Summerhill

Updated 4 November 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector.

Service and service type

Summerhill is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Summerhill is a care home without 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.

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 contracts and safeguarding teams. We also contacted the local Infection Prevention and Control team and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 three people and four relatives to gain feedback on their experience of the care provided. We observed staff engaging with people. We spoke with nine members of staff including, the registered manager, deputy manager, senior care staff, care staff and ancillary staff. We spoke with one visiting healthcare professional.

We reviewed electronic records relating to four people’s care and the management of medicines. We reviewed training records and a range of records relating to the management of the service.

Following a review of our findings, we identified concerns in respect of the provider’s compliance with the Health and Social Care Act (Regulated Activities) Regulations 2014. We wrote to the nominated individual and registered manager under Regulation 17(3) of the Health and Social Care Act (Regulated Activities) Regulations 2014, requesting they submit a detailed improvement plan stating how they proposed to fully address the areas of concern. This was received within the required timeframe. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 4 November 2022

About the service

Summerhill is a residential care home providing accommodation and personal care for up to 29 people. The service provides support to older people, some of whom may be living with a dementia. At the time of our inspection there were 25 people using the service.

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

Care records were not always accurate, complete or detailed. Personal emergency evacuation plans were not specific to the person and not written in line with guidance. Risks to the health and safety of people had not always been effectively assessed and mitigated. Systems were not effective in assessing, monitoring and improving the quality and safety of the service. Quality assurance systems had not identified the shortfalls in care records.

Practices in relation to IPC and the management of COVID-19 were in line with government guidance. However, the provider’s Covid-19 policies were out of date. We have made a recommendation about this.

Overall, recruitment practices were safe. However, the provider needed to make sure all applicants provided a full employment history. We have made a recommendation about this.

Records were not fully available to demonstrate how the provider was meeting their responsibilities under the duty of candour. The duty of candour regulation tells providers they must be open and transparent with people about their care and treatment, as well as with people acting on their behalf. It sets out some specific thing’s providers must do when something goes wrong with someone's care or treatment, including telling them what has happened, giving support, giving truthful information and apologising. We have made a recommendation about this.

Following the inspection site visit, we wrote to the provider requesting an improvement plan and details on action that would be taken to improve the service. This was received.

People’s needs were assessed before they moved to Summerhill and staff said they had no concerns about people’s care. People told us they felt safe and relatives confirmed they felt their loved ones were well cared for. 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.

Staff told us the morale at the home was good and they felt well supported by the registered manager and deputy manager. Staff completed a range of training to enable them to understand people’s needs. We observed patient and compassionate relationships between people and staff.

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 18 November 2021).

At our last inspection we recommended the provider keep infection control guidance under review to ensure best practice was followed. At this inspection we found some improvements had been made, however, we have made a further recommendation.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We had received some concerns in relation to the culture, care and management of Summerhill. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 changed from good to requires improvement based on the findings of this inspection. We found no evidence of concern in relation to the culture of the home however the provider needs to make improvements. Please see the safe and well-led sections of this full report

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We identified breaches of Regulation 12 and 17 in relation to risk management, the maintenance of records and quality assurance at this inspection. We have made recommendations in the safe and well-led key questions.

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

Follow up

We will request an update on the action plan from the provider to understand how they will continue to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.