Archived: Summerlea House Nursing Home

Updated 14 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was 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.

We undertook this unannounced comprehensive inspection of Summerlea House Nursing Home on 14 and 15 October 2015. At the last focused inspection in April 2015 this provider was placed into special measures by CQC and a condition placed on the registration of the service prohibiting admissions to the service without the prior permission of the Commission.

The inspection team consisted of three inspectors, a pharmacist inspector and an expert by experience in the care of older people. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the home, including previous inspection reports and service improvement plans. We reviewed notifications of incidents the manager had sent to us since the last inspection. A notification is information about important events which the service is required to send us by law.

The registered manager was on leave, we spoke with the deputy manager and 11 members of staff including; two registered nurses, care staff and senior care staff, kitchen staff and an activities coordinator. We spoke with two operational support managers from the registered provider’s head office. We spoke with 12 people who lived at the home and 4 relatives. Following our inspection we received feedback from five health and social care professionals.

We looked at the care plans and associated records for 17 people and the medicines administration records for 36 people. We looked at records relating to the management of the service including six staff recruitment records, records of complaints, investigation records, quality assurance documents including medicines and care record audits.

Updated 14 December 2015

We carried out a comprehensive inspection of this service in January 2015 and found the provider was not meeting the legal requirements in relation to standards of care and welfare for people who use the service. We carried out a focused inspection of this service on the 14 April 2015 to follow up on Warning Notices we had served on the provider in March 2015. Repeated breaches of the legal requirements were found in relation to the standards of care and welfare for people who used the service. Care and treatment was not designed to meet people’s needs or preferences. There was a failure to ensure systems and processes were in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of people, or to improve the quality and safety of services provided. After this focused inspection the service was placed into special measures and a condition was placed on the registration of the service prohibiting admissions to the service without the express permission of the Commission.

We undertook this unannounced comprehensive inspection on the 14 and 15 October 2015 to check the service had made improvements and met legal requirements. The service had taken sufficient steps to be taken out of special measures.

The home provides accommodation and nursing care for up to 74 older people. At the time of our inspection 38 people lived at the home.

A registered manager was in place; however they were on leave at the time of our inspection. 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.

At this inspection we found the registered provider and manager had not met all of the requirements of the Regulations to meet the fundamental standards, and further work was required to embed practices in the home.

Whilst medicines were stored and ordered in a safe and effective way, some medicines were not administered as they were prescribed.

Risk assessments in place informed plans of care for people to ensure their safety and welfare, and staff had a good awareness of these. Health and social care professionals were involved in the care of people, especially those with enhanced needs; care plans reflected this.

There were sufficient staff to meet the needs of people who lived at the home, however further work was required to identify the increased needs of people when they were admitted to the service. Staff had a good understanding of how to keep people safe, identify signs of abuse and report these appropriately. Processes to recruit staff were in place which ensured people were cared for by staff who had the appropriate checks and skills to meet their needs.

Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. People had opportunities to be involved in planning and reviewing their care however further work was required to embed this practice in the home.

People’s nutritional needs were met in line with their preferences and needs; people who required specific dietary requirements for a health need were supported to manage these. Some work was required to ensure staff accurately recorded and monitored the nutritional and fluid intake of people.

Care plans in place for people reflected their identified needs and the associated risks, however records were not always accurate and did not always reflect the care people received. Staff were aware of people’s needs and understood their role in supporting these. Staff were caring and compassionate and knew people in the home well.

There was a wide variety of activities available for people, however some people were at risk of isolation as staff did not always take opportunities to interact with them. We have made a recommendation to improve staff interaction with people.

Complaints had been responded to in line with the registered provider’s policy and this work needed to be sustained. Incidents and accidents had been reported and investigated however further work was required to improve the responsiveness of action plans and embed this practice in the home.

The registered provider had supported the registered manager and their staff with additional resources to improve the management structure in the home and improve the quality assurance systems in place. This work required further embedding in the service as audits in place to ensure the safety and welfare of people were not always effective. Care records were not always held securely and did not always contain information which was consistent or accurate.  People, their relatives and staff felt positive in the recent changes in the service; however these needed to be sustained.

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.