We carried out a review of the data available to us about Stanley House 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 Stanley House, you can give feedback on this service.
Stanley House is a care home providing nursing care for up to 21 people. It specialises in supporting people who have complex neurological needs including Huntington’s Disease, acquired brain injury (for example, due to a head injury or stroke) or people with mental health needs who also have physical disabilities. Care and support are provided in one adapted building and there were 20 people using the service at the time of the inspection.
People’s experience of using this service and what we found
People told us they felt safe and staff knew what to do if abuse was suspected. Evidence of safeguarding investigations were seen. Individual risk assessments had been completed. Medicines were managed safely, and actions had been taken to investigate any gaps.
People were complimentary about the staff; the staff had been recruited safely. Staff were wearing personal protective equipment, appropriate policies and guidance were available.
People received good care, people and their relatives were complementary about the service provided. People were involved in decisions and choices about the care they received. Care plans had been developed and contained information about how to support people's needs. People were supported with their communication. Activities were available to people, and engagement with the wider community was supported.
People were positive about their care and support and told us the staff were kind, caring and knew them well. People were encouraged to learn new skills and be as independent as possible. Staff supported people to live the lifestyle of their choice. People were treated with dignity and respect.
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.
The last rating for this service was good (report published 16 November 2020).
Why we inspected
The inspection was prompted in part due to concerns received about staff culture at another home on the same site. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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.
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.
The overall rating for the service has remained good. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stanley House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Stanley House is a residential care home providing personal and nursing care to 21 people living with either Huntington’s Disease, acquired brain injury or mental health needs who also have a physical disability. Care and support are provided in one adapted building and there were 20 people using the service at the time of the inspection.
People’s experience of using this service and what we found
The manager had made the necessary improvements at the home since our last inspection. Fire safety concerns have been addressed.
Relatives felt the manager and staff team worked in an open transparent way and were approachable.
People's needs were assessed before they moved to the service to ensure those needs could be met. Staff received training and supervision to support them in carrying out their role effectively. Safe staff recruitment systems were now in place to ensure staff’s employment histories were recorded in their recruitment files.
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.
Quality assurance and monitoring systems were now in place to help drive improvements at the service.
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 02 April 2020).
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last 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 coronavirus and other infection outbreaks effectively.
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.
The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stanley House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Stanley House is a residential care home providing personal and nursing care to 21 people living with either Huntington’s Disease, acquired brain injury or mental health needs who also have a physical disability. Care and support is provided in one adapted building and there were 21 people using the service at the time of the inspection.
People’s experience of using this service and what we found
Fire safety concerns in relation to the blocking of a fire extinguisher were a potential risk to people’s safety in the event of a fire.
Recruitment processes were not always fully completed to ensure the provider and registered manager was fully aware of potential employees work background.
Medicines were administered to people as prescribed however the administration of creams was not always recorded to evidence the application of these items.
Care plans were reviewed however these did not always fully reflect changes to people’s care needs or full guidance for staff to reference and follow.
Risks to people identified care and support needs were assessed and staff members were aware of these and recording their actions where needed. Staff were aware of how to prevent the risk of cross infection.
The provider and registered manager was aware of their responsibility to inform the Care Quality Commission (CQC) of safeguarding incidents within the home as well as the local authority. Staff had received training in this area.
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. Documentation in relation to this however, required improvement.
Assessments of care and support needs were undertaken prior to people moving into the home and an initial care plan was in place. Staff received training to enable them to have the knowledge and skills to meet people’s needs. Staff felt supported by the management team
People were supported to receive a balanced and varied diet and to have their health care needs met. People were cared for and supported by staff who were kind and caring. Staff respected people’s wishes and respected people’s privacy and dignity.
People were able to take part in fun and interesting things and at times able to involve their family members in events.
People and staff liked the registered manager and felt they were approachable.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This was a planned inspection based on the previous rating
The last rating for this service was Requires Improvement (published August 2018). There were breaches in relation to safeguarding people from abuse and improper treatment, notifying the CQC of safeguarding incidents and the governance of the service provided.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led sections of this full report.
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Stanley House is a ‘care home’. People in care homes received accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Stanley House accommodates up to 21 people within one adapted building. It specialises in supporting people who have either Huntington’s Disease, acquired brain injury or people with mental health needs who also have physical disabilities. At the time of the inspection there were 18 people living at Stanley House.
There was a registered manager in post at the time of the inspection, who had been in place since December 2016. 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 comprehensive inspection of the service in June 2016, the overall rating for the service was judged to be ‘good.’ At this inspection we have rated the service as ‘requires improvement’.
During this inspection we identified three breaches of regulation. These were in relation to safeguarding people from abuse or improper treatment; concerns about good governance; and failure to notify the CQC of incidents involving alleged harm or abuse.
Allegations of abuse or harm had not been investigated effectively or appropriately. Allegations of abuse or harm had not been shared by the provider with the local authority, or with the Care Quality Commission. This meant people were not always protected from potential abuse. The management team did not demonstrate an understanding of their role and responsibilities in terms of investigating and reporting allegations of abuse and harm.
Registered providers are required by law to notify the CQC of incidents where people have suffered harm, injury, abuse or suspected abuse. The provider failed to notify CQC of two allegations of abuse that had occurred in December 2017, and February 2018. The provider had also failed to notify us of one serious injury notification in November 2017.
We found management systems were not always effective. We found the provider lacked a clear strategy in relation to the effective monitoring of the quality of services provided by staff. This was demonstrated by the failure of the provider to identify allegations of abuse, and to ensure that action taken to investigate and ensure people were safe. Though the provider had some management systems in place to record and monitor the standards of care delivered within the home, these were not always completed or were effective.
Care plans and risk assessments were not always accurate and contemporaneous, and did not always reflect people’s current care needs. We found that staff supervision had not been consistently undertaken.
The use of bed rails can act as potential restraint. Where people lacked mental capacity to consent to their use, there was no consistent evidence of best-interests decision-making.
We identified concerns regarding pressure area prevention and management. This related to the use of appropriate equipment and the lack of referral to other health care professionals. Risk assessments regarding pressures sore management, were not being consistently reviewed.
Relatives and visiting health professionals consistently told us they believed people were safe living at Stanley House.
The registered manager showed insight into the Accessible Information Standard, and we saw people’s communication needs had been assessed and recorded.
Relatives and health care professionals were satisfied with the overall competence and knowledge of the nurses and care staff.
Staff adopted a kind and compassionate approach towards the people they supported.
Management promoted an inclusive culture, which encouraged people, their relatives, and staff to speak their minds at any time. The culture of the home was open and transparent.
You can see what action we told the provider to take at the back of the full version of the report.
Stanley House provides nursing care for up to 21 people. It specialises in supporting people who have either Huntington’s Disease, acquired brain injury or people with mental health needs who also have physical disabilities. At the time of our inspection there were 21 people living at the home.
A registered manager was in post at the time of our inspection. 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.
Staff knew how to recognise and report any concerns about people’s safety. Staff understood risks associated with people’s needs and how to keep them safe. There were enough staff on duty to respond to people’s health needs at the times when they needed support. The provider completed checks to ensure staff were suitable and safe to work at the home.
People were treated with dignity and respect and staff were kind and caring in their approach with people. People had care and support that was centred on them as individuals and their independence and freedom of choice were promoted and supported.
People’s health needs were responded to effectively with people being supported to access doctors and other health professionals when required. People had daily access to health professionals like neurologists, psychiatrists, doctors, occupational therapists and physiotherapists. People were supported to have their medicines when needed. Medicines were stored and administered appropriately.
People had access to a varied diet of food and drink. People were supported to have their food and drink safely. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon by staff.
Staff understood people’s individual communication styles and were able to communicate effectively with people. People’s permission was sought before any care or support was given. Time was taken to make sure that people could make choices and decisions about the care and support they received.
People were supported by staff that had the knowledge and skills to understand and meet their health needs. Staff had access to additional training to match people’s specific health needs. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance.
People and their relatives found the staff and management approachable, willing to listen to their views and opinions. People knew how to complain and who to complain to. Feedback from the people and their relatives was gathered on a regular basis and any areas identified for action were acted upon. Audits and checks were completed regularly to ensure that good standards were maintained.
The registered manager gathered and listened to the views and opinions of the people that lived there, relatives and staff. A range of audits and checks were also completed regularly to ensure that good standards were maintained.
The records of people's care were detailed and reflected people's individual needs. We saw evidence that the staff monitored people's care and involved other professionals where this was needed. The arrangements for the safe management of medicines were regularly monitored.
The staff team received training to give them the knowledge and skills they needed to do their jobs well. The registered manager acknowledged that opening another service had had an impact on staffing arrangements for a period of time. Families and professionals were positive about the staff and how they did their work. Staffing levels ensured that people received the care they needed.
The registered manager and other company directors provided effective leadership. They had well organised systems in place to support the safe delivery of the service. A health professional commented that the home was, 'Well organised and well led'.
The people we spoke with were positive about the service. One person smiled as they told us, 'I love it here, I have my privacy' and added, 'the staff are very nice and they look after me'. Another person said the home was, 'absolutely brilliant, it's a privilege to be here' and praised the staff, commenting that some of the younger people working there were, "a credit to themselves'.
The care plans were detailed and reflected the different amounts of care and support that people needed. The content of the plans showed that as far as possible people were involved in planning their own care and making decisions about this. People were viewed as individuals and encouraged to make the most of their abilities.
The staff team was experienced and received training to give them the knowledge and skills they needed to do their jobs well. The company directors worked full time for the service, one as the registered manager. Together they provided a well organised structure for the provision of the service.