Snapethorpe Hall

Updated 16 February 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Snapethorpe Hall 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. Snapethorpe Hall is a care home with nursing care, however they do not currently provide nursing care to people. 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 on both visits.

What we did before the inspection

We reviewed all the information we had received about this service since its last inspection in 2020. We requested feedback from stakeholders, including local safeguarding, infection control and commissioning teams. 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 7 people who used the service and 3 relatives about their experience of care provided. We gathered feedback from 15 staff members including the registered manager, the regional support team, the area director, the deputy manager, activities staff and care staff. We looked around the building and observed people being supported in communal areas.

We reviewed a range of records including 5 people’s care plans and risk assessments. We reviewed 25 people’s medicines records. We looked at 4 staff files in relation to recruitment and several agency staff profiles. We reviewed a variety of records relating to the management of the service, including policies, quality assurance records and training records.

Following the site visits, we reviewed further information and evidence from the provider including action plans, incident and accident records, complaints and staffing dependencies. We had meetings with the registered manager and area director after the inspection visits to discuss our concerns in relation to medicines, staffing and governance.

Updated 16 February 2023

About the service

Snapethorpe Hall is a residential care home providing accommodation for persons who require personal care for up to 62 people. The service provides support to people who have physical health needs and conditions such as dementia. At the time of our inspection there were 47 people using the service.

The home is set out across 2 floors, each of which has adapted facilities. Each bedroom has an en-suite facility. One floor focused on providing care to people living with dementia.

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

People and their relatives mostly told us they felt people were safe. We found people were at risk of harm as medicines were not managed safely and risks to people were not always well-managed. Risk assessments and care records for people were not always up to date and reflective of people’s current support needs and we found staff were not always following risk assessments in place.

Recruitment for permanent staff was managed safely; however, assurances in respect of agency staff were not always robust. The provider was actively recruiting more permanent staff.

People, relatives and staff raised concerns about staffing levels and consistency of staff. Staff were trained in safeguarding and knew the procedure to follow if they suspected people were at risk of harm.

During the inspection, the service had an infection outbreak. We found staff had not been appropriately deployed and the outbreak management was not robust. We saw some positive interactions between staff and people, however there were not enough staff available on one unit to respond quickly when people needed care, support or reassurance.

Governance processes were in place but were not being used effectively to identify shortfalls and drive service improvement. The registered manager required support around governance processes but the governance and delegation process was not always clear. Feedback from staff was mostly negative about the culture of the service and the management team. However, we found the provider challenged poor practice in the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service had recently had a refurbishment and the home was very well maintained, providing luxurious and spacious accommodation for people. Most people spoke positively about the care provided by care staff.

The regional management team were responsive to our inspection findings and responded after the inspection. We received updates about what action they were taking, including an action plan in respect of medicines management. The registered manager was new in post and was being supported by the area director to effectively communicate and respond to their regulatory responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 April 2020) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations and the rating remains requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to medicines management, appropriate staffing and management practice and oversight. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. The provider has taken action to mitigate some of the risks identified at this inspection. Please see the safe and well-led sections of this full report.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.

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

Enforcement

We have identified breaches in relation to the safe management of medicines, staffing and governance. We issued warning notices against the registered manager and provider relating to the breach of regulation 17. The provider and registered manager did not submit an appeal or representations against the warning notices.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.