We carried out a review of the data available to us about Yeovil - Sherborne House 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 Yeovil - Sherborne House Care Home, you can give feedback on this service.
Yeovil – Sherborne House Care Home is a care home and provides personal or nursing care for older people and those living with a dementia. The home can accommodate a maximum of 38 people. At the time of the inspection 31 people lived at the home.
The home also had a separate pathway unit called “The Wing.” The Wing accommodated 8 of the 31 people. This unit was for people who had been discharged from hospital to be assessed prior to going home or moving into alternative accommodation. The Wing was staffed by 2 NHS staff members, an occupational therapist and a physiotherapist. The NHS staff carried out the needs assessments when people came to the home and Altogether Care LLP provided the accommodation and care staff to deliver the regulated activity.
People’s experience of using this service and what we found
At the last inspection medicines management was not robust. At this inspection improvements had been made.
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.
The home had been extensively redecorated since the last inspection. The home environment had been adapted to meet people’s needs. Dementia friendly signage helped people move around the home safely and there were additional quiet seating areas.
Since the last inspection there was a new registered manager. The registered manager and other senior staff carried out a robust programme of audits which helped ensure good oversight of quality and emerging risk in the home. When issues were identified these were quickly resolved and learning shared.
Risks to people were assessed, recorded and regularly reviewed. Staff demonstrated a good understanding of the signs and symptoms that could indicate people were experiencing abuse or harm. Staff knew how to report concerns both internally and externally.
There were enough staff to meet people’s needs. Call bell response times were monitored to ensure people received timely support. Staff were recruited safely, thereby helping to ensure only suitable people were employed.
Staff received a comprehensive induction and ongoing training to help them understand and meet people’s needs. People and their relatives felt the staff were well trained and competent.
People were supported to access health services whenever required. This included the home’s rehabilitation wing and off-site services such as hospitals and GP surgeries.
Staff spoke positively about the registered manager and said they were proud to work at the home. They felt supported by their colleagues and senior management. The registered manager felt well supported by the provider. Staff were actively encouraged to gain additional skills and qualifications to develop their practice.
The home worked well with other organisations such as hospital discharge teams, social services and local colleges. The home also understood the importance and benefit of links with the wider community through social events.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 January 2020) and there was a breach of regulation.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 21 and 22 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
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.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Yeovil - Sherborne House 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.
We found the following examples of good practice.
People were supported by staff who understood how to keep them safe during a COVID-19 outbreak and prevent infections further spreading. Staff were seen regularly washing or sanitising their hands and changing their personal protective equipment (PPE) such as gloves, aprons and masks. Staff had multiple stations throughout the home to wash their hands and safely put on and take off their PPE. Face shields were regularly cleaned by staff. Clear signage was around the home to remind staff in case they were tired or new.
However, on a few occasions members of staff needed reminding about forgetting a step or incorrectly wearing their PPE. The registered manager told us they regularly reminded staff as part of staff meetings because they were aware how important it was.
People were able to have visitors in line with government guidance. One person commented they were able to speak on the phone regularly to family members. Other people had named visitors who were part of the home’s testing scheme. They could visit even though there was an outbreak in line with government guidance. One person raised they would like some more visits and the management were straight onto resolving this. Following the inspection, they had three relative visits organised. The registered manager made it clear that people’s welfare was always considered during visiting decisions whilst they were in outbreak.
Cleaning of the home had increased during the outbreak. Arrangements were in place even during staff absences to clean high touch points such as grab rails and light switches. The head housekeeper explained they had high standards and made sure everyone kept to these. Systems were in place to safely manage infected people’s laundry and keep it separate.
The management had a mixture of formal and informal systems in place to regularly check staff competencies and stocks of PPE around the home. On two occasions stations were missing items of PPE or a hazardous waste bin. The registered manager recognised this and immediately took actions to resolve the issue including formalising some of the checks completed. Following the inspection, they informed us staff had moved some of the PPE and clinical waste bin to allow access for ambulance staff. They have reminded the staff of replacing it once it was safe.
People had not been impacted by staff shortages and regular agency staff were used when required. Additionally, other staff had been willing to increase their working hours. The provider had systems in place to recruit new staff and valued staff they already had. This included working overseas to get qualified staff in their own country.
Yeovil – Sherborne House Care Home is a care home and provides personal or nursing care for older people and those living with dementia. The home can accommodate a maximum of 38 people. Of the 38 bedrooms, 19 had a sink and a separate toilet, and there were three communal bathrooms spread over two floors. At the time of the inspection 35 people lived at the home. The home also had a separate pathway unit they called “The Wing.” The wing accommodated nine out of the 35 people. This unit was for people who had been discharged from hospital to be assessed prior to them either going home or moving into alternative accommodation. The wing was staffed by two NHS staff members, one occupational therapist, and one physiotherapist. The NHS staff carried out the needs assessments when people came to the home and Altogether Care provided the accommodation and care staff to deliver the regulated activity.
Some people we met at Sherborne House were not able to communicate with us verbally. We therefore used our observations of care, and our discussions with staff, relatives, and professionals to help form our judgements.
People’s experience of using this service and what we found
The service had a home manager but there was no manager registered with the Care Quality Commission. The home manager did not understand their role fully. Quality monitoring systems included audits and regular checks of the environment to ensure people received good care. These were not effective; the service did not have an effective governance system in place
Medicine management was not robust, staff did not follow the providers medicine management policy and people did not receive their medicines safely.
The service did not have a homely feel. Soft furnishings such as curtains were hanging off the rails and people’s rooms were sparse and looked clinical. One person’s room had large chairs in the middle of the room and was not safe. People were all issued with plastic cups and the dining room door was locked to prevent people accessing it during the day.
People were supported by staff that were caring and treated them with dignity and respect. Staff understood the needs of the people they supported and knew them well. All the feedback we received from people, their relatives and healthcare professionals was positive.
Risks of abuse to people were minimised. Assessments of people’s needs identified known risks and risk management guidance was produced for staff which they understood.
The provision of activities within the service was extensive and people could take part in multiple activities, but they did not always reflect personal hobbies and interests.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update) The last rating for this service was good (published 22 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to the management of the service, and medicines management, at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The home has been extended since the last inspection which has increased the number of beds available from 29 to 37. At the time of this inspection there were 23 people living at the home and no one had moved into the new extension.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good
People were cared for by adequate numbers of staff to meet their needs and maintain their safety. People looked very comfortable and relaxed with the staff who cared for them. People received their medicines safely from registered nurses. A visitor told us, “They are in safe hands.”
People received effective care and support from staff who had the skills and knowledge to meet their specialist needs. Food and drinks served to people were well presented and appeared appetising. One person said, “Food is very good.” 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.
Staff were kind and caring towards the people who lived at the home. One person said, “Staff are kind and happy.” Another person commented, “Staff are always kind. They look after you.” People or their representatives were involved in decisions about their care and support including the care they wished to receive at the end of their life.
The service was responsive to people’s needs and they were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation.
The home was well led by a registered manager who had an excellent knowledge of people using the service and staff. Staff morale was good which created a happy environment for people. The provider had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.
Further information is in the detailed findings below
This inspection was unannounced and took place on 7 May 2015.
Yeovil – Sherborne House provides accommodation and nursing care to up to 28 people. The home specialises in the care of older people living with dementia.
At our last inspection of the home in February 2014 we found the home needed to improve some areas of the premises to ensure they were safe. The provider sent an action plan outlining the work that had been undertaken to make sure all areas of the building were safe for people who used the service. At this inspection we saw the required work had been carried out.
There is 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.
Without exception the registered manager was described as open and approachable. Their office was located in the centre of the home which enabled people and staff to discuss issues with them at any time. The registered manager was very visible in the home and people looked very comfortable and relaxed with them.
People said they were supported by kind and caring staff. One person told us “There are very nice staff here and they are definitely kind.” Another person said “Staff are nice and we all get on.” Throughout the inspection visit staff interacted with people in a kind and friendly manner. Staff sat with people chatting and looking through books and photo albums. One person said “I think it’s a lovely place.”
There were sufficient numbers of staff to meet people’s needs in a relaxed manner. Staff received on-going training to make sure they had up to date knowledge to safely and effectively support people.
One to one and group activities were arranged to make sure people received social stimulation and were assisted to occupy their time. There was a weekly activity programme displayed outside the dining room to let people know what was going on. For people who did not wish to join in with organised activities there were objects around the home for them to interact with.
People received care that was responsive to their needs and personalised to their wishes and preferences. Staff told us there were no strict routines in the home and they liked people to please themselves. One member of staff said “We don’t make people get up or go to bed at a certain time It’s really up to them. We want people to feel they are at home.” People looked very comfortable with the staff who supported them and felt safe at the home. One person told us “The staff are lovely with you.” A visiting relative said “I think they are very safe and happy here.”
Staff respected people’s privacy and made sure people’s dignity was protected. Each person had a single room where they were able to spend time alone or see visitors in private.
People’s nutritional needs were assessed to make sure they received a diet in line with their needs and wishes. Where concerns were highlighted regarding people’s food or fluid intake the staff involved appropriate professionals such as GPs and speech and language therapists. There was always a choice of food and staff assisted people to choose their meal. People were complimentary about the food served at the home. Where people required a specialist diet to meet their needs this was provided.
There were always registered nurses on duty to monitor people’s well-being. People also had access to other healthcare professionals according to their individual needs.
There were annual satisfaction surveys for people who lived at the home and their representatives. The results of the last survey showed a high level of satisfaction with all aspects of the service.
The relatives of people who live in the home told us that the home assisted them to understand the care choices available to their relatives. Relatives told us that people who live in the home could have their views taken into account in the way their care was delivered. A relative told us, "We have power of attorney. They discuss all their care with us."
We found that people's needs were assessed; and care was planned and delivered to meet people's needs. A person's relative told us, "My (relative) has been here for three years. The care here has been very good; the staff are helpful, nothings been too much for them.'
We found that people were not fully protected against the risks of the unsuitable design and layout of the property.
People were supported by staff that were appropriately qualified and physically and mentally able to do their job.
People's comments and complaints were listened to and acted on effectively. People could be sure that they would not be discriminated against for making a complaint. A person's relative told us, "I've never had any concerns. I know my (relative) is in safe hands." Another person's relative told us, 'I can't fault it ' I've never had any issues. But, if I had any, they would take notice, I'm sure.'
The relatives of two people using the service were spoken with and they told us that the staff couldn't do enough for their relative.
The home had sufficient staff working the day we visited to look after people and we observed staff talking and discussing people's care in the staff room. One nurse we spoke with about care plan reviews said "Whilst we formally invite people's relatives to a review we are always chatting and letting them know about things when they visit."
The home had appropriate policies and procedures that staff could use for guidance. One staff member told us "We meet and talk about how we care for people regularly; the audits and documentation here supports that."
However whilst staff were clear about the action they would take if they suspected abuse there was no readily available guidance for them.
At the time of the visit there were 25 people living at the home. We spent time during our visit observing care practices, talking with staff, management and visiting relatives.
There is a very relaxed and happy atmosphere in the home. People observed appeared content and well cared for. Staff working at the home were very attentive and showed a good knowledge of the people they worked with. All requests for assistance were dealt with promptly and kindly. When someone became anxious staff were quick to offer reassurance and calm the person.
We saw the main meal of the day being served and this appeared to be enjoyed by most people. Visitors said that the food was always very good and that portions were always ample. We observed that people who required support with meals were helped in an unhurried manner and their dignity was protected.
During the day there was constant interaction between people living and working at the home. We saw that staff explained all actions to people and offered reassurance before any tasks were performed.
There are various activities, some on a one to one basis, and others in a group setting where people are able to participate or observe. During the visit a pancake race was held in the garden which some people took part in and others watched. This appeared to give people pleasure and amusement. Generally people appeared animated and responsive to the staff who supported them.
On the day of the visit the home was clean and fresh and one visitor commented 'There are no smells, it's always very clean.'
There is clear signage throughout the home and objects of reference to assist people to orientate themselves and retain as much independence as possible. People were seen to have unrestricted access to their personal rooms and all communal areas.
At the most recent satisfaction survey carried out by the home 92% of people answered YES to the question 'Would you recommend this care home to your friends?' The remaining people responded MAYBE.