We carried out a review of the data available to us about Summerlands 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 Summerlands, you can give feedback on this service.
We found the following examples of good practice.
People that live at the service had been included in training sessions to increase their safety, such as hand hygiene and infection control. Staff had provided hairdressing and manicures for people, when visits to the home were not possible by professionals. Detailed risk assessments had been completed for each visitor so individual risks could be addressed.
Staff had a dedicated changing room, and their uniforms were laundered at work. The registered manager had supported staff with the skills and training that they needed. Staff had been trained in donning and doffing personal protective equipment (PPE) and their competency assessed.
The registered manager had provided people with accessible posters and leaflets about Covid-19. There was also information displayed about Wellbeing and Mental Health. Three staff were trained as Mental Health First Aiders who were able to support their colleagues as needed. The registered manager had started structured conversations with staff, recognising the difficulties of the pandemic to support them.
The registered manager explained they had responded to the pandemic early. This included ordering PPE, training staff in wound care and giving insulin.
Summerlands is a residential care home for up to 31 people older people. At the beginning of the inspection there were 28 people living at the home. Some of the people had dementia so had limited verbal communication. Summerlands is a care home over three floors with bedrooms on each one. There are communal areas such as a living room and dining room. The owners have spent time improving the surroundings including recently having the garden landscaped. There was still some work being undertaken at the time of inspection.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Why the service is rated Good
Since the last inspection there had been a change in registered manager and the owners had worked hard to ensure there were continual improvements at the home. These had been recognised by two members of staff receiving awards from the local authority to recognise the care and support they were delivering.
The owners promoted a drive to create an excellent care home by encouraging staff to identify new approaches and ways to have person led support. There was a strong emphasis on working with the community and empowering staff to champion different areas of care. These provided opportunities for people’s care to improve and promoted their well-being by being valued. There were occasions when the owners and registered manager went above and beyond to ensure people had received individualised care. Staff at all levels felt supported and were proud their work to improve the lives for people had been recognised.
The home had owners and management who strove to provide people with excellent care. People, visitors and staff told us the registered manager and the owners were excellent and had ensured the best care and support was provided. The registered manager and owners continually monitored the quality of the service and made improvements in accordance with people’s changing needs. When specialist knowledge was required the management brought in external agencies to assist with the auditing of the home.
People received good care from staff who knew them well and appreciated they were working in their home. Feedback from people, relatives and visitors to the home informed us about how well cared for they felt. Care and support was personalised to each person and being enhanced by using new systems they were introducing. This meant people were able to make choices about their day to day lives in line with their needs, hobbies and interests.
People’s privacy and dignity was respected by staff and their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received. People who had specific end of life wishes had their preferences facilitated by staff to help provide a dignified death. The owners and staff were currently working towards a nationally recognised standard to further improve people’s end of life care.
The service provided to people was responsive to people’s individual needs. There was an activities coordinator who strove to get feedback from people about the activities they ran. There was a range of opportunities for people and their families to participate in. Activities considered people’s hobbies and interests and were personalised as much as possible.
Complaints were fully investigated and responded to in a timely manner. The registered manager and owners valued any concern a person or their relative raised. People and relatives felt there was an open atmosphere at the home where they could speak with the management. Their feedback was regularly sort through formal and informal opportunities.
There were suitable numbers of staff to meet people’s needs and to spend time socialising with them. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely. People were protected from abuse because staff understood how to keep them safe and were sure action would be taken if any concerns were raised.
The home continued to ensure people received effective care. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.
People who required special diets had their needs met and meal times were treated as a social opportunity. Staff had the skills and knowledge required to effectively support people. People told us their healthcare needs were met and staff supported them to attend appointments. Two health care visitors were very complementary about how the home supported the people they saw.
Further information is in the detailed findings below
We inspected Summerlands on 13 May 2015. Summerlands is a residential care home that provides accommodation and support for up to 31 people. The people living there are older people with a range of physical, mental health needs and some people living with dementia. On the day of our inspection there were 30 people living at the home. Summerlands does not provide nursing care. Summerlands is a large detached Victorian House spread over three floors. People’s bedrooms were situated on the ground, first and second floors. The house is set within a large landscaped garden with accessible pathways and a pond.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
The concerns identified at the inspection in 2014 related to there being no assessments regarding people’s needs before they moved to the home and an absence of the recording of capacity assessments as required under the Mental capacity Act 2005. There were also gaps in the recording of medicines administration and gaps in recruitment records. An action plan was received from the provider which stated they would be meeting the regulations by 13 October 2014. At this inspection, we found that improvements had been made and that the compliance actions had been met.
People who lived at Summerlands told us they were safe. One person said “I feel safe here, the staff are lovely”. People said they felt safe as they were cared for by staff that knew them well and were aware of the risks associated with their care needs. There were sufficient numbers of staff in place to keep people safe and staff were recruited in line with safe recruitment practices. Medicines were ordered, administered, recorded and disposed of safely. Staff had received training in safeguarding adults and were in the process of updating their training.
People could choose what they wanted to eat from a daily menu or request an alternative if wanted. People were asked for their views about the food and were involved in planning the menu. They were encouraged and supported to eat and drink enough to maintain a balanced diet. One person said “There’s always good food, the menu gives choice, it’s well served and presented”
Staff were appropriately trained holding a Diploma in Health and Social Care and had received all essential training. Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation, which they put into practice.
Prior to admission, people were assessed by the registered manager so that care could be planned that was responsive to their needs. Care plans provided detailed information about people and were personalised to reflect how they wanted to be cared for. Staff followed clinical guidance and ensured that best practice was followed in care delivery. Daily records showed how people had been cared for and what assistance had been given with their personal care. People were encouraged to stay in touch with people that mattered to them. There was a range of social activities on offer at the home, which people could participate in if they chose. The home had a complaints policy in place and a procedure that ensured people’s complaints were acknowledged and investigated promptly.
The home was well-led by the registered manager who felt supported by the provider. A positive culture was promoted and new staff had a good understanding of how to communicate with people in an accessible way. There was a range of audit tools and processes in place to monitor the care that was delivered, ensuring a high quality of care. People could be involved in developing the home if they wished. They were asked for their views about the home through questionnaires and relatives were also asked for their feedback.
If you want to read the evidence that supports our summary please read the full report
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Is the service safe?
The service was not safe because prior to a person using the service the necessary information was not always obtained. An assessment of their abilities, needs and risks was not always carried out until they had moved in.
Staff understood how to protect vulnerable people in their care and knew how to report any concerns they had. They allowed people the freedom to be as independent as possible whilst recognising the need to protect them from harm. The administration of medicines was carried out safely. Some issues were found with the administration of over the counter 'homely' medicines which could put people at risk of harm.
Not all records for staff working at the home contained all the necessary information to ensure the relevant checks had been carried out.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Staff had a good understanding of the policies and procedures regarding this.
Is the service effective?
The service was effective because people told us they were 'Very happy' with the care and support they received. We saw that staff knew people well and treated them as individuals. One person told us 'I never wanted to live in a home, but this is not like a home, it's my home.' The care and support provided included ensuring a range of opportunities for engagement in meaningful activity were provided. We were told 'There is always something to do' and 'I enjoy being here. We have fun.'
Is the service caring?
The service was caring because people who lived there told us 'I am very well looked after. 'The staff are all lovely' and 'Everyone is kind and caring.' One relative told us 'All the staff are very caring, it's always good.' A visiting health professional said staff knew people's needs very well and were always polite. Several people described the people who lived there and the staff as 'one big family.'
Is the service responsive?
The service was not always responsive because staff had not always involved medical professionals in a person's care as required. One visiting health professional said staff made appropriate referrals to their service and were 'Very responsive' when they were given directions or advice. The plans of care contained detailed information regarding a person's needs and how they should be met. This included their likes, dislikes and how they liked to have their independence promoted. People's care and support was reviewed to ensure any changes required were accommodated.
Is the service well-led?
There were a variety of methods in place for monitoring the quality of the service delivered. These included audits of specific areas of the service including medicines, care plans and cleanliness. The views of people living there, staff and relatives were sought and changes made as a result of this. Staff said they were well supported by the manager and spoke highly of the service providers who they described as 'Very hands on.'
We spoke with six members of staff, two relatives, three people who use the service and two other people who provided a service to Summerlands. We also observed the interactions between staff and the people who used the service. We observed people being treated with respect and kindness and the atmosphere was a happy and relaxed one.
We looked through people's care records and found that comprehensive assessments and care plans were in place. We saw evidence that carers were asked for their views on standards of care at Summerlands and that they were actively involved in their relative's on-going care.
We observed a meal time during which people were supported in a caring and relaxed manner to eat their meal. We also spoke to staff and people who use the service about the quality of the food served and they commented on how much they enjoyed it.
We found a very clean environment where clear infection prevention and control procedures were evident and well managed. We found that people and their families liked the environment and that the staff worked together to ensure high cleaning standards.
We found that the provider had systems in place to support employees in carrying out their roles effectively and that all staff we spoke with stated that they were happy and felt well supported.
We found that staff went about their work in a calm and professional way and sought to provide a real sense of 'home' for the people they cared for. They treated people with kindness and protected their privacy.
The provider had taken steps to reduce the danger of people being abused and the people we spoke to told us they felt safe living at the home.
The provider had taken appropriate steps to check the background and qualifications of the staff it employed to care for people. However we found they had not taken steps to check that appropriate members of staff were protected against the risks of infection from blood borne diseases.
The provider had satisfactory systems in place to monitor the quality and safety of the service it provided.
Service users were happy with their personalised rooms, the food and the level of support that they received. They told us that they were able to be as independent as they wanted to be, but were supported when their abilities changed. Service users also said that their families and friends were able to visit at any time and were always made welcome with refreshments. One service user said that being able to paint was because staff had encouraged her to join the art classes and now her work and that of others is proudly displayed all around the home.