actions were taken to address incidents and share learning with staff. The registered manager was aware of their duty of candour.

Staff felt the registered manager was approachable, supportive and visible.

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 26 September 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, medicines and falls. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Stadium Court Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified a breach in relation to Regulation 17 (Good governance) at this inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

• A visiting policy was in place which had been shared with relatives. This included a visitor risk assessment, booking system and details of the procedure to be followed to keep people safe.

• When visits had been restricted other methods were used to ensure people continued to have contact with their loved ones such as, video/telephone calls and garden visits. The registered manager kept in regular contact with relatives and reviews were held to ensure people’s needs continued to be met.

• Social distancing within communal areas and periods of isolation were in place to reduce the risk of cross transmission.

• The environment was well maintained and clean. Additional cleaning of regular touchpoints was completed to lower the risk of cross transmission.

• Staff were supported by the registered manager to lower any anxieties and the provider had implemented an internal health and wellbeing service for staff to access if needed.

• The provider had a specific team to collate infection prevention and control information and guidance in relation to COVID-19. Analysis was completed after an outbreak within the provider group to ensure lessons were learnt and any improvements needed were implemented.

Stadium Court is a care home providing personal and nursing care to 83 people aged 65 and over at the time of inspection. The home can support up to 110 people across five separate units. At the time of inspection only three of the five units were in operation. One of the units open specialises in providing care to people living with dementia.

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

There was inconsistency across the three units, in relation to staff deployment which impacted on people’s experience of living in the home and the amount of quality time staff had to spend with people.

People’s equality and diversity was not routinely assessed or reviewed. We recommended the home reviews people’s equality and diversity needs.

People’s dining experience was not consistent across the units, we recommend that consideration be given to people’s dining experience.

Activities for people were provided, however, these were not always meaningful for people. We were assured these were currently being developed to make them more meaningful for people and would take people’s preferences into consideration. However, we did not see these plans had been made effective.

Medicines were being managed safely.

Systems were in place to ensure people were safeguarding from abuse, which included people’s risks were monitored and staff were knowledgeable in ensuring people were protected. People told us they felt safe living in the home.

People had personalised care plans in place which were reviewed and updated and included their support needs. These plans supported staff with information to supporting people in the home which detailed people’s preferences. People were supported with end of life wishes which were recorded.

People received enough food to meet their nutritional needs, however, improvements were needed to ensure people consistently had a positive experience throughout the home during meal times.

The service was in need for redecoration which had been recognised by the registered manager and the provider.

People knew how to make a complaint and complaints received were addressed in line with the providers policy.

The registered manager worked alongside the management team to continue to embed new ways of working and there were plans in place for the service to continue to develop. People and relatives spoke highly of the improvements that had been made thus far. A number of new systems to monitor and improve people’s experience of receiving care had been introduced however, although they had the potential to address the shortfalls in the home they were in there infancy and required further development.

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.

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 03 September 2018) and there was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the service through the information we receive. We will return to re-inspect in line with our inspection programme for requires improvement services.

There was 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. This registered manager was only planning on being there temporarily until a permanent manager was recruited. There were also unit managers for each unit who reported to the registered manager.

This is the homes first ratings inspection since it was registered.

At this inspection we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.

We have made a recommendation that arrangements for staff with a positive Disclosure and Barring Service (DBS) check are reviewed to reflect current working arrangements.

We have also made a recommendation that people’s care plans contain more personalised information.

Medicines were not always being managed or stored safely. We could not always be sure that people were receiving their medicines as prescribed.

Quality assurance systems in place did not always ensure that people received a safe and effective service. However, some improvements required had been identified and an action plan was in place that was in progress. People felt able to approach the registered manager or unit managers. However, there was some confusion from people, relatives and staff about the management structure and ongoing changes. People and relatives were asked for their opinion about care but some felt that communication could be improved.

There was mixed feedback about staffing levels and work was ongoing to improve staff deployment. People told us they felt safe but risks were not always assessed, planned for and managed appropriately. People were protected from potential abuse by staff who understood their safeguarding responsibilities. People were also protected from the risk of infection as the home was clean and tidy and systems were in place for infection control. The building was appropriately maintained and plans were in place in case of emergency.

People were not always supported to maintain their dignity. However, people felt staff were kind and caring. People were encouraged to be independent and there were no restrictions on people visiting the home.

We found that some staff had not always received refresher training relevant to their role. However, the provider was in the process of addressing this, to ensure staff had the appropriate skills to meet people’s needs. People’s human rights were protected because staff were aware of the principles of the Mental Capacity Act 2005, which was adopted in their care practices. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to have food and drinks of their choice. People had access to other health professionals to ensure their physical and mental health. The building was suitably adapted to cater for the people living in the home.

Complaints were recorded, investigated and responded. However prompt action was not always taken to ensure improvements were made with regards to concerns raised. People and relatives told us that they were involved in developing their care plan. People were supported to communicate and plans were in place to guide staff on how people communicated. Plans were also in place when people were nearing the end of their life to ensure their choices were respected. There were a range of social activities available for people to partake in and people could pursue their interests.

Other professionals who work with the home felt it worked well with their organisations and they noted many improvements had been made. Notifications were submitted as required.