Background to this inspection
Updated
16 March 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: One inspector carried out the inspection on both days and was assisted by an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service. The Expert by Experience on this inspection had expertise in dementia care and older people.
Service and service type: The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: The inspection was unannounced.
What we did: Before the inspection we reviewed information available to us about this service. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority who work with the service. Providers are required to send us key information about their service, what the service does well and improvements they plan to make. This information was sent to CQC before this inspection. We took this into account in making our judgements in this report.
During the inspection we spoke with a regional support manager, the registered manager, deputy manager, the maintenance person, two activity workers and two care staff. We also had a conversation with two healthcare professionals who were visiting the service. We spoke with seven people and two relatives. We received written feedback from seven other families after the first day of the inspection.
The majority of people stayed in their bedrooms during our inspection, except for mealtimes. Therefore we did not use the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We spent time observing the environment and the dining experience.
We looked at four people's care records including medication administration records (MARs) and a selection of documentation about the management and running of the service. This included recruitment information for four members of staff, staff training records, policies and procedures, complaints and staff rotas.
Updated
16 March 2019
About the service: Scarborough Hall and Lodge is a residential care home providing accommodation and personal care to 85 older people, some of whom have a physical disability or are living with dementia. At the time of our inspection 84 people were living at the service.
People’s experience of using this service: Improvements had been made to the assessment, monitoring and management of risk. People who used the service were kept safe through effective systems being used for medicine management, prevention of falls and infection prevention and control.
All areas were clean, tidy and there was effective cleaning taking place to keep people safe from the risk of infection. The rooms we looked at were nicely decorated in colours of people's choosing.
People told us they felt safe and well supported. The provider followed robust recruitment checks, and sufficient staff were employed to ensure people's needs were met. People's medicines were managed safely. The uptake and completion of staff training had improved and staff received regular supervision.
The provider had introduced new ways of working in regard to risk and falls analysis which had significantly reduced the number of falls in the service over the last year. People benefitted from the proactive approach to identifying risk and reducing this where possible.
Staff had received training and development around management of dementia and demonstrated a good understanding of dementia care. They worked with people’s individual strengths to ensure their independence, wishes and choices were promoted.
Communication was effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People and their relatives were supported to receive information in an accessible way either through easy read, large print and pictorial formats to enable them to be involved in their care and support.
People enjoyed good food. Their health needs were identified and staff worked with other professionals, to ensure these needs were met.
Staff knew about people’s individual care needs and care plans were person-centred and detailed.
People participated in a range of activities within the service and in the community, they also enjoyed the company of others in the service.
People were able to see their families as they wanted. There were no restrictions on when people could visit the service. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.
The service was well-led; systems were in place to assess and improve the quality of the service and complaints were responded to thoroughly. There was an open culture and learning was encouraged to drive improvement.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.
Rating at last inspection: Requires improvement (report was published 18 June 2018).
Why we inspected: This inspection was a scheduled inspection based on the previous rating. At the last inspection on 30 April 2018 there remained breaches of Regulations 12 and 18; safe care and treatment and staffing. The provider gave us an action plan outlining how they intended to meet the legal requirements. At this inspection improvements had been made in risk management and staff training and supervision. The two breaches of regulation were met.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.