Archived: Stanton Hall Care Home

Updated 22 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This unannounced inspection took place on 9 April 2018. It was conducted by two inspectors and a pharmacy inspector. A pharmacy inspector focused on the medicine administration and recording. This was an area of concern we had identified at inspections in 2014, 2016 and 2017.

To assist in our planning we sought feedback from the safeguarding team and from the community healthcare team prior to the inspection. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to formulate our inspection plan.

We used a range of different methods to help us understand people’s experiences. People who lived at the home had varying levels of communication We spoke with two people, however to enable us to understand how people’s needs were being met we observed the care that was provided. We saw the interaction between people and the staff who supported them throughout the inspection visit. We also spoke with two people’s relatives about their experience of the care that the people who lived at the home received. After the inspection we spoke with two health care professionals.

We spoke with the manager, one nurse, one senior care staff, and two care staff. The area manager was present for the feedback in relation to the inspection. We reviewed care plans for five people to check that they were accurate and up to date. We also looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement. For example, we reviewed audits and quality checks for falls, medicines management, fire risk assessments, health and safety checks and infection control. . We looked at three staff recruitment files. After the inspection we asked the manager to email copies of their staffing matrix, the most recent pharmacy inspection and a risk assessment to support areas discussed during the inspection. The manager sent these to us within the required timeframe.

Updated 22 June 2018

This unannounced inspection took place on 9 April 2018. At the last inspection we placed the home in special measures and the overall rating was ‘Inadequate’. There were also regulatory breaches in safe care and treatment, staffing and good governance. At this inspection these breaches had not been met and we identified further breaches in other Regulations. Following the last inspection in September 2017, the provider was asked to complete an action plan in November 2017, to show what they would do and by when to improve the key questions of safe and well led to at least good. The provider had not met all the actions on this plan at the time of this inspection and the overall rating for this service is Inadequate which means it remains in special measures. We do this when services have been rated ‘Inadequate’ and we cannot see sustained improvements.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures

Stanton Hall 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 care is provided in one building across two floors. There are communal living areas and dining areas on the ground floor. The home provides accommodation and nursing care for up to 45 people who are living with dementia. There were 15 people living at the service when we visited.

The service did not have 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. The provider had recruited a manager who had been working at the service since October 2017, they told us they were going to apply to register with us. At the time of this report they had commenced this process.

We found that risk was not managed sufficiently to ensure that people were kept safe. Due to the reduced staffing levels, plans were not always followed to ensure that people received safe care. Risk assessments were not followed and medicines were not always managed safely. The home completed cleaning schedules to prevent and control infections; however the fabric of the building required substantial maintenance and repairs and this had an impact on some areas of the home.

There were continued concerns about the leadership of the home and the support provided to reflect the care people required. These concerns had been identified and related to lack of maintenance of the building, audits and the staffing levels linked to the level of support people needed. The manager had not completed notifications to enable us to monitor and review the provider’s response to such incidents.

The records in place were not always clear or up to date, to guide staff on the support people required. People did not always receive stimulation which could reduce the risks associated with their individual safety.

At the last three inspections we identified there were not enough care staff, this continues to be a concern and this had an impact on people’s wellbeing. At times this had an impact on the care provided by staff. Safe recruitment procedures were not always followed to ensure that staff were safe to work with people.

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 support this practice. Staff provided a kind and caring approach to people and when possible spent time with them offering support and affection.

People’s health care and the support they received to prevent sore skin had improved. Referrals were made to a range of health care professionals and support was followed. People enjoyed the meals and their dietary needs were being met.

Staff training had improved and these skills were being used to develop the care provided. There had been no complaints to the manager or provider since our last inspection.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Registration Regulations 2009. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.