Saxonbury

Saxonbury provides all single bedrooms, suitable communal areas and access to a rear patio and garden.

We found the following examples of good practice

Information about COVID – 19 was available in a format suitable for the people living at Saxonbury and staff had helped them understand how to keep themselves safe.

There were procedures in place to support safe visiting by family members or professionals. Staff undertook screening of all visitors. Rapid response lateral flow tests (LFT) were undertaken for visitors before they entered the home. Visitors were provided with Personal Protective Equipment (PPE) and guided to its safe use.

People and staff were regularly tested for COVID-19. Staff had LFT testing three times a week as well as standard Polymerase Chain Reaction (PCR) tests weekly. The registered manager understood the actions they needed to take should any tests return a positive result.

The service had a good supply of PPE to meet current and future demand. Staff were using this correctly and in accordance with current guidance and disposal was safe at the time of this inspection.

The registered manager was aware of actions they should take should a person be admitted to the home or return following a hospital admission. All bedrooms were for single occupancy.

The home was kept clean. Staff kept records of their cleaning schedules, which included a rolling programme of continuously cleaning high touch surfaces, such as light switches, grab rails and door handles.

The provider had systems in place to support staff mental wellbeing.

Saxonbury is a 'care home.' People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and personal care for up to seven people and there were six people living at the home at the time of the inspection. Saxonbury is a detached property which has been extended and adapted to be suitable as a care home. All bedrooms were single rooms, with some on the ground floor and some on the first floor, accessible via a flight of stairs. Communal areas included a lounge, kitchen and dining room. An enclosed garden was fully accessible for people.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the overall 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.

The provider had arrangements in place to protect people from risks to their safety and welfare.

Arrangements were also in place to store medicines safely and to administer them according to people's needs and preferences. People were supported to access healthcare services, such as GPs and other health professionals.

Staffing levels enabled people to be receive all necessary care and support as well as enjoying a range of outings and excursions. Recruitment processes were followed to make sure only workers who were suitable to work in a care setting were employed. New staff received appropriate training and arrangements were in place to ensure other staff completed required update training. Staff felt supported by the management team.

Staff were aware of the need to gain people's consent to their care and support. 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. The arrangements included processes and procedures to protect people from the risk of abuse.

People were supported to eat and drink enough to maintain their health and welfare. They could make choices about their food and drink, and meals were prepared appropriately where people had particular dietary needs.

People and visitors found staff to be kind and caring. People were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people's individuality, privacy, dignity and independence. The home had an open, friendly atmosphere in which people, visitors and staff were encouraged to make their views and opinions known.

Care and support were based on plans which considered people's needs and conditions, as well as their abilities and preferences. Care plans were adapted as people's needs changed, and were reviewed regularly.

People could take part in leisure activities which reflected their interests and provided mental and physical stimulation, as well as opportunities to be part of the local community.

Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided. The registered manager and provider acted where these systems found improvements could be made.

The inspection was unannounced and was carried out on 01 March 2016.

There was a registered manager in place at the home. 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.

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.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. 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.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

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

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.

People who were not able to communicate verbally showed that they understood what was being said and were able to make their wishes known to staff. Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when engaging with people who could not communicate verbally and who used a variety of signs, noises and body language to express themselves. Staff were able to understand people and respond to what was being said.

People’s families were involved in discussions about their care planning, which reflected their assessed needs. Each person had an allocated keyworker, who provided a focal point for that person and maintained contact with the important people in their lives.

There was an opportunity for families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through an annual questionnaire. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found:

Is the service safe?

The manager had identified the risks and hazards associated with providing care within the home. These included risks associated with electrical equipment, the kitchen and fire safety. We saw care plans included risk assessments associated with specific elements of people's care, such as making a cup of tea or falling and specified the action required to manage those risks. The plans also contained an easy read version of these risk assessments available to people entitled 'Keeping me Safe'.

Systems were in place to ensure the manager and staff learn from events such as complaints, concerns, or safeguarding events. This reduced the risk to people and helped the service to continually improve. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, although no applications have been made. Relevant staff had received training to enable them to understand when an application should be made. This meant people would be safeguarded as required.

The manager ensured there were enough staff working at the home to meet people's care needs. We saw that staff had received appropriate training and support to ensure they had the skills and experience necessary to meet people's needs.

Is the service effective?

People told us staff sought their consent before they delivered any care. One person said, 'All the staff know me and what I like and don't like'. The care plans we looked at were personalised with an easy read version to reflect the individual needs and people's likes and dislikes. People and the relatives we spoke with told us they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking to staff that they had a good understanding of the people's care and support needs and they knew them well. One person said, 'I do like it here, if I need a doctor they take me there'. A relative told us staff 'definitely know how to look after [their relative]'.

Care records showed people had access to appropriate medical care, including GPs, dentists and chiropodists. A visiting health profession said it was a 'very conscientious home' and staff were 'very caring'. Therefore people's needs were known and met.

Staff received appropriate training to meet the needs of people living at the home. For example, training records showed staff within the home had received training in the management of autism, epilepsy and blood glucose. This meant people were supported by staff who were suitably trained.

Is the service caring?

People were supported by kind and attentive staff. We observed care in the communal areas of the home and saw staff interacting with people in a positive way. For example, we saw a member of staff providing appropriate support and encouragement to a person who wanted help with their food during lunch.

People told us they 'liked the home' and staff 'looked after them'. A relative said the home was 'very, very good' and their relative 'has been happy and healthy there'.

The home provided an opportunity for feedback through an annual satisfaction survey. We saw the results of survey from 2013, including a response from a visiting health professional, which were all very positive.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with their wishes.

Is the service responsive?

People had the option to engage in a range of activities and were involved in a number of outside activities such as a film club and 'easy does it' which is an exercise group. A visiting health professional told us that staff 'always ensure [people] have access to the community. In fact they are an integral part of the community'.

There was an effective compliments and complaints policy in place and we saw there was also an easy read version available to people in their support plan. One of the people we spoke with told us, 'If I was not happy I would tell the manager'. The manager showed us their complaints file and told us they had not received any formal complaints during the last year. The family members we spoke with told us they knew how to complain but had no reason to do so.

Is the service well-led?

We saw there was a structured quality assurance process in place to regularly assess and monitor the quality of the service people received. These included support plan audits; cleaning and infection control audits; medication administration record (MAR) audits and fire safety equipment audits. We found some of these audits were also carried out by external professionals. Where issues were identified we saw these were responded to promptly.

There was a staff meeting structure, where staff could raise any issues or concerns. The manager told us they regular meet with the providers, who had also visited the home. They said they felt they were supported in their role by the [provider] team.