Stanley House provides personal care and accommodation for up to 42 people. On the day of the inspection the registered manager informed us that 34 people were living at the home. This inspection took place on 27 and 28 June 2016. The inspection was unannounced and was carried out by one 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. Our expert for this inspection had experience of the care of older people and older people living with dementia.
A registered manager was in place. 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 and associated Regulations about how the service is run. The registered manager responsible for nursing was managing the service at the time of the inspection.
We carried out an unannounced inspection of this service on 1 April 2015. One breach of legal requirements was found. The provider had not ensured that people were protected against the risks of unsafe care being provided to meet people's needs. After this inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We checked that the provider had followed their plan, and to confirm whether they had now met legal requirements. We found improvements in these issues and the breach had been rectified.
People using the service and the relatives we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and generally understood their responsibilities in this area.
People's risk assessments provided staff with information of how to support people safely.
Staffing levels were usually sufficient to ensure people were safe though more staff cover was needed in the main lounge for a short time in the evening to ensure people were always protected from risks to their safety.
People using the service and relatives told us they thought medicines were given safely and on time. Some improvements were needed to the way medicines were recorded to evidence that medicines were always supplied to people.
The premises appeared safe with no tripping hazards observed.
Staff were subject to checks to ensure they were appropriate to work with the people who used the service.
Most staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed on relevant issues in order there was no risk of them not meeting people's needs.
Staff generally understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives, and the service had obtained legal approval for limiting people's choices when necessary for their best interests, though this was outstanding for one person.
People had plenty to eat and drink, everyone told us they liked the food served and people were assisted to eat when they needed help.
People's health care needs had been protected by referral to health care professionals when necessary.
People and relatives we spoke with told us they liked the staff and got on well with them, and we saw many examples of staff working with people in a friendly and caring way.
There was evidence that people and their representatives were involved in making decisions about their care, treatment and support.
Care plans were individual to the people using the service and covered their health and social care needs.
There were not always sufficient numbers of staff to ensure that people's needs were responded to in good time.
Activities were organised to provide stimulation for people.
People and relatives told us they would tell staff if they had any concerns and were confident they would be followed up to meet people's needs.
People, their relatives and staff were satisfied with how the home was run by the registered manager.
Management carried out audits and checks to ensure the home was running properly to meet people's needs.