Scalford Court Care Home

Accommodation is provided across two separate adapted units with vast external grounds. At the time of our inspection there were 51 people using the service.

We found the following examples of good practice.

During the COVID-19 outbreak, staff had supported people to maintain contact with friends and family via window visits, telephone calls and video calls. Visits in people’s bedrooms were facilitated for essential caregivers and people at the end of their lives.

All visitors were required to show a negative Lateral Flow Device (LFD) test result before they entered the service. Signage was displayed upon entry to the service, detailing the requirement for visitors to wear personal protective equipment (PPE), such as face masks.

A handwash basin had been installed in the foyer of the service to enable visitors to wash their hands prior to entering and exiting the service.

The service utilised an electronic system to evidence they had checked the COVID-19 vaccination status of visiting professionals. This evidenced they did not permit professional visitors to enter the service unless they were fully vaccinated against COVID-19.

An isolation area had been designated for use by people that found it difficult to isolate in their bedrooms if they tested positive for COVID-19. This was staffed at all times. This meant people had prompt access to staff provide reassurance and assist them to isolate effectively

Scalford Court Care Home is a residential care home providing personal care for up to 59 people. The service supports older people living with physical disabilities or dementia. Accommodation is provided across two separate adapted units with vast external grounds. At the time of our inspection 52 people were using the service.

People's experience of using this service and what we found

Risks associated with people's lifestyle choices, care and support had been assessed. Some risk assessments required further detail on the specific measures and equipment required. However, staff knew people well and knew what to do to keep them safe.

People were protected from abuse. Systems and processes were in place to identify and report any abuse or harm. Where incidents had occurred, the registered manager had reported to external agencies and taken action to reduce the risk of future incidents.

We have made a recommendation that the provider implements a systematic approach to determining staffing levels, with consideration to current guidance and best practice.

People were supported to take their medicines safely and as prescribed. The premises were clean and well maintained. Staff followed safe practices in preventing and controlling infections, including those associated with COVID-19.

The provider had systems in place to check the quality and safety of the services provided and monitor the quality of care. People and relatives felt engaged and involved in how their care was provided. Staff felt they could share their views and be involved in the service provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (Published 5 March 2020)

Why we inspected

The inspection was prompted in part by notification of incidents where people were at risk harm and staff recruitment concerns. We undertook a focused inspection to review the key questions of safe and well-led only. During our inspection, we found no evidence people had been harmed and the provider had notified and responded to incidents of concern in a timely manner.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Scalford Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit. If we receive any concerning information we may inspect sooner.

Scalford Court is a converted Hunting Lodge which now accommodates residents in two adjoining adapted wings.

People’s experience of using this service and what we found

People using the service, staff and visitors all said there were enough staff to meet their needs. Unexpected staffing shortfalls were met in-house. Agency staff were not used, so people always knew the staff looking after them.

People were supported appropriately to eat and drink within a relaxed mealtime environment, with snacks and drinks of their choice available at all times.

Everyone told us staff were kind and caring, and we saw many instances of kind, respectful interaction. Staff knew and understood people's individual needs well.

Managers and staff were clear about their roles and have effective quality monitoring in place. They demonstrated an understanding of risks and regulatory requirements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was requires improvement (published 04 January 2019).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This was the second comprehensive inspection; the last inspection was rated Good in April 2016.

Scalford Court Care Home is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 59 people. On the day of our visit, there were 54 people using the service.

The service did not have a registered manager, a previous manager and a newly appointed home manager were manging the service. 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 and associated Regulations about how the service is run.

The provider had not ensured that people were always protected from health and safety risks associated with accessing areas such as the kitchen and laundry; they took immediate action to protect people at the time of the inspection site visit.

Staffing levels ensured that people's care and support needs were safely met most of the time; the provider was continuing to employ staff. Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

There was a very positive culture within the home where staff communicated well and people’s needs were met. The provider had achieved a gold award from the quality team at the local authority and investors in people.

This is the first time the service has been rated Requires Improvement.

Further information is in the detailed findings below.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Scalford Court Care Home on our website at www.cqc.org.uk

Scalford Court Care Home is a care home registered to accommodate up to 59 people who are aged over 65 and who are living with dementia or have a physical disability. The home is split into two sides. One side was set over two floors, with lift access to both floors. The home has a variety of communal rooms and areas where people can relax. At the time of the inspection 54 people were using the service.

The service had a registered manager. 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 told us that they felt safe when staff supported them and that they enjoyed living at Scalford Court Care Home.

Risk assessments were in place which described how to support people in a safe way. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

The provider carried out the necessary pre-employment checks before staff started to work at the service.

Staff were trained and assessed as competent to administer medicines however, staff had not always signed to say that medicine had been given. People received their medicines as they had been prescribed by their doctor. We found that the temperature of the medication fridge had been recorded as being too high and no action had been taken. Where medicine was administered covertly this had been agreed with a doctor, however there was no specific guidance as to how this should be administered.

Staff were supported through training and supervision to be able to meet the needs of the people they were supporting. They undertook an induction programme when they started to work at the service and received further relevant training.

Staff sought people’s consent before providing personal care. People’s capacity to make decisions had been considered in their care plans.

People were supported to maintain a balanced diet. People were supported to access healthcare services.

People told us that staff were caring. Staff we spoke with had a good understanding of how to promote people’s dignity. Staff understood people’s needs and preferences.

People were involved in decisions about their care. They told us that staff treated them with respect.

People contributed to the assessment of their needs. People and their relatives were involved in the review of their needs.

People were supported to take part in activities that they enjoyed.

People told us they knew how to make a complaint. The service had a complaints procedure in place.

The service was well organised and led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

People were asked for their feedback on the service that they received. The provider carried out monitoring of the quality of the service.

As part of our inspection we spoke with seven people who used the service, eight members of staff working at the home and a visiting health professional.

People living at the home were generally quite happy with the service. They all told us that they liked their rooms and that the food was good. One person said: "The food is brilliant. The staff are brilliant." Another person told us: "There's always something going on here. I'm not bored." Several people who used the service said that the staff were very busy and that, at times, they did not have time to talk to them. We observed staff to be very busy during our inspection, however, we did find that people's care needs were being met.

Staff were generally happy working at the home. Care workers described a supportive environment and felt that the home had greatly improved since the current manager had been in post. Staff were very positive about the food at the home and said that there was plenty of activities on offer for people. One staff member said: "The food here is excellent. They've always cooked as fresh as they can."

We found that people were involved in their care planning and that they could choose how they spent their time. Suitable and nutritious food was being offered to people and the home and surrounding grounds were being adequately maintained. Selection and recruitment processes for staff were robust. Systems were in place to ensure that people's complaints were addressed and taken seriously.