Stratton House

Stratton House is a residential care home providing accommodation and personal care for up to 33 people. The service provides support to older people. At the time of our inspection there were 30 people using the service.

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

People told us they felt safe. Comments included, “I do find myself feeling safe here.” Staff understood their responsibilities to protect people from harm and abuse. Risk assessments had been carried out to assess risks to people’s safety, and care plans informed staff how to keep people safe. Safe recruitment practices were in place. We received mixed feedback in relation to the number of staff on duty; however the registered manager told us they were in the process of reviewing staffing levels. Systems were in place for people to receive their medicines in a safe way. Incidents and accidents were reported and reviewed.

There was a quality assurance system in place to assess the standards of care in the service. This was overseen by the management team. Staff spoke very positively about working at the home and the people they cared for. One member of staff said, “[Registered manager] is so supportive. He encourages me, and even if he's busy he's always happy to answer any queries. If I wasn’t so supported, I would have left.” People told us the registered manager was very involved with everyone who lived at the service and that the management team as a whole were approachable. One person’s relative said, “[Registered manager] is very approachable and helpful, as are the deputy and admin managers.”

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

Rating at last inspection

The last rating for this service was Good (published 21 November 2019).

Why we inspected

We received concerns in relation to safe care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stratton House 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.

Stratton House is a residential care home providing personal care without nursing for up to 33 older people. At the time of the inspection 31 people were living at the home and one person was in hospital. Some people had limited verbal communication, so we captured some of their experiences through observations.

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

People told us they were happy living at the home and they felt safe. All people were comfortable in the presence of staff and relatives were positive about how safe their family members were. Medicines were administered and managed safely. Risks had been identified with ways to mitigate them in place.

Systems were in place to audit the service and when issues were identified they had been resolved. The management strove to be open and continually develop and improve the support people were receiving. They were aware of their responsibility to notify the Care Quality Commission of certain events in line with their statutory obligations.

People were supported by enough staff to meet their needs. Staff had received a range of training including specialist training in health and social care. A range of volunteers helped to increase the social opportunities people could participate in.

People had care plans which were personalised and provided a range of information for staff to use to support their needs and wishes. There were good links with other health and social care professionals to meet the needs of people living at the home.

Staff were kind and caring and knew the people living at the home well. Staff respected privacy and dignity throughout the inspection. Strong links had been developed within the wider community which had a positive impact for people. Independence was promoted, as were the values of treating each person as an individual.

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 13 October 2018) and there was one breach in regulations. 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

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.

At the last inspection on 28 January 2016 we found the service was Good.

Stratton House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Stratton House provides accommodation and personal care for up to 33 people. At the time of the inspection there were 32 people living at the Service. The Service had a dining area, lounge and sitting area, various quiet seating areas throughout the service and an outside garden where people could sit and enjoy various aspects of the outdoor space.

The service had a registered manager in place. 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 home had quality assurance systems in place however these did not always identify shortfalls relating to inadequate storage of contaminated laundry and poor staff practice administering medicines. Quality assurance systems did not always identified shortfalls and actions required.

There were adequate hand washing facilities available and staff used personal protective equipment such as gloves and aprons when required. People also had personal evacuation plan in place in case of an emergency. The service ensured people had an assessment before moving into the home. Care plans contained important information relating to peoples like and dislikes, their previous occupation, families and routines. Care plans contained risk assessments and support plans confirmed people’s individual needs.

The care plans contained consent document and assessment to demonstrate the service was working within the principles of the Mental Capacity Act 2005. Capacity assessments were in place including best interest decisions if required. People had choice and control over decisions that affected their lives. Both People and staff were happy in the home and all felt it was a homely positive environment which encourages them to be as independent as possible.

People and staff felt the registered manager was accessible and approachable. They had their views sought and improvements were made to the service following this feedback. Where complaints were raised these were investigated although the provider’s complaints policy needed updating.

People felt supported by staff who were kind and caring and who respected their privacy and dignity. They were given choice about what they would like to eat and were complimentary about meals provided. People were supported and encouraged to spent their time on activities of their choice and visitors were free to visit when they wished.

People had access to a variety of activities which suited different abilities and interests such as gardening, chair exercises, book club, knitting and expeditions. People were involved in organising and running some of the activities. The home was also an important part of the local community. Students and volunteers were able to gain by supporting people both in the home and in the community.

Staff had daily handover meetings and staff meetings to ensure they were up to date with any changes to people’s care needs. Where health needs had changed referrals where made to the appropriate health professionals. Notifications were made when required.

Staff had training to support them in their role. The service under took and supported staff to learn how to provide sensitive end of life care. People were also supported by the Chaplin to design their end of life plan if they wished to do so.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Stratton House is a care home registered to provide personal care for up to 33 people. There were 30 people living in the home on the day of our visit.

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.

There were enough staff to meet people’s needs. People felt safe and supported by staff. Staff were provided with regular supervision and training to help them meet the needs of the people living in the home.

People were cared for in a kind and respectful way. One person said, “They really care, nothing is too much trouble”. Staff were polite and showed respect to people.

People were provided with a varied diet. The menus took into account the likes and dislikes of the people living in the home.

The registered manager understood their responsibilities with regard to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). This legislation is in place to protect the rights of people who lack capacity to make informed decisions, and to make sure people are only deprived of their liberty when it has been approved by an authorised body.

People’s care plans were detailed and provided guidance about how to meet the people’s care needs. The care plans provided detail about who had been involved. They were reviewed and updated regularly. This meant people’s records contained up to date and relevant information about how to meet their assessed needs.

There was a system in place to check, monitor and improve the standards of care and the quality of the service. Audits demonstrated that regular checks were completed.

Nine people we spoke with were positive about the staff team. They thought there was enough staff on duty to meet their care needs.

We looked at three care files and saw each person had care plan. Information was recorded about people's personal goals and details about their physical, mental and emotional wellbeing. Peoples' care plans described their preferences and routines. The information in the plans was well maintained and sufficient to assist staff to care for people safely.

We looked at the systems in place for the management of medicines and found there were appropriate arrangements in place.

People told us the staff dealt appropriately with any complaints they had. They said the views of both people who used the service and staff were listened to, and valued.

We asked six people if they thought there was enough staff on duty. They all told us they thought there was not enough staff around in the mornings. For example, one person said: 'it's a rare and valued experience when staff have time to talk to me.' From our observations and review of care planning and care delivery we found there were not enough staff on duty at all times to support people safely.

We looked around the premises to see if people lived in a clean and hygienic environment. We saw areas of the home were not clean.

We looked at three care files and saw each person had care plan. Information was recorded about people's personal goals and details about their physical, mental and emotional wellbeing. Peoples' care plans described their preferences and routines. The information in the plans was not, however, always sufficient to assist staff to care for people safely.

We looked at the systems in place for the management of medicines and found there were not appropriate arrangements in place.