Archived: Stoneham House

Updated 12 July 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 first inspection visit took place on 8 March 2017 and was unannounced. The inspection team consisted of an expert by experience and an inspector. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector returned on 17 March 2017 to gather further evidence. We received information of concern after our visits in March 2017 so an inspection manager and an inspector returned to the service on 7 April 2017 to meet with the registered provider. Two inspectors visited again on 22 and 25 May 2017. These visits were to review and update our initial findings as we had received further information of concern.

During our inspection we talked with ten people who lived at the service and observed the care of others in communal areas when they were not able to verbally provide us with feedback. We spoke with seven relatives and spoke or received feedback from a further five relatives following our visits. We spoke with one health care professional and with three social care professionals to gather their views about the quality of service currently provided. We looked at the care records for seven people as well as other records relating to the management of the service such as six staff files, policies and quality assurance records.

Updated 12 July 2017

The inspection took place on 8 March 2017 and was unannounced. A further visit took place on 17 March 2017 to continue with the inspection. We returned on 7 April 2017 to meet with the provider as since our previous visits the circumstances of the service had changed as the registered manager had left and we had received new information of concern. We shared information with Hampshire County Council who commission care at the service and who take the main lead in safeguarding people living at the service. Since our meeting with the provider on 7 April 2017 we received further information of concern and so visited the service again on 22 May 2017 and 25 May 2017. When we visited in March 2017 the evidence we gathered reflected a service which had continued to make some improvements.This report reflects evidence from all of these visits but focusses more on evidence gathered during the visits in May 2017 and information gathered following our visits in March 2017 as this more accurately reflects the current position of the service.

We last inspected the service in December 2015. At that time we found significant improvements had been made since our previous inspection in June 2015 but we judged the service required improvement overall.

Stoneham House is a private residential care home without nursing set on the outskirts of Southampton. It is registered to provide accommodation and care for up to 37 people who may be living with dementia. At the time of our most recent visit in May 2017 there were 14 people living at the service.

At the time of our visits in March 2017 a registered manager was in post. 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. At the time of our visits in April and May 2017 the registered manager had left and the service was being managed by an acting manager who knew people living at the service well.

Our main concern was the lack of structure within the service. Since the registered manager had left some of the provider’s family had taken over aspects of management, but they did not have the skills or experience to do this effectively. This meant for example, accountancy processes were unclear and responsibility about who should conduct audits of the service was vague. It was not clear who should be responsible for each aspect of the service.

There were not sufficient staff employed with the right skills and experience to lead a shift safely. Risk to people's care and welfare and environmental risk was not always properly addressed. The environment was excessively hot and some rooms had a malodour.

People were not always provided with care which focussed on their needs and wishes. The procedure to address complaints and safeguarding concerns was not robust. The culture of the service was not open and inclusive which meant staff did not always report or act upon concerns in a timely way.

We did however witness kind and caring interactions by staff and activities provided had improved since our last visit.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. 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.

There were eight breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.