The inspection took place on 11 September 2017 and was unannounced. Shelton Lock provides long term and respite care for adults with a range of physical nursing needs, including palliative and end of life care and respite care for adults. The service is registered to accommodate up to 40 people. At the time of the inspection 31 people were using the service.The last inspection took place in September 2015 before BUPA (The provider) changed their legal entity to BUPA Care Homes Limited. This was the first inspection of the service since the legal entity changed on 31 January 2017.
Shelton Lock had a registered manager. 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’s and staff comments found staffing levels were not always sufficient to consistently meet the needs of people using the service. We have identified this as an area of improvement as to how staffing levels are determined in the detailed findings of this report.
Staff were able to demonstrate a good understanding and knowledge of people's specific support needs, so as to ensure theirs and others safety. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow.
People’s safety was promoted as potential risks were assessed and regularly reviewed. Measures to reduce risk were implemented which included the use of equipment to support people safely and promote their independence.
We observed that staff followed safe procedures when giving people their medicines. Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.
The provider had robust recruitment processes in place. Staff understood their roles and responsibilities and would seek people's consent before they provided care or support. Staff received supervision and support, and had been trained to meet people's individual needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We observed examples of good practice where staff offered people choice, and people told us they did not feel restricted.
The dining experience for people was positive and people were in the main complimentary about the quality of meals provided. Catering staff responsible for the provision of people’s meals were knowledgeable about people’s individual dietary requirements and their diets were catered for.
People's healthcare needs were effectively managed and kept under review. Staff were observed to refer to and speak with health care professionals on both urgent and routine health care matters. People told us they had access to health care services and people’s records confirmed this.
People’s needs were assessed prior to their moving into Shelton Lock and were used to develop care plans which were reviewed and updated. Assessments were also used to gather information about people’s life histories. We found this information whilst gathered was not used to support people’s social interaction and engagement. People’s access to activities and stimulation was inconsistent, and further measures were needed to reduce the risk of social isolation. We have identified this as an area for improvement within the detailed findings of this report.
Systems were in place to seek and act on feedback from people using the service, which included the complaints policy and procedure. People referred to resident meetings; however they said these were not regularly held and that they would welcome the opportunity to take part. People’s views about staff having insufficient time to talk with them and take part in activities were discussed with the area and registered manager. The area manager said they would take action, by considering an increase in hours made available so additional support could be provided to assist and engage people in activities.
The provider had a range of quality assurance audits which had taken place that focus on specific areas, such as medicine, health and safety and infection control. Audits as to people’s care and support were also undertaken by the registered manager and area manager. The outcome of audits was used to develop the service and areas for improvement were recorded within an action plan.