Background to this inspection
Updated
28 March 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was completed by an adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type: The Shrubbery is a care home providing residential and nursing care to older people and younger adults.
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.
What we did: Before the inspection we reviewed the information we held about the service. This included information sent to us by the provider, as well as information we had received from the public. We also contacted the commissioners of the service to gain their views. We used all this information to plan how the inspection should be conducted.
A Provider Information Return (PIR) is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. The provider had not been asked to complete a PIR prior to this inspection.
During the inspection we spoke with the registered manager, area manager and two other members of the care team. We also spoke with seven people who live in the home, six relatives and a visiting health professional.
We looked at the care files of four people receiving support from the service, three staff recruitment files, medicine administration charts, staff training records and other records relevant to the quality monitoring of the service. We looked around the home and spent time in communal areas observing interactions between staff and people living in the home.
This report reflects the findings of the inspector and the expert by experience.
Updated
28 March 2019
About the service: The Shrubbery is a care home providing nursing and residential care to up to 36 people. At the time of the inspection there were 27 people living in the home.
People’s experience of using this service: People told us their needs were met by staff, however we found that people’s individual preferences were not always met. For instance, how often people liked to bathe or ensuring sufficient activities were available to people. We made a recommendation regarding this in the main body of the report.
The registered manager completed a variety of checks and audits, but these could be further developed to ensure checks on the quality and safety of all areas of the service were monitored and recorded.
People felt safe living in the home. Risks to people had been assessed and care plans described how these risks would be minimised. Medicines were managed safely and people received their medicines when they needed them. The home was clean and the equipment and utilities were safely maintained.
People told us staff were kind and respectful and staff knew the people they were supporting well. Care plans were detailed, up to date and reflected care that people needed and how they wanted to receive it. People’s nutritional needs were known and met by staff to reduce risks relating to malnutrition.
People’s capacity to make decisions was assessed and people were supported with decision making. These assessments did not always clearly reflect the decision to be made, but best interest decisions were specific and involved relevant people.
Staff were recruited safely. We received mixed feedback regarding staffing levels, but saw that people received support in a timely way and call bell response times confirmed this.
Staff were knowledgeable about safeguarding procedures and how to raise any concerns they had. Referrals to the local authority safeguarding team had been made appropriately. Staff received regular training to ensure they had the skills to meet people’s needs.
Staff felt well supported by the registered manager and told us they could raise any concerns with them.
Rating at last inspection: This is the first inspection for this service since the provider changed their name.
Why we inspected: This was a planned inspection based on our inspection schedule for new services.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.