The Shrubbery

Updated 15 January 2021

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 17 December 2020 and was announced.

Updated 15 January 2021

We carried out an unannounced comprehensive inspection of this service on 8 February 2018.

The home is registered to provide accommodation and personal care for adults and who may have a dementia related illness. A maximum of 28 people can live at the home. There were 27 people living at home on the day of the inspection.

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.

At the last inspection, the service was rated Requires Improvement overall with the rating of inadequate for safe. This was because the provider had failed to ensure systems and processes were in place to assess, monitor and mitigate risk to people living in the home. The rating for safe has been improved to Requires Improvement following this inspection as the provider will need to demonstrate that the changes made are effective and sustainability over time. At this inspection we found the service had improved and was now Good overall.

The provider was recruiting additional night staff to ensure there were enough staff at night to meet people’s needs. The new staff were planned to start within a few days. People told they felt safe living at the home and that staff supported them with maintaining their safety. Staff told us about how they minimised the risk to people’s safety and that they would report any suspected the risk of abuse to the management team. People got the help needed with staff offering guidance or support with their care that reduced their risk of harm.

There were staff available to meet people’s care needs or answer any requests for support in a timely way. People told us they received their medicines from senior care staff who managed their medicines in the right way. People also felt that if they needed extra pain relief or other medicines as needed these were provided. Staff wore protective gloves and aprons to reduce the risks of spreading infection within in the home.

People told us staff knew their care and support needs. Staff told us they understood the needs of people and their knowledge was supported by the training they were given. Staff knowledge reflected the needs of people who lived at the home. People told us staff acted on their wishes and their agreement had been sought before staff carried out a task. People were supported to have 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. People who lack mental capacity to consent to arrangements for necessary care or treatment can only be deprived of their liberty when this is in their best interests and legally authorised under the MCA. The procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

People told us they enjoyed their meals, had a choice of the foods they enjoyed and we saw where needed people were supported to eat and drink enough to keep them healthy. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People told us they enjoyed spending time with staff and spent time chatting and relaxing with them. We saw people’s privacy and dignity was maintained with staff supporting them to do this where needed. People’s day to day preferences were listened to by staff and those choices and decisions were respected. Staff told us it was important to promote a person’s independence and ensure people had as much involvement as possible in their care and support.

People were involved in planning their care and if requested their relatives were involved. The care plans reflected people’s life histories, preferences and their opinions. People told us staff offered encouragement to remain active and try activities on offer. People also told us they enjoyed the social aspect of the home and the activities offered.

People were aware of who they would make a complaint to if needed. People told us they were happy to talk though things with staff or the registered manager if they were not happy with the care.

The registered manager and staff demonstrated their commitment to care for people following best practice. They linked with care provider forums ensured people had access to the local community. The service had a good links with health and social care professionals.

The provider had a programme of audits in place to monitor the quality and safety of people’s care and support. The provider continually strived to make things work better so that people benefitted from a home that met their needs.