Stanecroft is registered to provide accommodation and personal care for up to up to 50 older people, some of whom are living with dementia. At the time of our visit 48 people lived here.
Care and support are provided on one level which is divided into five separate units. Each unit has its own kitchenette, dining and lounge area together with toilet and bathing facilities. Communal areas, for the use of people from all the units, include a large dining area, conservatory and secured gardens.
Modifications have been made to the home to meet the needs of people that live here. People were free to access all areas of the home. The front door was locked and operated by a button release so that people were kept safe.
The inspection took place on 12 August 2015 and was unannounced. At our previous inspection in September 2014 we had identified concerns in three areas at the home
Overall there was positive feedback about the home and caring nature of staff from people and their relatives. One person said, “Staff are very caring, nothing is too much trouble for them.” However there were two particular areas of concern they told us about, the lack of staff and lack of meaningful activities that interested them. Their concerns were borne out by our observations and discussions on the day.
The lack of staff to meet the identified needs of individuals had an impact across all five of the key questions that we looked at. It impacted on the safety of people as staff were not always available to give support that had been identified; It limited the effectiveness of the service to be able to provide person centred care, such as supporting people to eat; It affected the caring nature of the staff as staff had little time to spend with people to talk with them, as they were very task focused to try to do everything at once; It reduced the responsiveness of the service so that activities were not based around individual’s interests.
People were not always safe at Stanecroft. Risks to people’s health and safety had been identified and guidelines to minimise the risk were in place. However there were not enough staff in the home to ensure these risks were safely managed.
Not everyone could enjoy the food as staff were not always available to support them to eat in a timely manner, so when they did get the support to eat, the food was cold.
Everyone we spoke with praised the care and support they received from the staff and the registered manager. One person said, “I find it really good here. Anything I ask them, they get it done almost straight away.” Another told us, “I’m very happy here, they look after me very well.”
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.
Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). Decisions had been made for people with an appropriate assessment and review being completed. People told us that staff did ask their permission before they provided care. One person said that, "They always ask me, ‘can I do so and so before doing anything for me.”
Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards to ensure the person’s rights were protected.
People told us that they enjoyed the food and had enough to eat and drink. The menu had been improved in the last few months and most meals were made with fresh produce.
Staff had a good knowledge of their responsibilities for keeping people safe from abuse. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received training to support the individual needs of people in a safe way.
People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.
Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. However people and relatives told us that they had not always been included in the development of their care plans, or involved in reviews. People did not always receive the care and support as detailed in their care plans, as staff were not always available to support them when they needed it.
The staff were kind and caring and treated people with dignity and respect. One person said, “They look after us very well.”
People were supported to maintain good health as they have access to relevant healthcare professionals when they needed them.
People did not have activities that met their needs. Although the home had a dedicated activities centre, people only accessed it on certain days of the week. Activities were not based around the individual interests of people, and activities for people living with the experience of dementia, such as one to one time with staff were not regularly organised. The equipment and environment was personalised to the people that used it. The staff knew the people they cared for as individuals.
People knew how to make a complaint. Feedback from people was that the registered manager and staff would do their best to put things right if they ever needed to complain.
People and staff had the opportunity to be involved in how the home was managed. Meetings were held and the registered manager posted the actions that would be taken as a result of these meetings.
We identified two breaches of the regulations. You can see what action we told the provider to take at the back of the full version of this report.