We carried out a review of the data available to us about Stanhope Court Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Stanhope Court Residential Care Home, you can give feedback on this service.
We found the following examples of good practice:
• The service had procedures and protocols in place which ensured people were admitted into the service and relatives could visit safely in accordance with national guidance.
• People and their relatives were supported to understand the isolation processes and how the service could help to alleviate them feeling lonely, such as video calls with friends and loved ones and dedicated support time from their assigned staff member. There were additional staff working at the home which enabled daily activities and support to be increased.
• There was a family forum set up whereby good communication was enabled through emails and a WhatsApp group.
• Staff were supported in isolation/sickness absence by the provider. Staff support and wellbeing was considered and enhanced during the pandemic.
• Personal protective equipment (PPE) was widely available and used correctly and there was an extensive testing program in place for staff, residents and relatives.
• The home was clean and hygienic throughout. The lounge had been extended to enable good social distancing.
• Staff were trained in infection prevention and control (IPC) and had frequent refresher training and guidance in COVID-19 guidelines. They had good links with the local community trust IPC team for guidance and support.
• There was an IPC policy and procedures in place, however the recently revised policy had not yet been fully rolled out to all staff.
• The senior management team worked in isolation within their group, so they did not come into contact with each other. Regular meetings took place remotely. Staff were responsible, did not socialise and were very cautious of their behaviour outside of work, in order to minimise risks to colleagues and people.
The home is registered to accommodate up to 13 people in a single storey unit that is part of larger premises known as Meadowcroft, where a range of daytime activities is provided by Age UK Wirral.
The home is required to have a registered manager. 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. A new manager had recently been registered with CQC.
We last inspected Stanhope Court on 27 June 2017 when we found that the service over all required improvement and there was a breach of Regulation 11 of the Health and Social Care Act (Regulated Activities) Regulations 2014 because consent to care and treatment had not always been gained lawfully in accordance with the Mental Capacity Act 2005. During this inspection we found that improvements had been made in this area and good records were in place.
At the time of this inspection there were 11 people living at the home and one person was having a short stay there. There were enough qualified and experienced staff to meet people's care needs. Robust recruitment processes were in place to check staff were suitable to work with people who may be vulnerable.
The environment was safe, clean and well-maintained.
People’s medication was stored and handled safely.
People had plenty to eat and drink and alternative meals were always available. People received the support they needed to maintain nutrition and hydration.
Everyone we spoke with was very happy with the staff team and with the way that support was provided. The care files contained plenty of detailed information about the people who lived at the home and work was in progress to improve the presentation of the care files.
People had opportunities to join in social activities both within the home and in the adjoining day centre.
A programme of quality audits was in place and people were given the opportunity to express their views about the service at meetings of the resident and relative forum.
The standard of record keeping across the service had improved.
During this inspection we found that improvements had been made to many aspects of the service. However, we identified a breach of Regulation 11 of the Health and Social Care Act (Regulated Activities) Regulations 2014 because consent to care and treatment had not always been gained lawfully in accordance with the Mental Capacity Act 2005.
Stanhope Court is situated within the Meadowcroft building where a range of daytime activities is provided by Age UK for older people and for people living with dementia. The care home is registered to provide accommodation and personal care for up to 13 people. People who used the service were older people and were predominantly people living with dementia. At the time of this inspection there were 12 people living at the home and one person having a short stay there.
The home is required to have a registered manager. 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 person who was managing the home at the time of this inspection had applied for registration with CQC.
People told us that they felt safe and comfortable living at Stanhope Court. Improvements had been made to the recording, reporting and investigation of accidents and untoward incidents and action had been taken to prevent further occurrences.
There were enough staff to meet people's care needs. Robust recruitment processes were in place to check staff were suitable to work with vulnerable people. Staff received training relevant to their work. Everyone we spoke with was very happy with the staff team.
We found significant improvement to the safe storage and recording of medication.
People were happy with their meals. They told us they had plenty to eat and drink and that alternative meals were always available.
Building work had improved communal facilities for people living at the home and provided offices for the manager and the senior care staff. Friends and relatives were now able to visit without going through the reception and day centre areas. The environment was clean and well-maintained.
Information regarding mental capacity assessment, Deprivation of Liberty Safeguards, and consent was unclear and unsatisfactory and further work was needed in this area to ensure full compliance with the Mental Capacity Act.
Care files contained plenty of information about the people who lived at the home and work was in progress to improve the presentation of the care files.
A programme of quality audits was in place and people were given the opportunity to express their views about the service at meetings of the resident and relative forum.
We found a poor standard of record keeping across the service which meant that it was difficult to access clear and up to date information.
Stanhope Court is registered to provide accommodation and personal care for up to 13 people. People who used the service were all over 50 years of age and were predominantly people living with dementia. At the time of this inspection there were eight people living at the home and two people having a short stay there.
The service is also registered to provide personal care to people living in their own homes. A small number of people were receiving home support and during this inspection the Chief Executive told us that this part of the service was going to be discontinued in the near future.
Stanhope Court is situated within the Meadowcroft building where a range of daytime activities is provided for older people and for people living with dementia. Since our last inspection, the residential service had been given its own name which distinguished it from the daytime services.
The home is required to have a registered manager. 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 person who was managing the home at the time of this inspection had applied for registration with CQC.
At our last comprehensive inspection of the home in December 2015, we found a number of breaches of regulations. We served warning notices on the home for failing to provide safe care and treatment and safeguard people from abuse, and failing to provide good governance for the service. We found that improvements had been made in all of these areas but further improvements were needed to meet all parts of the regulations. However, in response to the improvements that had been made we took the home out of special measures.
In December 2015 we found that people were not getting the care they needed in a safe way. People’s health and welfare risks had not been properly assessed or mitigated against in the planning and delivery of care. Medicines were not always managed in a proper or safe way. There were no established systems in place to effectively record, investigate and act upon allegations of abuse in order to protect people from potential harm. The provider did not have effective systems in place to assess and monitor their service against Health and Social Care Act Regulations or to assess, monitor and mitigate risks to the health, safety and welfare of people who used the service.
During this inspection we found that improvements had been made to the investigation and reporting of untoward incidents and prevention of further incidents. However, we found that further improvements were needed to the documentation of this in people’s care files. We found that action had been taken to improve the safe management of people’s medication, however this had resulted in over-complication of medicines records which was onerous for senior care staff and made it difficult to check whether quantities of prescribed items were correct. Effective quality audits had been carried out and recorded and a relatives and carers forum had been established.
Building work was underway to improve communal facilities for people living at the home and to provide an office for the manager within the residential unit.
There were sufficient staff working at the home to meet people’s care needs. Robust recruitment processes were in place to check staff were suitable to work with people who may be vulnerable. Further training and supervision had been provided for staff. People were happy with their meals and enjoyed the range of social activities that was available.
People we spoke with found the home manager and the senior managers to be approachable and responsive.
We carried out an unannounced comprehensive inspection of this service on 11 and 13 May 2015. Breaches of three legal requirements were found. This was because: risk assessments relating to the health, safety and welfare of people using the service were not completed to a satisfactory standard and plans for managing risks were inadequate; assessments were not carried out in accordance with the Mental Capacity Act 2005; medicines were not always managed safely; staff employed by the provider did not receive appropriate support, training, supervision and appraisal; the provider did not have effective systems in place to assess, monitor and improve the quality and safety of the services provided.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.
We undertook a follow up inspection on 10 December 2015 to check that they had followed their plan and to confirm that they now met legal requirements. During the inspection we found breaches of Regulations 12, 13 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as a result of our findings we returned to complete a comprehensive inspection of the service on 29 December 2015.
Meadowcroft provides a range of services for older people and people living with dementia. In December 2013, a short stay unit accommodating up to eight people was registered and in April 2015 the number of places provided was increased to 13. The service is also registered to provide personal care for people in their own homes.
The service had a registered manager. 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.
Accidents and untoward incidents had not been investigated and had not been reported to the local authority or to CQC where required. Plans had not been put in place to manage identified risks to people’s safety. A significant number of medication errors continued to be reported and no action plan was recorded to address this.
People who used the residential service had a diagnosis of dementia which had an impact on their ability to consent to decisions about their care. People’s mental capacity had not been assessed in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had not been applied for.
Care records were poorly presented and did not give clear guidance to staff about people’s individual needs and how their needs should be met.
A range of social activities was provided every day in the day centre and people could choose which activities they participated in. We were told that people had a choice where they spent their time, however there was an apparent expectation that people would spend their daytime hours in the day centre.
There were enough staff to meet people’s needs and checks were carried out to ensure that new staff were recruited safely. Shortfalls in staff training were being addressed and all staff had been enrolled to the Care Certificate. A new system of staff supervision had been put in place. We observed staff supporting people at the service and saw that they were warm, patient and caring in all interactions with people. People were seen to be relaxed and comfortable in the company of staff. People who used the service and their relatives told us they were very happy with the service provided.
The premises were clean and bedrooms were appropriately decorated and furnished. Regular health and safety checks of the environment had been carried out. The premises did not provide a homely environment and there were minimal adaptations to help people living with dementia to find their way around.
We were concerned that the registered manager did not have an office within or near to the residential unit and the manager had additional responsibilities that were not related to the regulated activities. There were some audits in place to check the quality of the service, however these had not identified risks to people’s health, welfare and safety.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:
Ensure that providers found to be providing inadequate are significantly improve.
Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location from the providers registration.
We undertook this comprehensive inspection on the 11 and 13 May 2015. Meadowcroft provides a range of services for older people and people living with dementia. In December 2013, a respite care unit accommodating up to eight people was registered and in April 2015 the number of places provided was increased to 13. The manager told us that they intended to use four of these places to accommodate people on a long-term basis. The service is also registered to provide personal care for people in their own homes.
The service had a registered manager. 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 service encouraged people who used the service, their relatives and carers to complete a questionnaire at the end of their stay to gain people’s feedback on the quality of the service. These showed that people were very happy with the service they had received.
Age UK Wirral had produced a leaflet which gave clear details about recognising and reporting abuse. Most staff had received training about safeguarding.
There were enough qualified and experienced staff to meet people’s needs and checks were carried out to ensure that new staff were recruited safely.
We found that the premises were clean and bedrooms were appropriately decorated and furnished. Health and safety checks had not identified deficits in staff training, in particular with regard to fire safety, or that regular fire alarm tests had not been carried out. There were no personal emergency evacuation plans to provide information about people’s evacuation needs in case of an emergency.
Medication was appropriately stored. A number of medication errors had been reported by staff working in the service during April 2015 and no action plan was recorded to address this .
There were significant shortfalls in staff training and staff working on the residential unit had not been appropriately supported in their job role. We saw that regular meetings took place for senior staff and management but there were no meetings for care staff.
People who used the residential service had a diagnosis of dementia which had an impact on their ability to consent to decisions about their care. Their capacity had not been assessed in accordance with the Mental Capacity Act 2005.
People had a choice at mealtimes and were given a suitable range of nutritious food and drink. People identified at risk of malnutrition had their dietary intake monitored, however nutritional risk assessments had not been completed in a satisfactory way.
We observed staff supporting people at the service and saw that they were warm, patient and caring in all interactions with people. People were seen to be relaxed and comfortable in the company of staff.
We looked at the care records for the three people who were receiving respite care. Each record held information regarding people's individual health and social care needs. People’s care plans did not cover all of people’s needs and risks. They lacked person centred information to enable staff to understand and relate to the people they were supporting and people’s emotional needs.
A range of social activities was provided every day and people could choose which activities they participated in.
Complaints records were incomplete and did not show that the manager had responsibility for investigation and responding to complaints received.
There were some audits in place to check the quality of the service, however these required further development to ensure the risks to people’s health, welfare and safety were identified and addressed.
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
As part of this inspection we spoke with the one person who used the service, a relative of a person who used the service, the manager and two care workers. We also reviewed records relating to the management of the home which included, three care records including care plans, daily care records, risk assessments. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us that they felt their rights and dignity were respected. They told us they felt safe. Systems were in place to make sure that managers and staff learnt from events such as complaints, concerns, whistleblowing and investigations. There was sign posting information available to people who used the service to share their experience and to access independent support and advice. This reduced the risks to people and helped the service to continually improve.
We observed members of the staff team supporting people in a respectful and supportive manner. We observed one member of staff offering reassurance to a person who was becoming agitated about wanting to go home.
We looked at the training matrix for the staff team. This record showed the provider actively supported the staff team to undertake training to enable them to provide safe and appropriate care and support. This record also showed that staff received training around safeguarding vulnerable adults from abuse. We spoke with two members of staff who described how they would ensure the welfare of vulnerable adults was protected through the whistle blowing and safeguarding procedures. The manager was also very clear about his responsibilities in this area. We spoke with the relative of a person using the service they told us, 'I am so impressed with how the staff team care for mum and how patient they are, I have no concerns about how mum is treated or cared for. If I felt I had any concerns I would go to the care staff on duty and if I did not feel my concern was addressed I would speak to Mark (Registered Manager).'
People's health and care needs were assessed with appropriate referrals being made to external professionals who were able to assess and support the care of people in the home. We looked at the care records of the three our people using the service. We found that not all the care plans, risk assessments and management plans reflected their current needs and recorded the support people required or wanted. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to keeping accurate records and appropriate information in relation to the care and treatment provided to each person staying at the service.
Is the service effective?
People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well
Care needs such as mobility and healthcare needs had been identified in initial assessment documents. However, risk assessments and care plans we saw did not clearly show how these identified needs were to be met. Care plans were therefore not able to support staff consistently to meet people's needs.
Is the service caring?
People were supported by kind and attentive staff. One relative of a person using the service told us, 'this place is like a home from home, mum is very settled here it's a shame she can't live here permanently, the staff are so respectful and kind the entire focus of the service is about the person they are caring for.'
Is the service responsive?
Discussions with members of the staff team indicated that a detailed induction programme was in place to ensure the staff team had the necessary skills and competencies to meet people's needs.
The training matrix showed the provider supported staff to undertake training to support them in their roles. For example the training matrix for 2013/2014 showed the following training was to be provided to the staff team; understanding dementia, Mental Capacity Act and the Deprivation of Liberty Safeguards, break away training and emergency first aid. Members of the staff team spoken with told us, 'Age UK really invest in staff training I feel valued by this and feel people who use our service receive better and safer care because of it.' If a person comes to stay with a health or behavioural issue we have not had experience of supporting the manager sorts out some training, recently we had Parkinson's Disease training. I feel supported by the manager and the teams I work with I really enjoy my job.'
Discussions with the manager and information held on the staffing rota indicated that staff from the day service and the homecare service work in the respite service as well. The manager told us this cross over working supported people who use the respite service as they had already built relationships with members of the staff team.
We saw that care workers showed patience and gave encouragement when supporting people. Some of the records we looked at did not show people's preferences, interests and preferred routines. Other records we looked at were not as detailed as they could be.
Is the service well-led?
There was a Registered Manager in post at the time of our inspection. The service worked with other agencies and services to make sure people received their care and support in a joined up way.
The service encouraged people who used the service, their relatives and carers to complete a questionnaire at the end of their stay this survey is called 'Are we getting it right we want to hear from you'. We looked at six completed surveys that provided positive feedback for the service. The provider, Age UK also carried out an organisational survey on an annual basis to gain the views of the people who used their services and to adapt services to meet people's changing needs and expectations.
The quality assurance systems in place were informal with no documented formal feedback provided to the manager from audits carried out by senior managers within the organisation.
Records showed the service had not reviewed and updated the health and safety assessments to reflect the current building work being carried out at Meadowcroft.