Archived: Stanton Lodge Care Home

We considered all the evidence we had gathered under the regulations we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

Below is a summary of what we found.

Is the service safe?

Care records contained risk assessments and instructions on how these risks should be managed. For example, there were risk assessments related to moving and handling and preventing falls.

Systems were in place to make sure that managers and staff learnt from events such as accidents, complaints, concerns and investigations. This reduced the risks to people and helped the service continually improve.

We saw policies and procedures related to infection control. However, we found these were not always followed and this could put people at risk of the spread of infections. We have set a compliance action and asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of infection control.

There was a system in place to manage medications but some recording was inaccurate which did not protect people from the risks of unsafe management of medications. We have set a compliance action and asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of medicines.

The CQC monitors the application of the Mental Capacity Act 2005 and the operation of Deprivation of Liberty Safeguards (DoLS) which apply to care homes. DoLS is a legal process used to ensure that no one has their freedom restricted without good cause or proper assessment. There was a policy in place related to people's mental capacity and deprivation of liberty safeguards. Records showed, and staff told us, they had received training in this area. There was evidence to show that mental capacity and deprivation of liberty assessments had been made appropriately.

We found that care records were accurate and up to date. Maintenance contracts were up to date and regular checks were made on fire fighting equipment, gas and electrical installations.

Is the service effective?

The staff we spoke with were able to describe the individual needs of the people they cared for and how these needs were met.

The service worked well with other agencies and prompt referrals were made to health care professionals which helped ensure people's health care needs were addressed.

People's health and care needs were assessed and the care plans provided staff with information about how each person's care needs should be met.

Is the service caring?

We spoke with six people who used the service and their comments included, "If I want a shower they give me one when I want. They are great man. They have to look after us otherwise they will get wrong off the doctors," "They look after me. I have been here for two years," "I get on with the staff no bother," "Oh yes they always do look after me. I'm new. I have no complaints at all" and "I like it here and Mam visits me a lot. I think the staff are nice."

We spoke with a health care professional who was visiting the home. They told us, "They seem caring. I have never seen anything that worries me. If I did I would report it. People always seem clean."

We observed the interactions between staff and the people they cared for. We saw staff interacted well with people and were attentive and sensitive to their individual needs.

Is the service responsive?

There was a complaints procedure displayed in the home and each person was provided with a copy of this. A complaints book was maintained to record any complaints received in the home and the outcome of any investigations.

We saw prompt referrals were made to health care professionals when required and appropriate training was provided for the staff to help meet individual needs.

Is the service well-led?

The provider had systems in place to monitor the quality of the service people received. People were asked their opinion of the service and meetings were held every month to discuss day to day issues in the home, for example, menus and activities.

We saw records to show the manager was responsible for monitoring care records, incidents, risk assessments, complaints and health and safety.

A person who lived at the home told us, "The manager is okay. I just say if I have a problem - that's the beauty of it. The staff on duty said the manager was always available to offer support and was always ready to listen to any concerns or new ideas they wished to discuss. A health care professional who was visiting the home told us they had been unhappy about the attitude of a staff member at a previous visit. They had reported this and felt action had been taken because the person's attitude changed on their next visit to the home.

Surveys were issued to people who lived at the home and their representatives. The manager told us that surveys had been issued this year but the results were not yet collated.

An expert by experience accompanied us on our inspection. We spoke with 11 people and three relatives to find out their opinions of the home.

The home was divided into two units; a general nursing and residential unit and a neurodisability unit.

We found that improvements had been made both in care and staffing levels. We considered that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan and there were enough qualified, skilled and experienced staff to meet people's needs.

However, we concluded that the provider had not taken steps to provide care in an environment that was suitably maintained and staff were not always supported to deliver care and treatment safely because an effective supervision and appraisal system was not fully in place.

The home was divided into two units; a general nursing and residential unit and a neurodisability suite. We spoke with 11 people and two relatives in the neurodisability suite and 14 people and six relatives in the general nursing and residential unit.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Some people and relatives were complimentary about the care and treatment provided. One relative said, 'My father has been here nearly five years and I cannot speak too highly about this home and its staff.' One person told us, 'The day I moved here was the best day of my life.' Other comments included, 'It's the next best thing to being at home.' However, we found that care and treatment were not always planned and delivered in a way that was intended to ensure people's safety and welfare.

We found that there were not enough qualified, skilled and experienced staff to meet people's needs.

An effective system was not fully in place to regularly assess and monitor the quality of service that people received. In addition, people's personal records and those relevant to the management of the service were not always accurate or fit for purpose.