We carried out a review of the data available to us about Somerville House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Somerville House, you can give feedback on this service.
Somerville House is a residential care home providing personal care to up to 18 people. The service provides support to people with dementia, mental health conditions and older people. At the time of our inspection there were 17 people using the service.
People’s experience of using this service and what we found
People were supported to remain safe. Staff knew how to report allegations and concerns of abuse and understood their roles clearly and what was expected of them. Risk assessments were person centred and provided enough information to guide staff in their practice.
The provider had made improvements since our last inspection to fixtures, fittings and the cleanliness of the service. Effective systems were in place for maintaining good standards of cleanliness in the service. People told us the home was lovely, it was clean, tidy and they could put pictures on walls.
People received their medicines as prescribed. Medicines were stored correctly and disposed of safely. Staff understood their responsibility to raise concerns and report accidents and incidents.
Recruitment systems were robust, and people were actively involved in the recruitment of staff and choosing the staff who will work with them.
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.
The service was well led with a positive culture that was person-centred and provided high quality compassionate care.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 June 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced inspection of this service on 21 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and well-led.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe and Well-led which contain those requirements.
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. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Somerville House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
People’s experience of using this service:
The care home was not always clean and hygienic which placed people at risk of developing infections. Some furniture and equipment could not be effectively cleaned as it was not in a good state of repair. Not all areas of risk had been identified and addressed, which posed a risk to people’s health and safety.
Care plans did not always reflect the care and support people needed, though staff were knowledgeable about people’s needs and how to support them with their own routines.
Quality assurance systems had been implemented. However, they had not identified issues with furniture and equipment that needed repairing or replacing, infection control and shortfalls in care plans. People were included in the development of the service.
People were happy with the care provided as staff were kind and caring. People said, “It's like a home. People and staff have been here a long time, it's like a little family and it’s comforting.” Staff respected people as individuals and maintained their privacy and dignity.
People trusted and felt safe with staff as most staff had worked at the service for a long time. Recruitment, induction and ongoing processes helped ensure only suitable staff were employed and that they had the required skills and knowledge. Staff were supported by the management team and received supervision and annual appraisals though this was not always done in line with the providers policy.
Meals were prepared using fresh ingredients and people were complimentary regarding the food quality and choice. People’s healthcare needs were met through timely referrals to appropriate healthcare professionals and they received their medicines as prescribed.
Staff sought consent and 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 the service supported this practice. People were encouraged to participate in activities within the care home and the local community.
People and staff were happy with the management of the service and could approach the management team at any time. The registered manager prided themselves on knowing each person who used the service and providing person-centred care.
We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. The registered persons had failed to ensure a clean and safe environment and had not suitably assessed, monitored and improved safety whilst providing the regulated activity of personal care.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection: At the last inspection, on 10 July 2017, the service was rated Good (report published 1 August 2017). The last inspection was a focused inspection, which looked at whether the service was Well-Led.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
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.
Somerville house is registered to provide personal care for 18 older people, some of whom may be living with dementia or have mental health needs. The service is situated close to the city centre and the shopping area of Hessle Road; it has good access to all local facilities. Bedrooms, bathrooms and toilets are located on each of the three floors. The upper floors are accessed by a passenger lift and stairs. There is a sitting room with a dining area at one end, a second sitting room and a small quiet room with a table and chairs. There is an outside patio and garden area at the rear of the property.
The service had a registered manager. 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.
There had been some improvements in quality monitoring and there was a system in place, however this had only been partially completed since the last inspection. There was a list of audits and checks to be carried out each month; we saw these had concentrated on medicines and the environment. A process of updating care plans was also underway. The registered manager told us they would ensure the planned monthly checks in all areas would take place and people informed of what action they had taken to address any shortfalls.
There were discussions with people who used the service and staff on a daily basis but these had not been formally recorded. People who used the service and staff confirmed the discussions took place.
Staff confirmed communication was good within the service and they received information in the form of memos, the communication book and daily discussions. They reported a style of shift handover that was a mixture of verbal exchange and checking the communication book. The registered manager told us that following the inspection, written handovers would recommence.
We saw there was an open and inclusive culture within the service. People who used the service and staff felt able to raise issues with the registered manager and provider.
The registered manager had developed links with other agencies, for example the local medicines management team had visited to audit medication practices. Staff from commissioning and safeguarding teams told us they had no concerns about the service and the registered manager contacted them when required.
Somerville House provides accommodation and personal care for up to 18 people who may be living with dementia and/or enduring mental health needs. The service is located in a residential area in the west of the city of Hull and is set over three floors. At the time of the inspection, there were 18 people living at the service.
The service is required to, and did have, a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The registered provider did not have an effective system in place to monitor and improve the quality of the service provided. We saw there was no evidence of audits to highlight any shortfalls, drive continual improvement and to learn from any incidents that occurred at the service. You can see what action we have asked the registered provider to take at the back of the full version of the report.
There were enough staff to meet the current needs of people who used the service. Recruitment systems in place would ensure all employment checks were carried out prior to staff starting work at the service.
Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. People told us they felt safe living in the service and they had risk assessments to guide staff in supporting them.
Plans were in place for emergencies such as a fire or a flood and staff knew what to do in the event of an emergency. Safety equipment, and gas and electrical appliances were checked regularly.
We saw that people had person-centred care plans in place to instruct staff on how best to support them and meet their needs.
We saw that people enjoyed premises that were suitable for their purpose. The environment was well-maintained and comfortable. We found the level of cleanliness in the service was satisfactory; There were some areas of the service that needed minor attention which included the laundry area and one upstairs bathroom. The registered manager assured us these would be addressed.
Medicines were administered safely by trained staff and the arrangements for ordering and storage were appropriate.
The registered manager was able to show they had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to make decisions in people's best interests if they were assessed as lacking capacity. We identified a minor concern about the way the service obtained consent with one person. It was not clear how the registered provider had ensured they had been consulted about their care needs, and that the person had agreed and consented to the care and support being provided for them.
Staff understood people's care needs and spoke confidently about the support people needed to meet those needs. They told us they felt supported and had undertaken training that provided them with the necessary knowledge and skills they needed to carry out their roles.
People were positive about the care they received from the home and told us the staff were kind. Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection. People had access to community facilities and most participated in the activities provided in the service.
Staff respected people’s privacy and dignity. Staff understood their roles and people were supported in a person-centred way. People were helped to identify their own interests and follow them with the assistance of staff if required. These activities took place independently or as part of a group within the service as well as in the community.
Support and advice was given to people to enable them to make informed choices about the food they consumed. Access to healthcare services was readily available to people and the service.
People felt able to raise concerns and the registered manager was available for discussions with people who used the service, their relatives and staff.
We undertook this unannounced inspection on the 26 and 27 March 2015. The last full inspection took place on 23 May 2013 and the registered provider was compliant in all the areas we assessed.
Somerville House is registered to provide accommodation and personal care for 18 older people, some of whom may have dementia. The home is situated close to the city centre and has good access to all local facilities. Bedrooms are located on each of the three floors. The upper floors are accessed by a passenger lift and stairs. On the day of the inspection there were 18 people using the service.
The service has a registered manager. 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.
There were enough staff to meet the current needs of people who used the service. We saw there were some potential gaps in staffing numbers at specific times of the day. These were discussed with the registered manager and registered provider to check out. There were recruitment systems in place that would ensure all employment checks were carried out prior to staff starting work at the service.
Staff completed safeguarding training and knew what measures to take to help to protect people from the risk of abuse or harm. Risk assessments were completed although we found these lacked some important information to guide staff in how to manage and minimise risk.
People had their health needs met and had visits from professionals for advice and treatment. Staff administered medicines in a timely way so that people were not left waiting for their tablets.
People told us they enjoyed their meals and had enough to eat and drink.
Staff received guidance and completed essential and more specific training in order for them to feel confident when supporting people. The registered manager had completed training in how support people whose primary need was related to their mental health. A community psychiatric nurse had provided an awareness session for staff and additional training was being sourced.
Staff approach was seen as caring; they took time to speak to people, they respected privacy and dignity and they involved them in day to day decisions. We saw people were encouraged to participate in activities, to maintain their independence and to access community facilities.
We saw the care plans could be improved to include more personalised care and provide more thorough guidance to staff. Despite this we found staff knew people’s needs well.
People felt able to raise concerns and the registered manager and registered provider were available for people who used the service, their relatives and staff to talk to.
There were some checks completed but the quality monitoring system was more ad hoc than planned in a structured way and lacked robust recording. People’s views were sought in meetings and via questionnaires about the service. This helped to identify shortfalls so they could be addressed.
We found people’s needs were assessed and care was planned so staff had guidance in how to support people. People told us they were well looked after and could see their GP when required. Staff demonstrated they knew people’s needs well.
We found the service managed medicines well and ensured that people received their medicines as prescribed.
We found the service was clean, tidy and well maintained. Although there wasn’t a redecoration plan we were told this was ongoing. People told us they were happy with their home.
We found staff had access to training courses and supervision. This meant staff could develop their skills and knowledge and were supported by management.
We found the service had a complaints policy and procedure. People told us they knew how to make a complaint and said they felt able to complain knowing it would be addressed.
Most people spoken with told us they liked the meals provided. Comments included, 'I like all the food ' its hot and well cooked', 'I like the food, breakfast is good and I generally have toast, marmalade and shreddies' and 'The food is nice ' it's well presented and well cooked.'
One person did say that some days were better than others. This was mentioned to the manager so that staff could speak to the person and ensure their likes and dislikes were accommodated more fully.
People spoken with told us if they wanted to have something on the menu this would be arranged.
One person told us how the home was in their area and close to relatives. They said they liked living at the home and they could go to bed and get up when they liked. They also said the staff were friendly and went to the shops for them.
Another person spoken with said, 'The staff are wonderful ' they really are' and 'I'm poorly at the moment, they are good to me.'
One person spoken with told us that another person punched them on the arm and wouldn't let them pass by. They said they told staff about this. One person told us they became upset by the way another person who lived in the home spoke to staff.
People told us they knew who to raise any concerns with. One person told us 'I would see the boss.'