Stilecroft Residential Home

Updated 4 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a targeted inspection to check whether the provider was meeting requirements for ensuring people had enough to eat and drink and risks linked to people, including weight loss were managed. We will assess all of the key questions at the next comprehensive inspection of the service.

Inspection team

The inspection was undertaken by 2 inspectors.

Service and service type

Stilecroft Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Stilecroft Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 06 October and ended on 14 October 2022. We visited the location on 06 October. We reviewed people’s care records remotely on 11 and 13 October 2022. We spoke with the registered manager and nominated individual on 14 October 2022 to provide feedback. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service. We spoke with 3 members of staff including the registered manager and 2 senior care workers. We carried out observations throughout the service, including observing the people’s dining experiences during lunchtime.

We reviewed a range of records. This included 7 people’s care plans in part. A variety of records relating to the management of the service, including quality assurance checks and health and safety check records were also reviewed.

Updated 4 November 2022

About the service

Stilecroft Residential Home is a residential care home providing personal care to up to 44 people. The service provides support to older people and people living with dementia and mental health needs. At the time of our inspection there were 29 people using the service.

Stilecroft Residential Home accommodates people in one adapted building across three floors.

People’s experience of using this service and what we found

People were at risk of harm because of failures to adequate identify and address concerns about the quality and safety of the service. The registered manager and manager were working to make improvements, however quality assurance systems were not always effective in guaranteeing the quality and safety of the service.

Whilst noticeable improvements had been made in response to concerns identified at our last inspection, further improvements were needed. We identified new concerns, which placed people at risk of harm.

People were at risk as medicines were not managed safely. People did not always receive their medicines as prescribed. Staff did not monitor or escalate concerns where people refused their medicines repeatedly.

Environmental safety issues had not always been identified or addressed by the provider to keep people safe. This included issues we identified at the last inspection.

People were not always supported to have maximum choice and control of their lives and did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People and their relatives had confidence staff had the necessary skills and knowledge to provide effective support. We made a recommendation about first aid training.

People received personalised care from staff who knew about their preferences. The manager was working to improve and develop the variety of activities on offer to stimulate and engage people.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found 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 inadequate (published 30 September 2021) and there were breaches of regulation. The provider met with us and completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found the provider had made some improvements but remained in breach of some regulations.

At our last inspection we recommended that the provider improve the support given to people living with dementia. At this inspection we found the provider had not met this recommendation.

This service has been in Special Measures since 30 September 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check if the provider had made improvements and if they were now meeting the legal requirements. This report only covers our findings in relation to the key questions safe, effective, responsive and well-led.

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 inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stilecroft Residential Home on our website at www.cqc.org.uk.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have found breaches in relation to consent to care, safe care and treatment and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.