This was an unannounced inspection that took place on 12 November 2015.
Surrey Hills is registered to provide accommodation with nursing care for up to 45 people. At the time of our visit, there were 31 older people living at the home. The majority of the people who live at the home are living with dementia, some have complex needs. The home also provides end of life care. The accommodation is provided over two floors that were accessible by stairs and a lift.
There was a registered manager in post. 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 were at risk because there were not effective systems and arrangements to protect people from the spread of infection. Appropriate standards of cleanliness were not being maintained and staff were not following the provider’s Infection control policies and procedures.
People were safe at Surrey Hills. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.
There was sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work. Staff worked within best practice guidelines to ensure people’s care and support promoted well-being and independence.
Medicines were managed safely. Any changes to people’s medicines were prescribed by the person’s GP and administered appropriately.
Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The home had a business contingency plan that identified how the home would function in the event of an emergency such as fire, adverse weather conditions, flooding and power cuts.
Staff were up to date with current guidance to support people to make decisions. Where people had restrictions placed on them these were done in their best interests using appropriate safeguards. Staff had a clear understanding of Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) as well as their responsibilities in respect of this.
The registered manager ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. We found the staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.
People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and were involved in the regular monitoring of their health. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.
Staff involved and treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.
People’s needs were assessed when they entered the home and on a continuous basis to reflect changings in their needs.
People were encouraged to voice their concerns or complaints about the home and there were different ways for their voice to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the home.
People had access to activities that were important and relevant to them. People were protected from social isolation through systems the home had in place. There were a range of activities available within the home and community.
The provider actively sought, encouraged and supported people’s involvement in the improvement of the home.
People’s care and welfare was monitored regularly to ensure their needs were met within a safe environment. The provider had systems in place to regularly assess and monitor the quality of the care provided.
People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager. Staff felt that management were very supportive.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.