We carried out a review of the data available to us about Stoneleigh Residential Care Home Limited 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 Stoneleigh Residential Care Home Limited, you can give feedback on this service.
We found the following examples of good practice:
All areas of the home were clean and tidy. Domestic hours had been increased over all seven days since the start of the pandemic in order to maintain strict cleanliness of all areas. Each staff member had their own supply of hand sanitising gel on their person, and gel dispensers were positioned around the home as well as in the main entrance. The registered manager, provider and senior care staff monitored work practice, checked on the cleanliness of all areas of the home and staff compliance with hand hygiene and wearing personal protective equipment (PPE).
Staff were always required to wear a face mask when on duty. COVID-19 testing of people and the staff team had continued since starting in May 2020. Staff have been tested three times a week, once with a full PCR test and twice a week by a lateral flow test (LFT). People who lived in Stoneleigh Residential Home were tested every three weeks and retested should they show signs of illness.
Visits from healthcare professionals were kept to a minimum. The registered manager used emails and video calls to share any health care information and gain advice. Every person and staff member had already received their first dose of the COVID-19 vaccine and were expecting to have their second dose in mid-March 2021.
The provider visitor’s policy had been issued to all family and friends. Whilst the home had been closed to visitors, window visits, emails, and video calls were used so people could keep in touch with their family/friends. These visits had to be pre-booked. The home now had a garden room where visitors could physically visit. This contained two areas with a screen in between the person and visitor. Visitors testing procedures were in place, (LFT) and had been communicated to all staff, people and their families and friends. Visits in exceptional circumstances were supported and enabled.
External entertainers had been stopped but the staff team were keen to ensure people’s spirits were kept up. Small group activities were organised by the staff team and all birthdays and calendar events were marked. Those staff we saw during this inspection were interacting with people on a one to one basis but were socially distancing from their colleagues and people as much as they were able. When staff delivered personal care, they wore an apron and gloves as well as their face mask.
The home has had several new admissions since the start of the pandemic. New people were only admitted if they had a negative COVID-19 test. For the first 14-day period they would be isolated in their bedroom and tested regularly. If a person was hospitalised, upon return to the home, these same procedures were followed. If the home had an outbreak of COVID-19, people would be isolated in their rooms and the staff would work following barrier nursing procedures.
All staff had completed infection prevention and control training. The registered manager had completed a two- day infection control train the trainer course and the staff team had been continually updated. This extra training covered donning and doffing of PPE and hand hygiene as examples. The registered manager had increased the number of infection control audits being completed to ensure best practice continued.
The service had updated their infection prevention and control policies and procedures. They had a business continuity plan in place and revised this regularly. The registered manager and provider completed a daily tracker form for North Somerset Council and communicated with a contract compliance officer on alternate weeks. They kept abreast of any changes in policy provided by Public Health England, CQC and the Department of Health and Social Care.
During this inspection we checked that the provider was meeting the legal requirements of the regulation they had breached. We found the provider had made improvements and was meeting the regulation. At this inspection the service was rated Good.
You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Stoneleigh Residential Care Home, on our website at www.cqc.org.uk
Stoneleigh Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Stoneleigh Residential Care Home provides accommodation and personal care for up to 26 older people. At the time of our inspection there were 25 people were living at the service.
The service provides accommodation in a Victorian building, located close to the seafront and local parks. The service is across two levels and has two lounges, dining area and gardens at the front and rear of the property.
A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
The service had made improvements in medicines administration since our last comprehensive inspection in May 2017 and was now meeting the regulations. Other areas requiring improvement at our last inspection had been addressed. For example, quality audits systems now contained specific details, the provider had displayed their rating assessment as required and the detail of information recorded had improved.
Staffing levels were safe and provided by a consistent team. This ensured staff knew people well and had developed good relationships. People spoke positively about the activities facilitated by the service. People were involved in deciding the activities that should take place and new ideas were trialled. People were supported to maintain their hobbies, interests and social networks.
The service was clean, tidy, brightly decorated and well maintained. People had access to safe garden areas. People were encouraged and supported to remain independent.
People were supported by staff who kind, caring and responsive to their needs. There was a positive staff culture. Staff felt valued and supported. The atmosphere was calm, friendly and relaxed and people told us they felt at home. People’s family and friends were welcomed at the service.
Staff were supported to be skilled and knowledgeable in their roles through effective training and supervision. The service was meeting the Deprivation of Liberty Safeguards. Staff were clear about the systems in place around safeguarding adults and reporting accident and incidents.
People, relatives and staff were actively engaged with giving their feedback and identifying areas for improvement through meetings and surveys. Governance systems further reviewed and monitored the quality of care.
Care plans were person centred. People health needs were supported to obtain positive outcomes. People spoke positively about the food provided at the service. Positive feedback was received about how the service was led and managed.
We conducted a focused inspection in November 2016 to check if the provider had complied with the warning notice. During this inspection we checked that the provider was meeting the legal requirements of the regulations they had breached. You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Stoneleigh Residential Care Home, on our website at www.cqc.org.uk
Stoneleigh Residential Care Home provides accommodation and personal care for up to 26 older people. At the time of our inspection there were 24 people living at the service.
A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
The service had made improvements since our last comprehensive inspection in May 2016. Recruitment procedures had been improved and a checklist introduced. Emergency plans were now fully completed and contained individual detail. The service was now working in line with the Mental Capacity Act 2005 and was compliant with the requirements of the Deprivation of Liberty Safeguards.
However, we found further improvements were still needed. The management of medicines required improvement to ensure that systems and procedures were dependable and staff training was embedded. Information recorded within people’s daily notes did not always document the outcome. Incident and accident reports required consistent recording.
One notification had not been submitted to the Commission as required and the provider had not displayed their rating within the service. Systems had been improved to monitor the quality of the service. However, further improvements were needed to ensure areas that required action were fully identified and in a timely manner.
The service environment was well maintained. People were encouraged to maintain their independence within the service and the local community. People spoke positively about the activities provided by the service. People were involved in deciding what activities were on offer.
Staff were supported through an effective induction, training and supervision sessions. Systems were in place to positively engage with staff about how the service was run. This included surveys, meetings and idea forums. Staff were valued and there was a positive team culture.
People were supported with their nutrition and hydration and spoke positively about the food provided by the service. Staff were observed to be attentive to people’s daily needs. There had been several positive compliments about the home. People’s visitors were welcomed at the service and felt well informed.
The service was caring as people were supported by staff that were kind and respectful. We observed positive interactions and relationships between staff and people living at the service. Staff knew people well and understood their personal preferences. Staff were prompt to respond to people’s support needs.
Community links had been established that had a positive impact on people living at the service. Information was communicated effectively to staff. The provider and registered participated in training and development opportunities.
We found one 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 this report.
There was a registered manager in post who was also the provider. 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.
We carried out an unannounced comprehensive inspection of this service on 23, 25, 26 May 2016. A breach of legal requirements was found as care records did not contain support plans and risk assessments that identified people’s risk relating to skin care and their risk of choking. Personal evacuations plans did not contain details of what support or equipment the person would need in an emergency situation. Medicines were being left for people to take but records confirmed the person had taken them. We also found medicines returned to the pharmacy had not been recorded as returned.
After the comprehensive inspection, we used our enforcements powers and served a Warning Notices on the provider on 5 July 2016. This was a formal notice which confirmed the provider had to meet one legal requirement by 5 October 2016.
We undertook this focussed inspection to check they now met this legal requirement. This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stoneleigh Residential Home on our website at www.cqc.org.uk
At this latest inspection we found actions had been taken to improve people’s safety however guidelines were not always being followed. Personal evacuations plans did not always contain what equipment people required and medicines records were not always accurate.
One person was found to be at risk of receiving un safe food that was not prepared in line with their support plan. This placed them at risk of choking and was not in line with a recent speech and language therapist advice.
People’s care plans did not always hold relevant guidelines that would enable staff to provide care safely. Staff confirmed they accessed people’s care plans to follow guidelines about the assistance people required when mobilising.
People’s personal evacuation plans required updating to reflect the individual support and equipment people needed should they require assistance in an emergency.
People did not always receive their medicines safely as medicines were being left for people but record’s confirmed the person had taken them.
The legal requirement had not been met.
Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.
We inspected this service on the 23, 25 and 26 May 2016. This was an unannounced inspection. At our last inspection in January 2015 we found people did not have adequate risk assessments that identified risk relating to moving and handling and individual behavioural needs. During this inspection we found improvements in assessing risks had not been made. People were still at risk of unsafe care due to lack of risk assessments relating to moving and handling, skin ulcerations and choking.
At the time of this inspection there were 23 people living at the home. Stoneleigh Residential care home had 25 bedrooms, some with en-suites, over two floors. There were two lounge areas an entrance hall, dining area and upstairs offices. There is a front and rear garden. The rear garden has an outdoor seating area with table and chairs.
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 felt the home was safe although people did not always receive their medicines safely. Care plans did not have detailed risk assessments and guidelines for staff to follow where people could be at risk. Staff did not always have appropriate checks in place prior to commencing their employment. Staff had received safeguarding training and knew how to raise any concerns.
People who were unable to consent to care and treatment did not have completed assessments and best interest decisions paperwork in place.
People were supported by adequate staffing levels and by staff who felt well supported. Staff had received training and people were happy with the care and felt staff were kind and caring. Staff knew people well and people’s care plan’s identified people’s likes and dislikes.
People did not always have up to date care plans when their needs changed. People were supported to attend appointments and had referrals made to appropriate health professionals when required. Records were not always accurate to reflect people received their care in a safe way.
People were supported to access the local park and relatives were able to visit as often as they liked. People, relatives, staff and health professional’s views on the service were sought so that improvements could be made. People and their relatives felt happy to raise a complaint and the service had a compliments book so positive feedback could be gained.
People lived in a well maintained, clean and tidy home and fresh fruit was available in communal areas. People were encouraged to maintain links with the local community
and could visit the local café in the park and have free hot drinks and cake with their family.
The home’s quality assurance system was ineffective at identifying areas of concern found during this inspection.
We found breaches 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.
We carried out this inspection over two days on the 15 and 20 January 2015. At our last inspection in August 2014 we had areas of concern. These related to the safe administration of medication, assessing the quality of the service, and notifications in relation to deaths and injuries to people within the service. Following the inspection the provider sent us an action plan telling us about the improvements they were going to make. During this inspection we found that the provider had taken actions to address these issues.
Stoneleigh care home provides accommodation for up to 25 people who require personal and or nursing care. At the time of our visit there were 25 people living at the home. Stoneleigh had accommodation over two floors with stair lifts at each end of the building. The communal areas were accessible from the ground floor. These included two lounge areas and the dining area.
The home had a registered manager in place who was responsible for the day to day running of the home. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The home manager was present during the whole of our inspection.
We found at our previous inspection people were not protected against the risks associated with the administering of medicines. We found that during this inspection improvements had been made and that medicines were now being administered and recorded in a safe way. Creams and Lotions which had been applied had been correctly signed for and these were now all stored safely. There were appropriate arrangements in place for staff to monitor the medication stock.
Risks to people’s safety were not always identified and appropriately risk assessed. Assessments did not always identify behavioural and moving and handling needs. This lack of information could mean people were at risk of not receiving the care and support individual to their needs.
The home had a warm and relaxed feel. All people who we spoke with felt that Stoneleigh was their home and that they could come and go, accessing the different communal areas and activities as they wished.
People who we spoke with all felt well supported and that there was enough staff available. The service retained staff. Most had worked that the home for a number of years. There was a robust system in place for the recruitment of staff ensuring all checks were satisfactory before employment commenced.
The home had an electronic entry system. All visitors and people living at the home were able to use this entry system. All people we spoke with felt safe at the home and had no concerns if they wished to go out. All relatives confirmed they had unrestricted visiting times.
People were supported with their religious and personal interests. The home had various activities that all people felt able to join in with should they wish. We saw a wide range of activities available to residents and a weekly ‘easy-read picture’ programme displayed in the hall. Activities included music and movement sing-a-longs, quizzes, arts and crafts, reminiscence, hand massage, bingo, WII interactive computer sessions, theatre visits and walks in the park weather permitting.
There was a complaints procedure in place. The last complaint had been received in 2013. All people we spoke with felt able to raise any concerns or issues with staff and the manager of the home. Care plans confirmed that people were aware of the home’s complaints procedure.
Only one resident and relatives meeting had been held in the last 12 months. It covered a range of topics. A range of topics were discussed and shared. However due to the infrequency of these meetings it was difficult to see that important actions which had been raised had been addressed in a timely manner. People and relatives that we spoke with confirmed they had not received any minutes of these meetings but did feel able to approach and discuss any concerns with the manager of the home.
There was a new electronic care plan system in place. All Staff had their own log in and password details. There were some sections of the persons’ care plan that still required updating. This information could mostly be found elsewhere within the electronic system. We spoke with the deputy who confirmed some information still needed to go into the relevant sections.
People told us staff were responsive to their needs and that their care needs were being met. Throughout our inspection the atmosphere of the home was calm, relaxed and friendly. Staff were welcoming to people and visitors and we saw them regularly engage in a conversation. People were not hurried or rushed with any conversation or task undertaken.
Staff we spoke with confirmed they felt well supported and had no concerns working at Stoneleigh. People who we spoke with were all happy with how approachable and accessible the manager and their deputies are.
All certificates relating to the building maintenance were accessible and current. There was a handyman on site who carried out daily maintenance and we saw weekly fire tests were completed and confirmed with the date any actions were required.
The home was clean and tidy and all people who we spoke with were happy with the standard of cleaning to their rooms and communal areas.
The home had a system in place for sending out quality assurance questionnaires. We saw the service has taken action where people were unsure about the homes complaints procedure. Most staff were 100% satisfied with working at the home only one saying they felt the service could involve them more. Family’s had also been sent questionnaires. Where comments had been made about the laundering of clothes the manager had purchased a marker pen so clothes could be named. Activities had also been raised through comments in these questionaries’ and we saw the manager had discussed options with people within the home.
The service had not returned their Provider information return (PIR) report within the timescales set. All future PIR's will need to be required within the timescales set by the CQC. If the PIR is not returned it will affect the rating for the service.
Incidents and accidents were being recorded and actions taken when required. We have prompted the provider to ensure all notifications relating to incidents and accidents are made without delay.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you would like to see the evidence supporting our summary please read the full report.
Is the service safe?
The home had failed to address actions required by us in relation to management of medicines. We observed a range of issues relating to medication. These included medication which had not been taken when the record documented it was, lack of records about disposal of medication and inaccurate documentation and labelling of skin creams and sprays. We have warned the provider they must take action to meet the requirements of the law to ensure the safety of people in relation to management of medication.
The home had a policy and procedure for assessing people who were unable to make decisions. At the time of our inspection the registered manager confirmed there were no mental capacity assessment or best interest decisions in place. People we spoke with felt able to make choices regarding their care.
CQC monitors the operation of Deprivation of Liberty Safeguards which applies to care homes. There were no current applications in place at the time of this inspection.
Is the service effective?
People told us they were involved in their care and felt able to change these arrangements. They confirmed they were able to have lunch in their room if they wished or change the day of their bath. Care plans confirmed people's wishes and choices. Staff we spoke with had a good knowledge about people's preferences.
Is the service caring?
Care plans were detailed and reviewed. All people who we spoke with were happy with their care and felt well looked after by staff. Comments included 'staff are very nice and very helpful, they help with anything I need', 'staff are very good, very helpful, if I can't manage it staff will help me, I only have to ring the bell' and 'staff treat me with respect and kindness'.
We saw staff speak to people in a calm and reassuring way. All staff knocked before they entered people's rooms.
Is the service responsive?
The home had a complaints folder. There had only been one complaint in the last seventeen months. People and relatives who we spoke with felt able to raise their concerns with the manager or staff. Only one relative said they had a reason to complain but this had been resolved to their satisfaction.
The home had a system for recording incidents and accidents. These were inconsistent. Where one person had experienced falls, appropriate action had been taken. However where another person had fallen, their care plan failed to reflect their falls. We fed this back to the registered manager.
Is the service well-led?
The home sent out annual questionnaires. People were happy with the service they received. Comments included 'I have a lovely view and it's a nice place' and 'I am very very happy here'.
We had not been informed of notifications relating to deaths and other incidents as the provider was required to do by law. We reviewed incidents and accidents and found that people had fallen and required medical assistance which we had not been made aware of. We also found the home had 5 deaths since June 2011. The home not notified us about these deaths. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to notifying us of relevant matters.
The home had a system in place to undertake regular checks relating to Health and Safety. The provider had not identified a range of other matters in its audit systems. These included staff training in safeguarding, inconsistency in cleaning schedules and inconsistencies in its internal records relating to admissions, deaths and discharges. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring their audit systems identify relevant matters to ensure quality of care for people.
We visited Stoneleigh to check if the service had implemented the action plan they had submitted to CQC to ensure they were compliant with the essential standards of quality and safety.
During this visit we looked at the medicines records and medicine stocks for people who used the service. We found that although improvements had been made, there were inaccuracies in the records. This meant that people could not be assured the arrangements in place to manage medicines were effective.
We looked at people's individual files which incorporated their personal history, likes and dislikes, care plans and risk assessments and found they encompassed the safety and well-being of people who use the service.
People who used the service told us that they knew how to raise a concern or complaint and felt confident in doing. They said if they had any issues or concerns they could "talk to the manager." There were policies and procedures in place providing guidance and all staff had received training which was identified on the training schedule.
We reviewed the medication records and found shortfalls in the way daily recordings were completed which may have an impact on the people who use the service.
People who lived in the home were positive about the service and said they were treated with dignity and respect. Each person we met said they were happy living in Stoneleigh. People said they could talk to staff to make changes to their care and that staff treated them as individuals.
People told us they had good relationships with the staff and were able to talk to staff if they had any worries or concerns. Staff were able to tell us what action they would take if they saw anything which might affect the well-being of people using the service.
Most of the records held by the service were complete and kept up to date. This helped and supported staff to maintain the comfort and well-being of people using the service.
Systems were in place for monitoring the service and collecting people's views on the quality of care. The manager who was also the owner worked in the home and surveys were carried out annually, so the views of people living in the home were heard. The summary of the surveys were published so people could read the actions taken by the home to make changes or improvements to the service where necessary.
Having assessed the available evidence, we considered the service demonstrated how it met the safety and care needs of the people living in the home.
On this inspection we spoke with several people who lived in the home and we observed care and support delivered to people. We also talked with the manager.
We reviewed the information held about people and plans for their care. We also reviewed the systems in place to assess and monitor the quality of service provision and
We found the service to be compliant with outcome 4 and 16.
We were told that outings were arranged occasionally, for example a few people had been accompanied by staff to visit the pier and had enjoyed fish and chips for lunch in Septembe. We heard that when staff had time they take people to the park for a walk. We were told that the majority of people in the home spend their time watching TV/ videos, listening to music or reading.
People we met said that they joined in with activities, but only when they felt that they wanted to. One person said 'We like it here. We do not join in with activities through choice. They are there if you want them.'
We asked people about menus and choices. Everybody we spoke with was complimentary about the food provided in this service. One person said 'The food is very good. If you do not like something they will do something else you would prefer. There is plenty of choice'.
One relative told us that they visited different times of the day. They told us that they had no complaints. 'Staff are very respectful and treat mother well'. "I would complain to the manager or deputy manager if there was problem". We met and talked with three people who live at Stoneleigh care home. We asked whether they felt their care needs were being met. All of the people we spoke to confirmed that they were.
One visitor told us 'The district nurse visits every day to check mum's legs otherwise she is fit and healthy'. They confirmed that an 'End of Life Plan' had been discussed with them and their mother. They said 'We have no complaints about the care and treatment provided in this home.'
We observed care and support being given to people at Stoneleigh care home and saw it being delivered with sensitivity and kindness. We saw that members of staff knew people by name and when asked about these people's individual care needs they knew what was required. We saw that members of staff respected people's privacy and dignity and helped people to be as independent as they wanted to be without compromising their safety and health. People told us that "Most of the time" members of staff come to help them quickly and when they need them. People told us that "staff seem to know us well and often anticipate our needs". One person told us 'We ring the bell and staff come. It is not usually a long wait. They are very good you always know they are going to come. It is a friendly atmosphere'.
One relative told us 'staff are very nice. They are respectful and treat mum well. I have never seen staff get irritable. I would complain to the management if there was a problem'.
We found that people who live at Stoneleigh Residential care home are generally safe, but there are some risks to their outcome, health and wellbeing due to failings in the record keeping. We have required that improvements are made to protect people from harm.