Angels (Stratton House) Limited

Updated 17 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

The inspection was conducted by two inspectors.

Service and service type

Angels (Stratton House) Limited is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Angels (Stratton House) Limited is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. However, they were currently absent from the service and were not present during the inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 staff members which included the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 7 people's care records. We reviewed daily records relating to food and fluid intake, wound management and skin integrity. We reviewed accident, incident, and safeguarding records. A variety of records relating to the management of the service, including provider and manager audits and the service’s action plan were reviewed.

Updated 17 October 2023

About the service

Angels (Stratton House) Limited is a nursing home providing personal and nursing care for up to 24 older people, some who are living with dementia. At the time of the inspection there were 21 people living at the service. The service is laid out over two floors that can be accessed by stairs and a lift. There are two communal lounges, a dining room and level access to front gardens.

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

Governance systems continued to not be fully effective and meant repeated shortfalls at the service were found in relation to record keeping and risks to people. There was a lack of provider oversight. The service was reliant on the local authority identifying areas of improvement and directing changes.

Improvements had been made to ensure a stable, consistent staff team who knew people well. There was a friendly and positive atmosphere at the service. We received positive feedback about the support people received from staff, who were caring and responsive to people’s needs.

Staff now received regular supervision and training. Recruitment procedures were now fully followed. Improvements had been made to the environment and décor. People’s rooms were homely. The service was clean and tidy. Infection prevention control measures were in place and adhered to.

Care plans continued to need development to ensure they were person centred and accurate. People’s capacity was assessed in relation to specific decisions. However, improvements were needed to ensure capacity assessments and best interest decisions fully followed the Mental Capacity Act 2005 guidance. The recording and management of complaints had improved. However, the provider needed to ensure if complaints were escalated the complaints procedures could be effectively followed.

Medicines were managed safely. People enjoyed the food at the service and different diets were catered for. Activities were provided. We received positive feedback about the registered manager and how the service was being led. Staff were supported.

Accidents and incidents were reported and recorded. Safeguarding systems were in place to protect people from abuse. However, potential safeguarding concerns were not always identified as the records were not followed through.

Communication had improved both internally and externally, which supported lessons being learnt. Regular meetings occurred with staff and comprehensive handover information. Relatives were kept updated and informed. Relatives were involved in reviews of people’s care. People, relatives and staff were asked for feedback through surveys.

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 requires improvement (published 18 May 2022).

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 the provider remained in breach of regulations.

At our last inspection we recommended that provider reviewed documentation around consent to specific areas of people's care in line with The Mental Capacity Act 2005 (MCA). At this inspection we found that the provider had met this recommendation but improvements were still needed in fully following MCA guidance.

The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last four consecutive inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

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 remained requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for (Angels) Stratton House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified repeated breaches in relation to Regulations 12 (Safe care and treatment) and 17 (Good Governance).

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.