Archived: Smalley Hall Care Home

Updated 19 February 2016

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.

This inspection took place on 27 October and 5 November 2015. The first day of the inspection was unannounced. The inspection was carried out by two inspectors and an Expert by Experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert-by-experience for this inspection had experience of caring for older people with physical health needs. They also had experience of supporting people to access community health services.

Prior to the inspection we looked at information we held about the service. We reviewed our previous inspection records. We looked at information received from local authority commissioners and the statutory notifications the provider had sent to us. Notifications are changes, events or incidents that providers must tell us about.

We spoke with eleven people living at the service, seven relatives and six staff. We also spoke with three health professionals. Not all the people who lived at Smalley Hall Care Home were able to fully communicate verbally with us at the time of our inspection. Therefore, we used the Short Observational Framework for Inspection (SOFI), to capture the experiences of people. SOFI is a way of observing to help us understand how people experience care.

We observed how staff supported people living at the service and reviewed three people’s care records. We reviewed other records relating to the care people received. This included some of the provider’s audits on the quality and safety of care, medicine records and staff recruitment and staff training records.

Updated 19 February 2016

This inspection took place on 27 October and 5 November 2015. The first day of the inspection was unannounced.

We had previously inspected the service on 28 June 2014, where we found breaches in the regulations relating to the management of people’s medicines, planning and delivery of care, and the provider’s systems to assess and monitor risks to people’s health, welfare and safety. We asked the provider to send us an action plan to demonstrate how they would meet the legal requirements of the regulation. At this inspection we found that the breaches in regulations had been addressed.

Smalley Hall Care Home provides accommodation for up to 26 older people who require personal care, some of whom have dementia. There were 19 people using the service on the day of our inspection.

The service had a registered manager at the time of our inspection. 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 registered manager was not available on our inspection.

People felt safe at the service, but told us that they did not always feel staff were able to meet their needs in a timely manner.

People were protected from the risk of abuse because the provider took steps to recruit suitable staff.

Medicines were managed and administered by staff with training to do this.

Staff were knowledgeable about people’s individual care needs and preferences. These were clearly documented and reviewed regularly.

Staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. Staff sought people’s consent before offering care. Where people could not make decisions about their own care, decisions were made in their best interests in accordance with the MCA.

People were not always given additional support to ensure that they had enough to eat. People were involved in making decision about food and drink, and were complimentary about the variety and quality of the food.

Staff knew how to monitor people’s ongoing health needs and when to refer them for specialist support. Records of care were clear and detailed, and health professionals felt confident that staff knew how to support people.

We saw staff treat people in a kind and caring manner, and with respect and dignity.

People and their relatives felt that staff did not have enough time to support them in meaningful activities beyond essential care tasks. People were positive about the activities offered by the service, and felt they had opportunities to express their views about their care.

The provider had a range of ways to seek people’s views, and people and their relatives knew how to make a complaint. The provider investigated complaints and took action where this was required to improve care.

Quality assurance procedures were in place to identify where the service needed to improve. We saw where these had led to improvements in the service. However, the audits had not identified any issues with staffing levels or how staff spent time supporting people.