Summerfield House Nursing Home

Updated 6 April 2024

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.

Inspection team

Four inspectors and 2 Experts by Experience visited on 16 January 2024. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Two inspectors and a senior specialist visited on 24 January 2024. Two inspectors undertook a night visit on 25 January 2024 and 2 inspectors visited on 5 February 2024. A regulatory co-ordinator made phone calls to staff.

Service and service type

Summerfield House Nursing Home 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. Summerfield House Nursing Home is a care home with 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. However, the registered manager resigned and left on 7 February 2024 and an interim manager is now in place.

Notice of inspection

The inspection was unannounced. Activity started on 16 January 2024 and ended on 8 February 2024. All site visits to the service were 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 quality and safeguarding teams. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time with people in the communal areas observing the care and support provided by staff. We spoke with 20 people who used the service and 18 relatives/friends about their experience of the care provided. We spoke with 42 day and night staff including the registered manager, regional managers, deputy manager, unit managers, nurses, care staff, laundry and catering staff. We spoke with 4 visiting professionals.

We reviewed a range of records. This included 18 people's care records and 15 medicine records. We looked at 7 staff recruitment files. A variety of records relating to the management of the service were reviewed.

We provided feedback to the registered manager and/or regional manager when we visited on site and at the end of the inspection.

Updated 6 April 2024

About the service

Summerfield House Nursing Home is a residential care home providing nursing and personal care for up to 107 people, some of whom may be living with dementia. The home is purpose built providing accommodation on three floors: Oak, Cedar and Maple. Each floor has separate adapted facilities. Oak provides residential care, Cedar specialises in providing care to people living with dementia and Maple provides nursing care. There were 94 people living at Summerfield House when we inspected.

People’s experience of the service and what we found:

People were at risk of harm as the provider had not always identified, assessed or mitigated risks. Systems in place to manage medicines were unsafe which placed people at risk of harm. There were not always enough staff to meet people's needs and keep them safe. Staff were not always appropriately deployed and training was not kept up to date. Recruitment processes were not robust.

People were not always treated with dignity and respect. Staff were not always caring. Some staff were task focused, lacked empathy and did not communicate with people when providing support. People were not always protected from the risk of abuse and improper treatment. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the systems in place did not support this practice.

Care was not person-centred, and people's needs and preferences were not always met. The culture of the service was not person-centred. Systems and processes had not identified, or resolved in a timely manner, concerns around person-centred care, safeguarding, medicines and dignity and respect. The provider's systems and processes were not established or operated effectively to ensure continuous learning and the improvement of the quality of care.

People's care records were variable. Some had detailed and personalised information, whereas others were not always accurate and up to date. The environment was clean and well maintained. Infection control was well managed. People were supported to stay in touch with friends and relatives and there were no restrictions on visiting. People had access to healthcare services.

Feedback from people and relatives was generally positive describing staff as good and helpful. Some individual staff were noted to be exceptional and said to go 'above and beyond'. We also saw staff who did treat people with respect and maintained people’s dignity.

The provider took action during and after the inspection in response to the concerns we raised. An action plan has been put in place and additional senior management have been brought in to support the staff team. The local authority and ICB continue to work with the provider to make improvements.

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 Requires Improvement (published 9 November 2023). There was 1 breach of regulation and 3 recommendations. At this inspection we found the provider remained in breach of regulation.

Why we inspected

The inspection was prompted in part due to concerns received about the management of the home, care and treatment and privacy and dignity. A decision was made for us to inspect and examine those risks.

The inspection was also prompted in part by notification of incidents where people’s safety, health and well-being had been put at risk. These incidents are subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incidents. However, the information shared with CQC about the incidents indicated potential concerns about the management of risk. This inspection examined those risks.

We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Summerfield House Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified 6 breaches in relation to safe care and treatment, privacy and dignity, safeguarding, staffing, recruitment and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.