We carried out a review of the data available to us about Shaftesbury House Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Shaftesbury House Residential Care Home, you can give feedback on this service.
Shaftesbury House Residential Care Home is a residential care home providing accommodation and personal care to up to 28 people. The service provides support to older people in one adapted building. At the time of our inspection there were 27 people using the service, some people were living with dementia.
People’s experience of using this service and what we found
There were systems in place to assess and mitigate risks of avoidable harm and abuse. The service learned from incidents to reduce future occurrences. People were supported by a staff team who were available when needed. Staff recruitment was done safely. People received their medicines when needed. The service was clean and hygienic. People were supported to have visits from their family and friends.
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.
People’s care records identified the care and support people required to meet their assessed needs and preferences. People’s end of life decisions and how they wished to be cared for was included in their care records. People were supported to participate in social activities to reduce boredom and isolation. There was a complaints procedure in place.
The registered manager understood their role and responsibilities. There was a programme of audits and monitoring systems which supported the provider and registered manager to identify shortfalls and address them.
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 requires improvement (published 14 March 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook this focused inspection to check improvements had been made following the last comprehensive inspection. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which had been rated requires improvement.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to 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 COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shaftesbury House Residential Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At our previous inspection of 27 November 2017, this service was rated requires improvement overall. The key questions safe, effective, responsive and well-led were rated requires improvement and the key question caring was rated good. There was a breach of Regulation 12: Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service wrote to us to tell us what improvements they had implemented to meet the requirements of Regulation 12.
At this inspection of 30 January 2019, we found that the service had made some improvements, but we found further shortfalls during our inspection. The service continued to be rated requires improvement overall and in safe, responsive and well-led. The rating of good had been sustained in caring and improvements had been made in effective which was now rated good. The service was no longer in breach of Regulation 12.
There was a registered manager in place. 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.
There had been changes in the management team for the service. There was a programme of audits which assessed and monitored the service provided. However, whilst some improvements had been made since our last inspection, further improvements were needed.
Improvements had been made in how risks of pressure ulcers developing were assessed and staff were guided how to reduce these risks. However, risks associated with choking were not robustly assessed and reduced.
There were systems in place designed to safeguarding people from abuse, however, we had received a concern from a person which had not been appropriately acted upon. This was addressed swiftly by the registered manager when we had reported what we had been told.
Improvements were needed in how people’s care was planned for and met. People’s choices were not always documented about how they wanted to be cared for at the end of their life.
People’s had access to social activities to reduce the risks of isolation and boredom. However, there was limited information about the one to one time provided to people when they chose to spend their time in their bedrooms.
People were provided with their medicines when they needed them. There were systems in place to manage people’s medicines safely. Improvements were ongoing in how the staff recorded how people were provided with medicines prescribed to be administered externally, including creams.
There were systems to ensure that there were sufficient numbers of care staff to meet people’s needs. Staff recruitment processes reduced the risks of staff being employed in the service who were not suitable. Staff were provided with training to meet people’s needs. Improvements had been made in the provision of one to one supervision meetings for staff.
There were infection control systems to reduce the risk of cross contamination. The environment was well maintained and suitable for the people using the service.
People had access to health professionals when needed. Staff worked with other professionals involved in people’s care. Improvements had been made in how the service monitored how much people had to eat and drink.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People shared positive relationships with staff. People’s privacy, independence and dignity was respected. People were listened to in relation to their choices about how they wanted to be cared for. People were asked for their views about the service and these were valued and listened to.
There was a complaints procedure in place and people’s complaints were addressed.
There were 26 people living in the service when we undertook this comprehensive unannounced inspection on 27 November 2017.
There was not a registered manager in place. 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. There was a new manager working in the service and their registered manager application was being processed at the time of our inspection.
This service was rated as Good at our last inspection of 9 November 2015. During this inspection of 27 November 2017 we found that the service had not sustained the previous Good rating. The overall rating was now Requires Improvement. The key questions Safe, Effective, Responsive and Well-led were rated as Requires Improvement. We found a breach of Regulation 12; Safe Care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Caring was rated as Good.
Improvements were needed in people’s care plans to identify how people were provided with person centred care which was tailored to meet their specific needs. There were some inconsistencies in care records which needed attention to ensure that staff were provided with the most up to date guidance on how people’s needs were met. The new manager and the regional manager had identified improvements needed in the care plans and had an action plan in place to address this. However, this was not yet fully implemented.
There were systems in place to provide people with their medicines, which were prescribed to be administered orally safely. However, improvements were needed in how staff recorded when people had been provided the medicines that were prescribed for administration externally, such as creams. This includes the application of barrier creams, used to reduce the risks of pressure ulcers. The records for when people repositioned did not identify that guidance in the care plans had been followed.
The ways that the service assessed risks to people and actions taken to reduce the risks required improvement to provide people with safe care at all times.
People’s nutritional needs were assessed. However, the systems in place for monitoring what people had to eat and drink were not robust.
There were systems in place designed to keep people safe, this included appropriate actions of reporting abuse. Staff were trained in safeguarding and understood their responsibilities in keeping people safe from abuse. However, there had been an incident which had not been reported appropriately until we had advised the service to do so.
The environment was clean and hygienic and there were infection control systems in place. However, there was a toilet in the lounge area, which was open plan with the dining room. The door to the toilet opened into the lounge. This was a potential risks to infection control and was not respectful of people’s privacy. There was a programme of refurbishment and redecoration in the service planned.
There were some staff vacancies which were being covered by existing staff and agency staff. The service was actively recruiting to these vacant posts. Recruitment of staff was done safely and checks were undertaken on staff to ensure they were fit to care for the people using the service.
Staff spoke about people in a caring and compassionate way. People had positive relationships with the staff who supported them. People’s views were listened to, valued and used to plan and deliver their care.
People were supported to see, when needed, health and social care professionals. The service worked with other professionals involved in people’s care to improve people’s lives.
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 supported this practice.
People were provided with the opportunity to participate in activities that interested them.
People’s views were listened to and acted upon relating to their end of life care. There were systems in place to support people to have a pain free and dignified death. However, a fault in a pressure relief mattress for one person was not supportive of this practice.
There was a system in place to manage complaints and these were used to improve the service.
Where incidents had occurred the service had systems in place to learn from these and use the learning to drive improvement in the service.
There were quality assurance systems in place which assisted the provider and the manager to identify shortfalls and address them. Where shortfalls were identified there were plans in place to address them to improve the service people received. However, these were not yet fully implemented to ensure that people were provided with good quality care at all times.
Shaftesbury House Residential Home provides accommodation and personal care for up to 28 older people, some living with dementia.
There were 28 people living in the service when we inspected on 9 November 2015. This was an unannounced inspection.
There was not a registered manager 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. There was a manager working in the service and they were in the process of completing their registered manager application.
There were procedures and processes in place to ensure the safety of the people who used the service. Risk assessments were in place to guide staff on how risks to people were minimised. People were provided with personalised care and support which was planned to meet their individual needs.
People, or their representatives, were involved in making decisions about their care and support. The service was up to date with the Deprivation of Liberty Safeguards (DoLS).
People’s nutritional needs were being assessed and met. Where concerns were identified about, for example a person’s food intake, appropriate referrals had been made for specialist advice and support.
People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.
There were appropriate arrangements in place to ensure people’s medicines were obtained, stored and administered safely.
Staff were trained and supported to meet the needs of the people who used the service. Staff were available when people needed assistance, care and support. The recruitment of staff was done to make sure that they were able to work in the service.
Staff had good relationships with people who used the service and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.
A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.
Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed promptly. As a result the quality of the service continued to improve.
We saw that the staff were attentive to people's needs and they responded to requests for assistance promptly. We saw that the staff interacted with people in a caring, respectful and professional manner.
We looked at the care records of three people who used the service and found that they experienced care, treatment and support that met their needs and protected their rights. The provider worked with other professionals who were involved in people's care and support which ensured that people were provided with a consistent service which met their needs. We found that people's comments and complaints were acted upon in a timely manner.
Discussions with staff and the training records that were seen showed that people were supported by sufficient staff numbers who were trained to meet their needs.
We looked around the service and found that people were provided with a clean and hygienic environment to live in. Equipment, such as hoists and portable electrical appliances, were regularly checked to ensure that they were fit for purpose and safe for people to use.
People told us that they were consulted about the care and support they were provided with and the staff listened and acted on what they said. One person said, "They (staff) always ask me what I want and how I want it." Another person said, "The manager spoke to me and my (relative) before I moved in about what I needed."
People told us that they felt that their needs were met. One person said, "If I need help I just have to ask and they do it for me." Another person told us that the staff knew them well and supported them in the ways that they preferred. Another person said, "You won't find anything wrong here, it is a very good place."
People told us they liked the choice of food and drinks on offer. They gave examples where a cook had prepared particular meals for people when they said they liked something that was not on the menu.
People living in the home told us they were able to spend their time as they wanted. One person showed us the activities schedule for the week and told us what they would take part in. We were unable to speak with some people living in the home because of their deteriorating physical and/or mental health. We observed how staff responded to their needs and saw they did this with dignity and respect. We saw two members of staff positively engaged with people by encouraging them to take part in activities and discussion.