Sterling House

Updated 28 June 2023

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and a medicines inspector.

Service and service type

Heath House 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. Heath House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since it had been registered. We spoke with professionals from the local authority and integrated care board who had recently visited the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people using the service and 4 relatives. We spoke with 7 staff, this included 2 care assistants, 2 agency staff, the manager, a company director, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We observed the care being provided, this included over lunchtime and medicines administration. We reviewed 9 medicine administration records (MARs) and the care records relating to 8 people’s care.

Updated 28 June 2023

About the service

Heath House is a residential care home providing personal care to up to 17 people. At the time of the inspection the service was providing support to people living with dementia and people experiencing poor mental health. At the time of our inspection there were 9 people living in the service, 8 of whom were receiving the regulated activity of accommodation for persons who require nursing or personal care.

Heath House consisted of 17 one-bedroom flats, which included a living area, kitchen, and shower room. There was a small communal lounge and dining room.

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

People were not safe living in the service. Individual risks to people and environmental risks had not been assessed and responded to. Infection control risks had not been adequately responded to. Medicines were not handled or stored safely. People did not always receive their medicines as prescribed. Staff had not received training in responding to safeguarding concerns. No system was in place to ensure safeguarding concerns were reported and investigated as required. People told us they did not feel safe living in the service. People and relatives raised concerns about the high turnover of staff and high use of agency. Staff were not effectively deployed.

People were supported by staff who had not received adequate training and support to carry out their roles and meet people's needs safely. The physical design and service environment had not been adapted to meet the needs of the people living in the service. This had resulted in people's needs not being met. People and relatives raised concerns about the quality of the food provided. People's preferences and input had not been used to help ensure the meals provided were suitable. Staff were not proactive in seeking input from health professionals. People's health needs were not met and recommendations from health professionals were not always followed. CCTV was being used in internal areas but people's consent to be recorded had not been sought.

People were not treated with respect and their dignity was not upheld. Staff had failed to consider how to support people's independence as a result people's dignity had been compromised. People and their relatives were not involved in the support provided. Their views, opinions, and preferences were not sought. The lack of engagement and involvement of people and their relatives had resulted in people’s needs not being met.

People did not receive person-centred care. People's care plans contained limited information on their needs and preferences. People told us there was not enough social activities and entertainment. People's communication needs were not always supported. Robust responses to concerns and complaints had not been made.

No governance frameworks or systems were in place. This meant the quality of the service and any potential risks had not been effectively assessed or monitored. The service had started providing the regulated activity in February 2023, since that date there had been 3 different managers in post. The provider had failed to put in place effective systems to maintain oversight and information within the service. This had resulted in the current manager having limited information and no systems to ensure a safe and good quality service. Records had not been sufficiently maintained. Effective actions to improve the quality of the service had not been taken. People, relatives, and staff had not been fully involved in the support provided. Their feedback had not been sought. People and relatives told us communication was poor. The provider worked with local authority and health care staff during the inspection to address the most serious concerns identified and ensure people’s safety.

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 25 October 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, staff training, management of risks to people, and governance.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing, the premises, consent to care, dignity and respect, person-centred care, and good governance at this inspection. We imposed urgent conditions on the provider's registration as a result.

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

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.