Station View

About the service

Station View is a residential care home providing accommodation and personal care to 6 people at the time of our inspection. The service can support up to 32 people in 1 adapted building.

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

People and their relatives told us they felt safe living at Station View, and they were happy with their care and support. Feedback from people reflected that staff knew how to keep them safe.

At our last inspection we recommended that the provider improve their records regarding the safe storage of medicines. At this inspection we found this was improved and audits included storage checks and related records.

Infection prevention control practices were in place. Staff were following current guidance and maintaining use of personal protective equipment (PPE) where it was appropriate. Additional cleaning of all areas and frequent touch surfaces was in place and recorded regularly by staff. Training included hand hygiene and other infection prevention control related subjects.

Medicines were stored, managed, and administered safely and records regarding people’s medicines were completed effectively. People received the medicines they needed to support their health needs. The registered manager closely monitored the use of any ‘when required’ medicines in an individualised way. Fire safety was managed well, and appropriate checks were in place

There were systems in place for communicating with people, their relatives and staff to collect their views and feedback regarding people’s care and support. The environment was clean, safe and maintained to a good standard. It was also adapted to meet people’s needs.

Individualised risk assessments were in place to ensure people could take risks safely. Staff were confident about how to raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.

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 follow up

The last rating for this service was good (27 November 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• All staff and visitors had to wear appropriate personal protective equipment (PPE), complete a health declaration form, NHS Track and Trace information and had their temperature checked prior to entering the home.

•The home had ample supplies of appropriate PPE which was stored hygienically and kept safe. Staff were provided with separate areas to put on and take off PPE safely.

• Staff supported people’s social and emotional wellbeing. The service had used different methods including information technology to assist communication with staff wearing face masks. The provider and staff kept family members up to date about the latest guidance and their relative’s health via regular telephone calls, letters and other technology including face time and handheld radios for window visits.

• The registered manager explained the quality systems they had in place to check the service was providing safe care. There was a robust communication system on place to ensure staff received consistent updates in relation to infection control policy and practice.

•Additional cleaning of all areas and frequent touch surfaces was in place and being carried out and recorded by housekeeping staff. Additional cleaning of people’s bedrooms of people who were isolating was also carried out.

• All staff, including catering and housekeeping staff had undertaken training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training.

Further information is in the detailed findings below.

Station View is a ‘care home’ situated in Harrogate. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and care provided, and both were looked at during this inspection.

Station View can provide support for up to 38 people. On the first day of our inspection 18 people were living at the service. The service provided mainly short-term support. The building is all on one level and is separated into five units, referred to as flats. Each flat has a dedicated purpose of either rehabilitation support, a period of assessment, respite support or to accommodate emergency admissions.

At our last comprehensive inspection of the service, in March 2016, we awarded the service a rating of ‘Good’. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Quality assurance checks completed by the registered manager and provider did not identify some of the issues we highlighted during our inspection, for example risk assessments not being updated and a lack of temperature checks for storage of medicines. The management team were responsive to the issues raised. The provider was in the process of developing their quality assurance tools to ensure the safety of the people who used the service and demonstrated they wanted the service to continually improve.

People were protected from avoidable harm. Staff received safeguarding training and understood how to report their concerns. For areas of potential risk, risk assessments were completed. Measures to reduce the risk of harm were not always recorded however staff had a clear understanding of what actions to take. Safe staff recruitment procedures had been followed. The service was clean and staff had access to personal protective equipment to control the spread of infections.

Staff completed training in the areas considered mandatory by the provider and demonstrated a good knowledge of their role. Staff received supervisions and appraisals to monitor their performance and development. Staff described feeling well supported. People had access to healthcare professionals and a multi-disciplinary team monitored their progress. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in place supported this practice.

The people who used the service provided positive feedback about the staff team who were observed to be caring and kind. People who used the service told us about the rapport and friendships they had developed with staff. Staff promoted people’s dignity and respect through their interactions.

People’s care records were personalised and staff provided person-centred care. The staff and management team promoted people’s independence. Consent was obtained from people before providing care. There was a compliments and complaints policy in place and the registered manager had followed the procedure when responding to these.

People’s views were sought about the quality of the service provided and their responses were used to consider how the service could improve.

Station View is a service owned and operated by North Yorkshire County Council. The service offers a range of different services, which include short stay/respite care, day care, interim care and rehabilitation beds. People’s stay varies from a few days up to a maximum of six weeks or when the person is ready to return home. The accommodation is provided in five separate flats each with a sitting room, kitchen and dining area. All with single bedrooms. There are two outdoor garden areas with parking facilities to the front of the building. Station View does not provide long term care. The service can accommodate up to a maximum of 39 people. On the day of our inspection 11 people were staying at Station View for rehabilitation or short stay/respite care.

The service did not have a registered manager in post to manage the service. Station View has been without a registered manager since November 2014. 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.

People’s safety was promoted because risks that may cause them harm had been identified and managed. People were supported by care staff who encouraged them to become independent. Appropriate risk assessments were in place to keep people safe. People we spoke with said they felt safe and they spoke positively about the care and support they received during their stay.

Medicines were managed safely, staff had been trained to administer medicines and had an up to date policy which provided them with good practice guidance. The deputy manager took responsibility for medicines and we saw they completed monthly audits. This meant if any errors did occur they could be resolved in a timely manner.

Staff recruitment processes included carrying out appropriate checks to reduce the risk of employing unsuitable people.

Staff received a range of training which supported them to understand and meet people’s needs. Staff received supervision of their work and felt well supported by more experienced staff and the deputy manager.

The assessment and the planning of people’s care was thorough and ensured staff had good information of people’s individual needs and preferences. People told us care staff ensured their dignity and privacy was met. Care plans contained information which provided staff with a sense of what was important to the person, they were reviewed and updated on a regular basis.

The service worked closely in partnership with health and social care professionals. This was to ensure people received the right support in becoming independent, during their stay at Station View and then enabling them to return to their own home.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions.

People told us the food was good and we saw people had access to a choice of nutritious home cooked meals along with regular drinks and snacks throughout the day.

People knew how to make a complaint if they were unhappy and all the people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything.

People were asked to complete a survey about the quality of the service at the end of their stay. The provider reviewed this feedback used it to address any shortfalls and improve the service.

Staff morale was good and all of the staff we spoke with told us how much they enjoyed working at the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people's relatives and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We found that people were supported to make choices and preferences about their care and support, and people experienced care and support that met their needs.

When people were identified as being at risk, their care plans showed the actions that would be required to manage these risks. These included the provision of specialist equipment such as pressure relieving mattresses, hoists and walking aids.

People who required rehabilitation to enable them to return home, had access to health care professionals such as physiotherapists, during their stay at the service.

People we spoke with told us that they thought that Station View was a good service. One person told 'I find it very good, you get well looked after. I could not do without it' another person said 'Yes you are quite safe here; they (staff) are all good to you. At night they check that you are alright.'

Systems were in place to make sure that the manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

The service had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). Senior staff had been trained in this area to help to protect people.

Is the service effective?

Staff we spoke with were knowledgeable about the people they supported and knew people very well. People's health and care needs were assessed with them, and they were involved in developing their plans of care. People told us they were included in decisions about how their care and support was provided.

People who required rehabilitation to enable them to return home, had access to health care professionals such as physiotherapists, during their stay at the service. From speaking with staff they were able to demonstrate a good understanding of people's care and support needs.

Is the service caring?

We saw staff were attentive and respectful when speaking with or supporting people. People looked well cared for and appeared at ease with staff. The home had a relaxed and comfortable atmosphere. One person said 'The staff here are smashing, they are really good and they help me with things I am not able to do myself' another said 'They made a cake for my birthday, the staff are all very nice.'

One relative said 'I am always made to feel welcome when I visit. I am able to make a cup of tea as and when we want.'

When speaking with staff it was clear that they genuinely cared for the people they supported. One member of staff said 'Station View is good to work at and is improving all the time. Residents here are treated with respect and are cared for.'

Is the service responsive?

There were sufficient staff available to meet people's needs; staffing was arranged flexibly in order that people could be supported in activities of their choice and for some people when they required support with rehabilitation. Staff completed specialist training in order to enhance their skills and knowledge and met individual's needs.

The service carried out an annual satisfaction survey. Results were collated and analysed and action plans were agreed and completed.

People we spoke with knew how to make a complaint if they were unhappy. People told us they were confident that any issues they raised would be looked into and action taken.

Is the service well-led?

Effective management systems were in place to promote and safeguard people's safety and welfare.

People we spoke with and their relatives told us they thought that the service ran well. One person we spoke with made it very clear that if they were unhappy with anything they would stop coming to the service. They told us 'I have not got one complaint, if I did I would stop coming.'

The quality assurance system included audits and checks carried out by staff at the service and by other people from within the organisation. Records showed that issues were identified and responded to in a timely way. As a result the quality of the service was continuously improving.

People who used the service told us they were happy with the care and support they received. People made comments such as, 'Excellent care, I have been so well looked after by everyone.' And 'Amazing caring staff, very thoughtful in everything they do.'

We found that there were robust systems in place to make sure people were kept safe. Staff had received safeguarding training and had a good understanding of their role in protecting people using the service.

There were effective systems in place to reduce the risk and spread of infection. We spoke with people who used the service and their relatives who told us that they thought the home was clean and well-maintained.

People were also protected from unsafe or unsuitable equipment by regular checks and audits being undertaken to ensure they were safe.

We found that the medication procedures were robust and observed that staff administered medication in a safe way. We also saw that the storage and management of medication was maintained. This was important to make sure that everyone's health needs were managed safely.