Stratton Court

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked at 1 quality statement in this key question. This key question has not been fully assessed to give a rating. We found 1 breach of the legal regulations in relation to people’s care records and the governance of the service. Some of the provider’s systems to monitor the quality of the service being provided and the accuracy of people’s care records were not always effective. People’s risks were not being effectively monitored by the provider. The provider’s systems to monitor people’s care had not identified their care records were not being consistently completed by staff. It was unclear from people’s care monitoring charts that they were being supported in line with risk assessments and management plans. The provider had not ensured the upkeep and cleanliness of all of the home had been maintained to reduce the risk of spread of infection. Satisfactory employment checks of new staff had not been fully explored which put people at risk of being supported by unsuitable staff. We have asked the provider for an action plan in response to the concerns found at this assessment. The provider was developing their auditing systems to improve their ability to assess the performance of the service and take action to drive improvements. Staff and people’s relatives praised the management of the home. We were told they were approachable and would listen to their concerns.

This service scored 7 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff gave mixed feedback about the visibility of the management team. Comments included, “Some days I barely see them [management team]. They usually do the walk around every morning. When we need them, they will come” and, “The managers do check in on you and ask if you're OK. We don’t see them though. I can go a whole shift and not see anyone [from the management team].” Despite the lack of visibility staff spoke highly of the registered manager and comments included, “I feel more supported here than anywhere else” and, “The [registered manager’s] door is always open downstairs.” Staff felt they had not always been given opportunities to attend regular staff meetings to enable them to understand any changes in the home such as new protocols. However, staff told us they were kept updated about people’s needs during shift handovers or via their seniors. Discussions held with the staff on the different units indicated there was some inconsistencies in staff knowledge. For example, staff were not always aware of people’s required fluid intake targets and whether these were being achieved each day. Staff did not take appropriate action when people’s pressure relieving air mattresses were alarming.

We were not assured by the provider’s governance systems. The provider had completed their own monitoring processes and identified areas which required improvement including the actions needed to achieve this. However, there remained some outstanding actions, such as sufficient numbers of staff specifically trained staff in medicines management and dementia care. The provider’s systems to monitor the recruitment process of new staff had not identified gaps in the employment checks of staff. The provider's audit system had not identified gaps in people’s care records such as how to support people who experienced frustration and behaviours which challenged others and required one to one support. They had not identified instances where care monitoring charts were not consistently completed in accordance with the risk management plans. A monthly wound audit was completed which identified the types of new and pre-existing wounds; however, the audit did not fully identify whether the treatment plan from the previous month was effective or required to be reviewed. The registered manager used trackers to help monitor staff development and monitor incidents and safeguarding concerns and events which were notifiable to CQC. We saw evidence of compliments and external reports which praised the quality of care being provided to people. The management team were aware of their roles and responsibilities. The registered manager was working with representatives of the provider to develop their auditing systems to improve their ability to identify trends, patterns and act on any concerns. Policies were in place to ensure staff and managers’ practices were in line with the provider’s expected care standards and in line with relevant legislation and regulations. However, we noted that some policies would benefit from additional evidence-based guidance to help direct staff practices.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.