Background to this inspection
Updated
12 April 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Stewton House Nursing home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Stewton House Nursing home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service 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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also sought feedback from external professionals that work with this service and reviewed information we had received about the provider before our inspection.
During the inspection
We spoke with four people who used the service. We observed people and their interactions with staff and each other. We spoke with 11 relatives about their experience of the care provided.
We spoke with 10 staff during our inspection including housekeeping staff, kitchen staff, carers, senior carers, nurses, the deputy manager, and the registered manager.
We reviewed a range of people’s care records. We looked at three staff files in relation to recruitment practices. We reviewed various records relating to the management of the service including health and safety checks and incidents and accidents.
Updated
12 April 2024
About the service
Stewton House Nursing home is a residential care home providing personal and nursing care to up to 48 people in one adapted building. The service provides support to older people some of whom are living with a physical disability or receiving end of life care. At the time of our inspection there were 41 people using the service.
People’s experience of using this service and what we found
The provider had not informed the local authority safeguarding adults' team and CQC of safeguarding concerns. People were at risk of entrapment from bed rails. Environmental safety measures such as window restrictors or appropriate risk assessments were not always in place. People did not always receive their medicines safely. Relatives and staff felt there was not always enough staff on duty. Lessons were not always learnt following incidents and accidents. Staff did not always use personal protective equipment effectively.
Systems and processes to ensure consistent quality assurance such as auditing of medicines and incidents and accidents were not always effective. There was limited assurance around management oversight and ensuring risks to people were mitigated in line with people's care plans. People using the service had limited ways in which they could give feedback on their experiences of the care provided. There was evidence the provider worked in partnership with external professionals.
People had positive mealtime experiences and their nutritional needs were met. In addition, staff received supervision and training from the provider. The environment was well maintained, and people could personalise their rooms.
People and their relatives felt the staff were caring. We observed people being treated with dignity and respect. People were encouraged to be involved in their care and their independence was promoted.
Care plans contained information promoting people's care and communication needs being met. People could access activities and visits from relatives were supported to minimise the risk of social isolation. There were systems to manage complaints and concerns. People had appropriate plans in place for end-of-life care and support.
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
This service was registered with us on 18 June 2021 and this is the first inspection since the sale and transfer from the previous provider.
Why we inspected
This inspection was prompted by a review of the information we held about this service. 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.
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 monitor the service and will take further action if needed.
We have identified breaches in relation to safeguarding, safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.