Selkirk House

Updated 11 March 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 included checking the provider was meeting COVID-19 vaccination requirements. 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 carried out by one inspector

Service and service type

Selkirk House 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. Selkirk House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 16 February 2022 and ended on 17 February 2022.

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 eight people who lived at the home and two people's relatives. We spoke with eight care staff and a housekeeper. We also spoke with the registered manager, deputy manager and the provider’s care quality advisor. We spoke with a visiting health professional to hear their views of the care provided.

We looked at a range of records about people's care including six care files, medicine records and people’s care monitoring charts. This was to assess whether the care people needed was being provided. We reviewed records of the checks the manager and the provider made to assure themselves people received a quality service. We also looked at personnel files for three members of staff to check that safe recruitment procedures were in operation.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed information the registered manager sent us.

Updated 11 March 2022

About the service

Selkirk House is a residential care home providing regulated activity of accommodation for persons who require nursing or personal care to up to a maximum of 42 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 38 people using the service.

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

Prior to the inspection we received concerns related to infection control practices at the service. During the inspection we saw some staff not wearing their face masks correctly. This was immediately addressed by the registered manager who arranged for all staff to re-visit their infection prevention and control training. We found no other infection control concerns and we were satisfied that the concerns we had identified had been addressed.

People told us they felt safe living at Selkirk House. One person commented, “I love living here and I'm a safe as I can be." People were supported by staff who understood their needs and knew how to protect people from the risk of abuse.

Risks relating to each person had been identified and care plans and risk assessments were in place to guide staff how to manage and reduce risks. Care plans and risk assessments included detailed information about people's skin integrity and the support they needed to minimise the risks of developing pressure sores. Where people were unable to change their position in bed to relieve pressure on their skin, staff regularly helped them to do so. Equipment such as specialist pressure relieving mattresses were in place, and daily checks were made to ensure their effectiveness.

Effective systems were in place to ensure people received their medicines as prescribed and medicines were received, stored, administered, and disposed of safely.

We observed there were enough staff to care for people safely and meet their needs. Staff were available to respond to people's requests for assistance and the atmosphere was calm and relaxed. However, some people and staff told us that at times, people had to wait for their care needs to be met. We discussed this with the registered manager who told us they were currently recruiting more staff to ensure staffing levels responded to the identified needs of people.

Recruitment practices at the service ensured that, as far as possible, only suitable staff were employed.

A positive culture was shared to ensure good outcomes for people. Incidents were investigated and improvements were made. Managers and staff were clear about their roles and regulatory requirements.

Staff we spoke with told us communication between staff and managers was good. Staff said they were able to share feedback during regular supervision meetings and staff meetings. Daily handover meetings took place between shifts and where possible the managers attended.

The registered manager and provider had systems in place to monitor the quality and safety of the home. This included audits, improvement plans and gaining feedback from people and staff.

The service worked in partnership with other organisations to make sure they were following current practice, providing a quality service and to ensure the people in their care were safe.

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 good (6 November 2017).

Why we inspected

The inspection was prompted due to concerns received about infection control, skin care, medicines management and lack of support for staff. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well led sections of this report.

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