Archived: Summerfields Care Home

Updated 6 August 2015

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 was an unannounced inspection carried out over two days on 10 April and 22 April 2015. The inspection team was made up of two adult social care inspectors and an expert by experience (ExE.) An ExE is a person who has personal experience of using or caring for someone who uses this type of care service. The lead adult social care inspector returned to the home (unannounced) for a second day to complete the inspection process.

Prior to the inspection taking place, information from a variety of sources was gathered and analysed. This included notifications submitted by the provider relating to incidents, accidents, health and safety and safeguarding concerns which affect the health and wellbeing of people who lived at the home.

We undertook this inspection in response to some concerns we had received in relation to the care being provided at the home and to check whether the provider had made improvements to ensure they were now meeting their regulatory requirements.

To gain a balanced overview of what people experienced when using the service, we also contacted the Local Authority safeguarding team, the local authority contracts team and Healthwatch to obtain their views regarding service provision.

Information was gathered from a variety of sources throughout the inspection process. We spoke with ten staff members at the home. This included the Registered Manager, seven members of the care staff team, and two ancillary staff.

We spent time with the people who lived at the home to see how satisfied they were with the service being provided. We observed interactions between staff and people to try and understand the experiences of the people who could not verbally communicate. We observed care and support being provided in communal areas around the home and spoke in private to three people who lived at the home.

We used the Short Observational Framework for Inspection (SOFI) SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We also spoke with five relatives who were visiting the home on the day of inspection.

As part of the inspection we also looked at a variety of records at the home. This included the care plan files belonging to five people who lived at the home and recruitment files belonging to five staff members. We viewed other documentation which was relevant to the management of the service.

We looked around the home in both public and private areas to assess the environment to ensure that it was conducive to meeting the needs of the people who lived at the home.

Updated 6 August 2015

This unannounced inspection took place on 10 & 22 April 2015.

Summerfields Care home is situated in Morecambe and is registered to provide care and accommodation for up to 33 people living with Dementia. All accommodation is offered on a single room basis. The home has a variety of communal areas for people to use. There are passenger and stair lifts for ease of access between floors. There were 22 people living at the home at the time of inspection.

A registered manager was in post at the time of the 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 service was last inspected in April 2014. The registered provider did not meet all the requirements of the regulations at that inspection as they had breached regulation 19, complaints. We used this inspection to review what actions had been taken and found that the provider had put systems in place to ensure that complaints were appropriately received and managed.

Feedback received during this inspection from people using the service was positive. All of the people we spoke with confirmed that they were happy living there and the service being provided. Feedback from family members and friends of people who lived at the home was also positive. Families stated that they were happy with the service provided. Relatives said that the staff were caring and that people’s needs were generally met.

Although people who lived at the home said that they felt safe, we noted that safety of the people was sometimes compromised. We found that people were not always kept safe as deployment of staffing meant that there was not always oversight of people in the main lounge area. We identified a high number of people were injured following falls when staff were not present. Poor deployment of staff sometimes led to disorganisation and a lack of consistency of support for people.

Processes and systems were in place to protect people from abuse. Staff were aware of how to report abuse and whistle blow. The provider had a robust recruitment system in place.

People were not safe from risk of injury as the registered manager had failed to ensure that the environment in which people were living was adequately maintained. We found slip, trip and fall hazards in one lounge, poor lighting in communal areas and windows without restrictors. We noted an electrical inspection assessment had found the electrics were unsafe but there was no evidence that this had been actioned. These environmental hazards posed a risk to people who lived at the home.

People were not protected from unsafe care as adequate processes and systems were not in place for the management of medicines. The numbers of trained staff available to administer medicines was inadequate. We found that best practice for administering medicines were not always followed.

It is a requirement of the Care Quality Commission (Registration Regulations 2009) that the provider must notify the Commission without delay of any serious injury to a service user or any abuse or allegation of abuse in relation to a service user. This is so that we can monitor services effectively and carry out our regulatory responsibilities. The registered manager had not notified the Commission as required.

Mandatory staff training was not completed by all staff members to ensure they were equipped with all skills required to do their role. Staff were not aware of the Mental Capacity Act (MCA) (2005). Ongoing support to staff was provided through quarterly meetings with the registered manager.

Although care plans and risk assessments were in place for each person we found paperwork was often incomplete. This made it difficult to follow and assess the effectiveness of the care being provided.

We observed mixed interactions between staff and people at the home. Some staff demonstrated behaviours which showed that they treated people with compassion. On other occasions we noted staff failing to engage with people and meet their needs.

Care provided was often delivered as a means to meet staffing need rather than the people who lived at the home. We observed people being denied choices because staffing levels dictated how the service was run. People were unable to have baths because of a lack of staffing and people were delayed from going to bed when they requested to do so.

Feedback from staff was mixed. Overall, staff said that morale was low and there was a lack of leadership within the home. A recent restructure within the home had caused disparity between staff and confusion over accountability and roles and responsibilities. Despite morale being low, staff described working with the people who lived at the service with care and commitment.

We found that there were a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we have asked the provider to take at the back of the full version of this report.

We found that the environment was not dementia friendly for people with dementia. There was a lack of appropriate signage to promote independence of people living with dementia and the provider had done little to make the environment wholly inclusive. We have made a recommendation about using good practice guidelines to improve the service.

On the day of inspection activities were planned but were cancelled at short notice, this meant that people spent time sitting in the lounge with no activities. There was evidence that activities did take place in the home as we noted people’s drawings and hand crafted vases that had been made by the people who lived at the home. We have made a recommendation about using best practice guidelines to promote and increase appropriate activities for people living with dementia.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included quarterly satisfaction surveys and ‘relatives meetings’. Overall satisfaction from relatives and people who lived at the home was seen to be positive.