Archived: Sovereign House

Updated 18 May 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.

The inspection took place on 18 January 2016 and was unannounced. The inspection was undertaken by two inspectors, a Specialist Advisor and an expert by experience (ExE). An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The specialist advisor was a member of the inspection team who had specialist knowledge about nursing practices.

We looked at information received from statutory notifications the provider had sent to us and commissioners of the service. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are representatives from the local authority who contract services, and monitor the care and support when services are paid for by the local authority.

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. The information provided by the provider reflected what we found during our inspection.

We spoke with 16 people who lived at the home and spent time observing how they were cared for and how staff interacted with them so we could get a view of the care they received. 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 six relatives to gain their views about the quality of care provided.

We spoke with the deputy manager, the provider, 11 members of care and nursing staff, the cook and the maintenance worker. We reviewed five people's care records to see how their support was planned and delivered. We also spoke with three health professionals who visited the service during our inspection. The registered manager was not present on the day of our inspection however we arranged to speak with her after our visit to gain her views about the service.

We reviewed eight staff files and training records for all staff. We reviewed records of the checks the staff and management team made to assure themselves people received a quality service.

Updated 18 May 2016

This inspection took place on 18 January 2016 and was unannounced.

Sovereign House provides residential and nursing care for up to 60 people, who are living with dementia or have physical disabilities. The bedrooms are located across the ground, first and second floor which are accessible by stairs or elevator. The service is split into three floors; the ground floor offers residential care whilst the first and second floor offer nursing care for people with more complex needs. At the time of our inspection there were 60 people using the service.

A registered manager was 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.

The service was last inspected on 5 February 2015 when we found the provider was not meeting the required standards. We identified two breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to improve staffing arrangements and record keeping.

The provider sent us an action plan outlining how they would improve. At this inspection we checked improvements had been made. We found improvements had been made and sufficient action had been taken in response to the breaches in regulations .

People told us their care and support needs were met by staff who were knowledgeable and knew them well. Staff had undertaken training relevant to the specific needs of people who lived at the home and staff told us they were supported within their job roles.

Everyone we spoke with said they thought the home was a safe place to live and that they were well cared for. Staff had a good understanding of how to report any safeguarding concerns and how to keep people safe from avoidable harm.

The provider used a dependency tool to assess the number of staff needed and told us that staffing was provided at a level higher than the dependency tool stated. We observed that there were enough staff to meet the personal and health care needs of people and to keep them safe.

People received their medicines as prescribed and checks were undertaken to ensure they received them in a safe way.

The provider followed the principles of the Mental Capacity Act (2005). Mental capacity assessments were completed when needed and specified the nature of the decision the person was being asked to make. When people had a Deprivation of Liberty Safeguards (DoLS) authorisation in place for continuous monitoring, it was reviewed within the specified time frame to ensure that people were not being deprived of their liberty unlawfully.

Staff ensured they maintained people’s privacy and dignity and treated people with compassion and respect.

Health and safety risk assessments had been completed. Specific risk assessments had been completed about the risks associated with people’s care and staff had a good understanding of the support to be provided to keep people safe. Any incidents were logged and an analysis of accidents and incidents was completed so the provider and staff could identify any trends and manage them accordingly.

There were robust recruitment procedures in place to reduce the risk of unsuitable staff being employed at the service.

People’s nutritional and hydration needs were being met. People had a choice of meals which met their dietary requirements and preferences. People were supported to maintain their health and wellbeing.

People had opportunities to maintain relationships with people important to them. Group activities were provided, however people had limited opportunities to pursue their individual hobbies and interests.

People and their relatives knew how to raise complaints and were confident actions would be taken in response to these. People had opportunities to put forward their suggestions about the service provided.

There were processes to monitor the quality and safety of the service provided and actions were taken to drive improvement in the service.