Archived: Surrey Hills

We found the following examples of good practice.

People were supported to host visitors in a COVID-19 secure way. The manager regularly updated people’s families around the changes to the national guidance on visiting in care homes during the pandemic.

The provider effectively supported the manager to implement clear plans for infection prevention and control (IPC), COVID-19 outbreak management and a national testing program for people and staff. These were kept under ongoing review according to national guidance changes. Staff were knowledgeable on how to adhere to those plans and demonstrated this in practice. For example, staff were regularly tested for COVID-19, knew how to recognise COVID-19 symptoms and self-isolated when required.

Staff wore required personal protective equipment (PPE) on the day of the inspection. Staff told us they were trained on the safe use of PPE and IPC. The manager supported staff to assess their individual risks in relation to COVID-19 and implemented adequate measures to minimise those risks. Staff told us they were well-informed and felt supported by the provider throughout the pandemic.

The home was clean and hygienic. Staff undertook additional cleaning duties and the daily cleaning was underway on the day of the inspection. Staff could access required PPE and handwashing facilities around the home and there was supportive signage available around IPC systems.

Surrey Hills is a care home providing nursing care for up to 45 older people, the majority with a diagnosis of dementia. At the time of the inspection there were 37 people using the service.

People’s experience of using this service and what we found

People told us they felt safe living at Surrey Hills, they told us that staff were kind and considerate towards them. Relatives told us they felt reassured by the caring attitude of staff. Incidents and accidents, including complaints and safeguarding allegations were reported and investigated appropriately. The provider assessed risks to people and the environment which meant they were kept safe from harm. Regular checks took place to ensure the environment was clean and people protected from the risk of poor infection control. People were supported to take their medicines in a safe manner from trained staff. There were enough staff employed to keep people safe and recruitment procedures were robust

People told us they received care and support from competent and trained staff. Records showed care workers received regular training and supervision. This meant they were able to carry out their roles effectively. Before people moved into the home, their needs were assessed, and risk and care plans developed to ensure they received good care. People’s nutritional and health care needs were identified, and the provider worked in partnership with community health teams to ensure people received appropriate care. 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 were treated with care and respect. Care workers treated them as individuals and cared for them in a manner that promoted their independence and maintained their privacy. People were able to express how they wanted their care to be delivered and staff respected their choices. The provider supported people to maintain relationships that were important to them.

End of life care plans were in place and the provider worked with community teams to ensure people received good quality end of life care. There was a thriving activity programme in the home and people were supported to pursue interests to avoid social isolation. The provider took on board any complaints received, listening when concerns were raised and followed up on any actions.

People, relatives, staff and health care professionals all felt the service was managed well. They praised the registered manager for enabling an open culture where they felt ale to express their views. Quality assurance checks such as clinical governance reports and audits took place which helped to maintain a good level of service.

Rating at last inspection

The last rating for this service was Good (published 31 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Surrey Hills is a care home registered to provide accommodation and nursing care to up to 45 people. At the time of our visit, there were 32 people living at the home. Many of the people living at the home were living with dementia and some had more complex health needs.

There was 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.

At our last inspection in October 2015 we identified concerns regarding infection control. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

People lived in a clean and safe environment. Improvements were made in cleaning processes and the provider undertook regular audits of the home environment, as well as the care that people received.

People were supported by staff who knew how to respond if they suspected abuse. Risk assessments were regularly carried out and measures were in place to protect people. Staff supported people in a way that promoted their independence whilst risks were managed. Where incidents or accidents occurred, measures were put in place to prevent a reoccurrence.

Staff were given appropriate training for their roles. Staff felt supported by management and had input into how the home was run. The provider was working with staff to implement new models of practice that would improve the quality of care that people received.

There were sufficient staff present to meet people’s needs. Caring interactions between people and staff were positive as staff had time to spend with people. Staff knew people well and had access to person-centred care plans. People’s needs were regularly reviewed and changes in need were met. The provider had carried out checks to ensure that staff were suitable for their roles.

People received their medicines safely. We recommended that the provider ensures best practice is followed when recording administration of creams. Staff worked alongside healthcare professionals to meet people’s needs.

Staff offered people choices and involved them in their care. People told us that staff routinely asked them for consent and respected their privacy and dignity. Staff worked in accordance with the Mental Capacity Act (2005) and people’s rights were protected.

People and relatives were regularly asked for feedback. Meetings took place for people and relatives where any changes or concerns could be discussed. People were told how to complain and complaints were responded to appropriately. Where feedback or complaints were received, these were actioned by management.

We found that people's care needs had been assessed. We found that some people did not have skin care plans in place, although the risks to them had been assessed and managed. We spoke with the manager who took immediate action to address this.

We found that staff understood people's care needs and that they were caring.

The home was clean and processes were in place to manage the risk of infection.

Appropriate checks had been completed in relation to new staff.

Although new staff had received training as part of their induction. The provider had not ensured that all staff had kept up to date with their required training. Staff had not received an annual appraisal of their work.

There were processes in place to monitor the quality of the service provided.

People's records had been stored securely.