Archived: Shandon House

Updated 22 October 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 was an unannounced inspection which took place on 15 and 16 August 2016. An unannounced inspection means the provider and staff did not know we were coming. It was undertaken by an inspector 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.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the home, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection, we spoke with twelve people who lived at the home, four visiting relatives, and seven staff members including the acting manager and owner. We also spoke with a visiting healthcare professional who was at the home during the inspection.

We met with people who lived at Shandon House; we observed the care which was delivered in communal areas to get a view of care and support provided across all areas. This included the lunchtime meals. We spent time sitting and observing people in areas throughout the home and were able to see the interaction between people and staff. This helped us understand the experience of people who lived at the home.

We looked at six care plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at the home. This is when we looked at their care documentation in depth and obtained their views on their life at the home. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection we reviewed the records of the home. These included staff training records, staff files including staff recruitment, training and supervision records, medicine records complaint records, accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

Updated 22 October 2016

Shandon House provides accommodation and personal care for up to 25 older people. There were 20 people living at the home at the time of the inspection. People required a range of care and support related to the frailty of old age. Some people lived relatively independent lives, others required support with personal care or mobilising safely, others had a degree of short term memory loss. People were able to live at the home permanently or for periods of respite care. Staff could provide end of life care with support from the community health care professionals, but usually cared for people who need prompting and minimal personal care support.

Shandon House is a family run home; it is owned by Bree Associates Limited and has one other home within their group. Accommodation was provided over four floors with a passenger lift that provided level access to all parts of the home. People spoke well of the home and visiting relatives confirmed they felt confident leaving their loved ones in the care of staff at Shandon House.

There is a registered manager at the home; however she was on a phased return to work following maternity leave at the time of the inspection. In her absence the home was being managed by an acting manager with oversight from the owner of Bree Associates Limited.

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.

We carried out an inspection of Shandon House on 6 and 8 July 2015 where we found the provider had not met the regulations in relation to the safe management of medicines and people’s personal records were not accurate and up to date. The provider did not have an effective system to regularly assess and monitor the quality of service that people received.

An action plan was submitted by the provider that detailed how they would meet the legal requirements by December 2015. At this inspection, on 15 and 16 August 2016 we found the provider was now meeting the legal requirements.

Although people received the care and support they needed we found some of them spent long periods of time with nothing to do and had a lack of stimulation. We made a recommendation about this.

People were looked after by staff who knew them well and had a good understanding of their individual needs. People were able to get up and go to bed when they wanted to. They were able to move freely around the home with support of the staff when needed. Staff were kind and patient, they worked at people’s pace and did not hurry them. People were supported to maintain their independence as far as possible.

Where people lacked capacity to make their own decisions there was evidence discussions had taken place with appropriate professionals and people’s representatives, to ensure appropriate decisions were made in the person’s best interests. People were supported to maintain their own health, they were able to see their own GP or other health professionals. Staff supported people to attend hospital appointments when they needed to.

Risks were safely managed, risk assessments were in place and staff had a good understanding of the risks associated with the people they looked after. Staff knew what actions to take to protect people from the risk of abuse. People were supported to receive their medicines when they needed them. Medicines were stored, administered and disposed of safely by staff.

There were enough staff with the appropriate knowledge and skills working at Shandon House. Areas for improvement in staff knowledge and practice were identified and staff were supported to develop through supervision and training.

People’s nutritional needs were met. They had a choice of meals and drinks throughout the day. People were involved in the day to day running of the home. They were regularly asked for feedback about the way the service was run through questionnaires and meetings. There was a complaints policy in place and people said they were able to raise any concerns they had.

The quality assurance systems ensured the home delivered a good level of care. Where shortfalls were identified, systems were put in place to ensure issues were addressed and prevent reoccurrence.

The owner and managers took an active role within the home. They knew people and staff well. They were open and approachable and promoted a positive culture. There were clear lines of responsibility and accountability within the management structure.