Background to this inspection
Updated
20 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was undertaken by two adult social care inspectors and an expert-by-experience on 28 August 2018 and was unannounced. An expert by- experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection we looked at other information we held about the service such as notifications and previous reports. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. At our last inspection of the service in August 2017 we did not identify any concerns with the care provided to people.
During the inspection we met all the people who lived at the service and spoke with 10 people in detail about their care. Some people living at the service were living with dementia which meant they had limited ability to communicate and tell us about their experience of being supported by the staff team. Therefore staff used other methods of communication, for example by providing visual prompts. Others were able to tell us about the care and support they received. As some people were not able to comment specifically about their care experiences, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living in the service.
We also looked around the premises. We spoke to the provider, seven staff and three relatives. We looked at records relating to individual’s care and the running of the home. These included four care and support plans and records relating to medicine administration. We also looked at the quality monitoring of the service.
Updated
20 September 2018
We carried out an unannounced comprehensive inspection on 28 August 2018.
Sheldon House is a care home without nursing for up to 30 people. On the day of our inspection there were 25 people living at the service. It specialises in care for older people who are living with dementia or who experience other enduring mental illness.
People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 provider was in the process of interviewing for a new manager who would register with the Commission.
At the last inspection on 27 June 2017, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated good:
We received information of concern prior to our visit. This included care plans and risk assessments not being updated, incident forms not completed, poor leadership, care staff not being able to access information about people and GP’s not being contacted about people’s health concerns.
However, at this inspection we found these concerns unsubstantiated.
We met and spoke with most of the people living in the service during our visit. However, some people were not able to fully verbalise their views, so staff used other methods of communication, for example pictures. Others could tell us about the care and support they received. Due to people’s needs we spent time observing people with the staff supporting them.
People remained safe at Sheldon House. People who were able to told us they felt safe living there. One person said; “Yes I do (feel safe), I have never felt so relaxed as being here. I was alone before.” A relative said; “Yes, I do. I think it’s the best one she’s (their relative) been in, she’s been in lots of homes. She’s more like herself now.”
People received their medicines safely by staff that had received regular updated training. People were protected by safe recruitment procedures. This helped to ensure staff employed were suitable to work with vulnerable people. People, relatives and the staff team confirmed there were sufficient number of staff to help keep people safe. Staff said they were able to meet people’s needs and support them when needed.
People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible.
People continued to receive care from a staff team that had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). The Care Certificate training looked at and discussed the Equality and Diversity and Human Rights policy of the company. One staff member said; “I love the atmosphere here and staff morale is good.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s wishes for their end of life were clearly documented. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.
People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were upheld and consent to care was sought. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people’s preferences and wishes. Information held included people’s previous history and any cultural, religious and spiritual needs.
People were observed to be treated with kindness and compassion by the staff who valued them. The staff, some who had worked at the service for a number of years, had built strong relationships with people. All staff demonstrated kindness for people through their conversations and interactions. Staff respected people’s privacy. People or their representatives, were involved in decisions about the care and support people received.
The service remained responsive to people's individual needs and provided personalised care and support. People’s equality and diversity was respected and people were supported in the way they wanted to be. People who required assistance with their communication needs had these individually assessed and met. People were able to make choices about their day to day lives. The provider had a complaints policy in place and records showed all complaints had been fully investigated and responded to.
The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. People, relatives and staff said the providers were approachable.
People lived in a service which had been designed and adapted to meet their needs. The provider monitored the service to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service. The provider listened to feedback and reflected on how the service could be further improved. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.