Shangri-La Residential Home

Updated 1 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was unannounced and was completed in response to concerns raised about the safety and quality of the service. The inspection was carried out on 10 October 2017 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.

Before the inspection we reviewed information we held about the home including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law. We also reviewed the action plan sent to us by the provider following the last inspection in December 2016.

We spoke with nine people living at the home and four family members. We spoke with the registered manager, the deputy manager and five care staff. We also spoke with ancillary staff including a member of the domestic team and the cook. Following the inspection we received additional information from a social care professional and a healthcare professional.

We looked at care plans and associated records for five people and records relating to the management of the service. These included staff duty records, three staff recruitment files, records of complaints, accidents and incidents and quality assurance records. We observed care and support being delivered in communal areas and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 1 December 2017

Shangri-La provides accommodation and personal care for up to 26 older people, some of whom live with dementia. Accommodation is arranged over two floors with stair and lift access. At the time of our inspection 20 people lived at the home.

We rated the home ‘Requires Improvement’ at its last inspection in December 2016. At that inspection we identified four breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. These included breaches of Regulation 9, person centred care; Regulation 11, need for consent; Regulation 12, safe care and treatment and regulation 17, good governance.

At this inspection we found the provider had rectified the breaches found at the last inspection; the home is now rated ‘Good’.

There was a registered manager at the home. 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.

People and their families told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

There were suitable systems in place to ensure the safe storage and administration of all oral medicines. However, the system in place to ensure that topical creams were not used beyond there ‘safe to used by date’ was not robust. This was discussed with the registered manager who told us that they would review the current system and take immediate action to ensure that creams were labelled clearly. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Risks to people had been assessed and completed risk assessments contained detailed personalised information about the person and their circumstances. Risks assessments identified the risks along with the actions taken to reduce these risks. Staff were able to explain the risks relating to people and the action they would take to help reduce the risks from occurring.

There was enough staff to meet people’s needs and staff had the time to engage with people in a relaxed and unhurried manner. People received person centred care from staff who knew each person well and understood there needs and personal preferences.

Staff had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

Staff developed caring and positive relationships with people and were sensitive to their individual choices, treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People were provided with appropriate mental and physical stimulation through a range of varied activities.

People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs. People and their families were encouraged to provide feedback on the service provided both informally and through quality assurance questionnaires.

People and relatives were able to complain or raise issues on a formal and informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home.

There were systems in place to monitor the quality and safety of the service provided and manage the maintenance of the buildings and equipment.

People and their families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role.