Stoneswood Residential Home

We found the following examples of good practice.

The building was clean, well ventilated and decorated to a high standard. The risk of infection transmission was minimised through enhanced cleaning practices.

Staff ensured people using the service could maintain links with family and friends, through the use of social media, phone and video calls and a weekly newsletter. The home had a safe and welcoming visiting ‘pod’, which relatives could access without walking through the communal areas of the home.

There was a screening procedure in place for visitors. This included taking people’s temperature.

Information was displayed at the entrance and throughout the building to remind people to be careful about infection transmission, to wash their hands and to comply with government guidance around wearing PPE.

There was an ample supply of PPE for staff and visitors to use. Hand sanitiser was readily available throughout the service. Staff had received training on the correct use of PPE and hand washing.

People who used the service and staff were regularly tested for COVID-19 in line with current government guidance. Risk assessments had been completed to assess the impact of COVID- 19 on people and staff.

The registered manager worked closely with the local authority infection control team to ensure the service followed up to date government guidance.

The registered manager had an ‘open door’ management approach and was on hand to offer emotional support to staff.

The service is also registered to provide personal care to a small number of people living in their own self-contained flats. At the time of this visit, the service provider told us no one living in those flats was receiving any personal care provided by the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager was first registered in October 2010 with the CQC but had managed the service prior to CQC registration.

At the last inspection of June 2016 the service were found to be in breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. Regulation 2014 The need for consent. We found that the home had not submitted applications for Deprivation of Liberty Safeguards for all the people who lived in Stoneswood who did not have the capacity to consent or object to their care and treatment. The service sent us an action plan to show how they were going to meet the regulation and we found that the regulation was met at this inspection.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff were safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and homely in character. The environment was maintained at a good level.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business contingency plan for any unforeseen emergencies.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. This helped to protect the health and welfare of staff and people who used the service.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of their responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

Further training was given to some staff to become ‘champions’ in topics like dementia care which enabled them to support staff to provide a better understanding of people with this illness.

We observed there were good interactions between staff and people who used the service. People told us staff were kind and caring.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to remain independent where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed.

People were treated with respect and dignity.

We saw the service had embraced technology in activities, care planning and family contact.

People were treated in accordance to their age, gender, sexuality and religion.

Plans of care were individual, person centred and reviewed regularly to help meet their health and social care needs.

We saw that people could attend activities of their choice and families and friends were able to visit when they wanted. We saw there were plans to help people who used the service meet people from other organisations.

Audits, surveys and key worker sessions helped the service maintain and improve their standards of support.

People thought the registered manager was approachable and supportive.

Stoneswood is a large converted stone built building in Delph, near Oldham. It is sited on the side of a hill with views across the Pennine Moors. It offers accommodation and support for up to 41 people, all in single rooms. At the time of our inspection there were 40 people living at the home. The service is also registered to provide personal care to a small number of people living in their own self-contained flats attached to the care home. At the time of this visit, the service provider told us no one living in those flats was receiving any personal care provided by the service.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the second day of the inspection. A registered manager is a person who has registered with CQC 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.

We found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. We found that the home had not submitted applications for Deprivation of Liberty Safeguards for all the people who lived in Stoneswood who did not have the capacity to consent or object to their care and treatment. You can see what action we have told the provider to take at the back of the full version of the report.

We saw that great care was taken to ensure that people received the right medication and systems to manage medicines were safe. The staff worked in cooperation with other health and social care professionals to ensure that people received timely, appropriate care and treatment.

We found sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

People’s care records contained detailed information to guide staff on the care and support to be provided. They also showed that risks to people's health and well-being had been identified, such as the risk of poor nutrition and risk of injury.

The staff we spoke with had an in-depth knowledge and understanding of the needs of the people they were looking after. We saw that staff provided respectful, kind and caring attention to people who used the service.

We saw that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse. All staff had access to the whistleblowing procedures (the reporting of unsafe and/or poor practice).

Mealtimes were a relaxed and social occasion with good interaction between people. Specific dietary requirements such as sugar free or soft foods were provided to people who needed them and staff were aware of people’s dietary needs.

All areas of the home were clean and procedures were in place to prevent and control the spread of infection.

A fire risk assessment for the premises was in place and systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints.

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

This summary is based on a visit to the home where we spoke to the manager and observed staff interactions with people using the service. We looked at records and talked in private with five visiting relatives, three people using the service and two members of staff. We also spoke with a visiting health care professional and a representative of the service provider.

The full report contains the evidence to support this summary.

Is the service safe?

We undertook a tour of the building. This included communal areas and a small selection of people's bedrooms. No obvious hazards to people's health and safety were seen.

People who used the service told us they felt safe and that they had not seen poor practice from any member of staff. Visitors also told us they believed their relative to be safe. One person told us 'everybody seems kind, considerate and welcoming'.

Similarly staff told us that they believed people were safe. Staff told us they understood the need to be vigilant about poor practice and understood their responsibility to whistle blow if necessary.

Staff had access to appropriate equipment to minimise risks of injury to themselves or people who used the service. The equipment was regularly maintained. Staff also had access to and used personal protective equipment (PPE) to help minimise the possibility of cross infection.

Staff members spoke positively about the support they could get from their colleagues and managers. They also told us they were not asked to undertake tasks they were not trained for or did not feel confident to do.

Quality audits included issues relating to health and safety in the building.

Is the service effective?

Each individual's care needs were assessed and reviewed. A care plan was developed on the basis of the assessment.

Staff were made aware of the up to date needs of each individual. Staff told us that communication within the home was good.

People who used the service, and their relatives where appropriate could contribute to decisions about the best way to meet their needs. People who used the service and visitors who we asked, all told us they were listened to by the staff at the home.

People told us they were confident that there was good communication with the staff and they were kept informed of their relative's changing needs. Comments included: 'I can sit and talk [to staff]'; 'You can meet at any time if there are any issues and the manager is always ready to have a word'; '[care is] absolutely brilliant' and 'we discuss [relative's] care needs and they keep me informed'.

People had good access to health and social care professionals in the community.

Is the service caring?

Observations of interactions between staff and people using the service indicated a warm and caring atmosphere.

All people who used the service and their relatives spoke positively about the caring attitude and approach of the staff. Comments included: 'staff are very helpful and will do anything you ask them for'; 'staff look after you very well, [staff] never let you struggle, you just ask and they will help you' and '[Stoneswood] is absolutely smashing ' staff treat me well ' staff who look after me talk to my family'.

A visiting health care professional told us they found the home to be 'very welcoming, staff are always smiling. It is a warm and caring environment'.

One member of staff, when asked what the best thing about the home was, said 'the very pleasant atmosphere. It is an easy, relaxed place with brilliant staff'.

Is the service responsive?

We did not look specifically at the service's complaints procedure at this visit. However, people using the service and visitors who we asked during our visit said they believed they would be listened to if they had a complaint. Staff were confident that the manager and service provider would respond positively to any issues which were raised.

People who used the service and their relatives said that they were comfortable talking to staff and believed that their views were listened to.

There were quality monitoring and quality assurance systems in place. These included responding to suggestions and observations made.

Is the service well led?

A representative of the service provider was present in the home very frequently.

There were clear lines of accountability between the manager and the care staff, including the seniors. This did not detract staff from seeking support from any of their colleagues.

The manager set clear expectations around best practice. They were supportive of staff training and support. One staff member described the manager as 'wonderful' and who was 'fair and can be firm'. A visitor made the observation that "everybody knows Val [the manager] is in charge, but she is very approachable'.

People's care and support was based on a written plan which itself was based on a comprehensive series of assessments. Care plans were regularly reviewed. Comments from people using the service included: 'it's very good', 'they treat me well', and 'I felt part of the place almost as soon as I came here'. Visitors told us there was good communication with the home.

Staff told us that communication within the team was good and they were kept up to date with the changing needs of individuals.

The provision of food and drink was good.

The building was clean, tidy and well maintained.

Staff were appropriately vetted during their recruitment. They were able to access training and support after their appointment.

People using the service and their relatives were very positive about the care provided by the staff team. Comments included "just brilliant"; "excellent communication"; "very friendly establishment and very pleasant building"; '[staff are] very very very nice people" and "staff who do the work are always pleasant and approachable".

People who used the service were involved in discussions about how best to meet their care and support needs. People's needs were regularly reviewed and staff were kept up to date with their current circumstances.

People's medication was appropriately stored and administered.

Staffing levels were such that people's identified needs could be met in a timely manner.

People who used the service and their relatives could talk to staff about any complaint which would be listened to and acted on.