Sheridan House

We found the following examples of good practice.

The premises were clean and well maintained. Cleaning schedules were in place and an additional cleaner had been employed. Hand sanitiser was readily available, and staff were wearing personal protective equipment (PPE) appropriately.

The registered manager and staff recognised the importance of maintaining people’s well-being. There were staff members in post to help support people’s social needs, and to ensure they did not feel isolated, including subscribing to performances on social media.

Two visiting pods had been created: one outside with views of the sea and another in the spacious entrance hall of the home. These had been in regular use; we saw a relative using this system during our inspection after undertaking a Lateral Flow Test to show they were not COVID-19 positive. There was a thorough cleaning system in place between visits.

End of life care visits took place whilst following good infection control procedures. The registered manager and staff were proud of this element of care at the home, and were committed to continuing with their normal high standards.

There was a clear procedure for staff in how they travelled to work. For example, staff did not car share. Where necessary, the provider collected staff rather than them using public transport.

Staff accessed weekly testing. People who used the service were also supported to access regular testing and had been offered the vaccine.

Staff had completed infection control and prevention (IPC) training. The management team had systems in place to check staff practice. This included observing staff to ensure they followed good practice infection control guidelines and were competent in their practice.

The registered manager linked in with local resources, such as the Provider Engagement Network, to update their knowledge and practice. They had appointed a new manager who was working with them to run the home and oversee good infection control practice.

The registered manager said the service was well supported by the local primary healthcare team, with regular contact with GPs.

People’s experience of using this service:

Sheridan House continued to be led by an experienced registered manager and management team who worked closely together. There was a positive culture that was person-centred, open, inclusive and empowering. The registered manager was also one of the directors of the service. A registered manager is a person who has registered with CQC 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.

The registered manager was a strong role model for all staff and constantly looked for ways to improve practice to provide people with opportunities. They spent time at the home and people living there knew who they were. The registered manager was supported by the other directors and family members who worked with her to sustain the standard of care and introduce new processes to improve the service further. The management team knew everyone living at the home well and provided day to day support and care. They were passionate about the service being people’s home. They employed a team of dedicated staff to ensure they had the same ethos as they did. The registered manager said they had worked hard to get the right staff. Staff said there was a good team spirit at the service.

People and relatives described the service in positive terms. Everybody without exception praised the care and support provided by the staff team. They said they were caring, approachable and always available if they wanted to talk with them. People were consistent in their response. For example, “Since entering Sheridan, I feel 20 years younger.” Visitors echoed these views, saying “I can't recommend Sheridan highly enough” and “they are willing to ‘go the extra mile’.” People were supported to lead as independent life as possible for example managing their own medicines. People said how important it was to feel in control of their lives.

There was an on-going sense of collaboration between the management team, staff, relatives, visitors and people living at the home; all with the goal to make the home a pleasant and vibrant place to live, work and visit. Staff worked as a team to create a better quality of life for people and ensured they were at the heart of the way the service was run. Staff spoke with respect and affection about the people they cared for. They were attentive and reassured people and ensured people were comfortable and had all they needed. They were intuitive to people’s specific needs and responded proactively to them.

People said how important it was to them to stay connected to friends and family; there continued to be a strong sense from a number of people that they were in charge of their life. This approach was promoted by the registered manager, including encouraging people to visit at different times before making a decision to move in.

People had a clear understanding of the purpose of the pre-admission assessment before they moved in. They had received information about the service, so they knew this was part of the process of making a decision around the suitability of the home. People, or where appropriate their relatives, were involved in developing their care, support and treatment plans. People understood the purpose of their care plan and told us they had agreed the content. People’s description of their level of support showed they were in control and care was provided on their terms.

People living at the home discussed how their sense of identity and maintaining their dignity was extremely important to them. It was clear they viewed their rooms as their private space and had personalised them to reflect their interests and previous livelihoods. The providers had created an enabling environment to support people's independence. The layout of the home meant corridors were short to enable people to access their rooms more easily. As a result, the style of the home was not institutional. People took their time to walking independently with some having daily routines to maintain their mobility.

People living at the home were at the heart of the events and activities that were arranged. All staff took a pride in their work and our conversations with them showed they worked as a team to create a better quality of life for people. There was a wide range of activities and social events based on feedback from the people living at the home. Staff worked as a team to make activities and events as social and pleasurable as possible.

Staff said they worked in a culture where their views and suggestions were listened to and implemented. The registered manager and the management team had established a service where staff were clear about the values and ethos of the home. There was a commitment to reflection and learning so that the service was continually evolving in line with good practice guidance and research. People said they did not have any cause for complaint, but that they would be able to raise concerns with staff or the registered manager if they needed to. Complaints and concerns were taken seriously and used as an opportunity to improve the service. There were systems to monitor the quality of the service, including responding to suggestions for improvements.

There was a commitment to care for people at the end of their life. Staff were proud of their skills in caring for people who were dying and were committed to enable people to have a dignified death.

The home was built to a high standard and reflected the provider's ethos to put people at the heart of the service. In a written statement the providers explained their aim, which included 'the building should be bright with as much natural light as possible to promote wellbeing.' People told us the positive impact the design had made on their daily lives and their sense of well-being. There was a large garden with uninterrupted sea views, which people said they used in good weather. There was a patio area with seating that provided ample room for a group of people to meet. Several people had direct access to the garden from their rooms, and where possible these rooms were matched to people whose well-being was improved by being close to the garden.

People were complimentary about the approach of staff, such as “The staff are kind to all and just like a happy family. Nothing is too much trouble.” Throughout our inspection, the atmosphere was relaxed. People were at ease with one another and with staff. Staff knew people as individuals and carefully changed their approach to ensure people felt included and valued.

People felt safe living at the home. They did not have concerns regarding the staffing levels which met their physical and emotional needs. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. There were checks carried out on the building and equipment to ensure these were safe.

People were positive about the standard of the food and were able to make choices about what they had to eat. The chef explained how they worked with people to ensure they understood their individual likes. They ensured food was not repetitive and was adapted, if people's care needs changed, for example if they became unwell.

Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe. Safe recruitment procedures ensured that people were supported by staff with the appropriate experience and character. People received their medicines in a safe and caring way. People visiting and living at the home praised the standard of cleanliness and the lack of unpleasant odours. People expressed satisfaction with the standard of the laundry. All these factors helped maintained people's dignity.

People living at the home said they were confident staff could meet their care needs because they had the right skills. A common theme from their feedback was the staff were "friendly" and put them at ease. Visitors to the home praised the qualities of the staff group and the registered manager. They told us they had a good rapport with staff and described the peace of mind it gave them knowing the staff group's commitment to provide a good standard of care and support.

We met with staff who held different roles within the home; communication amongst the staff team was good which meant the staff group was kept up to date with people's care needs. People were supported with their health and had access to health and social care professionals, when necessary. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and demonstrated through their practice an understanding of how this impacted in the way they worked.

Rating at last inspection (and update):

The last rating for this service was Outstanding (published January 2017). At this inspection, the service was rated as Good.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.

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

The service was last inspected in July 2013 when it was judged to be compliant with all the areas that we inspected.

There was a registered manager at service who had registered with CQC since our last inspection.

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.

Sheridan House was very well run by an experienced registered manager and deputies who worked closely together. The service had a positive culture that was person-centred, open, inclusive and empowering. Staff said the registered manager and senior listened to them. Staff welcomed feedback from people living at the home. The registered manager provided strong leadership and was a good role model for all staff. She had established a service where staff were clear about the values and ethos of the home. A person living at the home wrote ‘I never thought I would be lucky enough to end my days in such delightful circumstances...Sheridan is part of the Eden Alternative scheme, so we are treated as adults with minds of our own.’

People consistently told us about the excellent care and support they received, these views were echoed by visitors. For example, a visitor wrote ‘Sheridan is a warm, safe and caring home. I was astonished at the skill and professionalism of all the staff when my father was going through tough times towards the end. There was a positive solution to everything - and they had time to advise and support me too!’ People were supported to lead as independent life as possible for example managing their own medicines and were encouraged to be involved in the running of the home. People said how important it was to feel in control of their lives. There was a sense of collaboration between the registered manager, staff, relatives, visitors and people living at the home; all with the goal to make the home a pleasant place to live, work and visit.

There was a commitment to care for people at the end of their life. Staff were proud of their skills in caring for people who were dying; more experienced staff recognised how younger staff might need support both practically and emotionally. Those who were skilled and passionate about enabling people to have a dignified death were supported by the registered manager to spend time with the person. A health professional said staff knew when to contact them and were quick to pick up on changes to people’s health and well-being. They said the skills of the staff group enabled people to “die with dignity” and described the care as “person centred.” They said the home was “a peaceful and calm place.”

People told us how important it was to them to stay connected to friends and family; there was a strong sense from a number of people that they were in charge of their life. This approach was promoted by the registered manager, including encouraging people to visit at different times before making a decision to move in. People said they had a clear understanding of the purpose of the assessment before they moved in and had received information about the service so they knew this was part of the process of making a decision around the suitability of the home.

People, or where appropriate their relatives, were involved in developing their care, support and treatment plans. People understood the purpose of their care plan and told us they had agreed the content. It was clear from our discussions with people they had been consulted by staff and records showed they had signed their care plan to agree the content. They were involved in the monthly reviews of their care plan and understood the purpose of them.

People living at the home were at the heart of the events and activities that were arranged. People praised the staff and the role of the activities coordinator and their approach. Visitors echoed these comments, describing the staff member as “brilliant.” All staff took a pride in their work and our conversations with them showed they worked as a team to create a better quality of life for people. People met with the cook to organise celebration meals; the cook gave examples of the menus people had chosen and showed us the wide range of birthday cakes they had made for birthdays and seasonal events. There were a wide range of activities and social events based on feedback from the people living at the home. Staff worked as a team to make activities and events as social and pleasurable as possible.

From meeting with the people living at the home, we recognised their sense of identity and maintaining their dignity was extremely important to them. It was clear they viewed their rooms as their private space and had personalised them to reflect their interests and previous livelihoods. The commitment of the providers to create an enabling environment meant a great deal of thought had taken place to how staff and the environment could support people’s independence. The layout of the home meant corridors were short to enable people to access their rooms more easily. It also meant that the style of the home did not look institutional. Some people said this design feature meant they did not need the support of staff; we saw people taking their time to move around the building independently.

The home was built to a high standard and reflected the provider’s ethos to put people at the heart of the service. In a written statement the providers explained their aim, which included ‘the building should be bright with as much natural light as possible to promote wellbeing.’ People told us the positive impact the design had made on their daily lives and their sense of well-being. There was a large garden with uninterrupted sea views, which people said they used in good weather. There was a patio area with seating that provided ample room for a group of people to meet. Several people had direct access to the garden from their rooms.

People were complimentary about the approach of staff, such as “very kind”; one person described the home as a “friendly place.” Throughout our inspection, the atmosphere was calm and relaxed. People were at ease with one another and with staff. Staff knew people as individuals and carefully changed their approach ‘going the extra mile’ to ensure people heard them or understood the choices being offered.

People felt safe living at the home. Comments from people living at Sheridan House included “Staff are very kind.”; “If you can’t be at home, this is the best place to be” and “Really very lovely.” People looked at ease in their surroundings and with each other and staff; the atmosphere was calm and unrushed. They did not have concerns regarding the staffing levels which met their physical and emotional needs. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. There were checks carried out on the building and equipment to ensure these were safe.

People were positive about the standard of the food and were able to make choices about what they had to eat. Staff took time to explain the ingredients in meals, including puddings to ensure people were making an informed choice. People consistently told us “Food is very good”, “I can’t fault it at all” and the cook was “very good.” People said they spoke with the cook to give them feedback and make suggestions. The cook explained how they worked with people to ensure they understood their individual likes. They showed a strong commitment to ensuring food was not repetitive and was adapted if people’s care needs changed, for example if they became unwell.

Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe. Safe recruitment procedures ensured that people were supported by staff with the appropriate experience and character. People received their medicines in a safe and caring way. People visiting and living at the home praised the standard of cleanliness and the lack of unpleasant odours. People expressed satisfaction with the standard of the laundry and the quality and comfort of the home’s furnishings. All these factors helped maintained people’s dignity.

People living at the home said they were confident staff could meet their care needs because they had the right skills. A common theme from their feedback was the staff were “friendly” and put them at ease. Visitors to the home praised the qualities of the staff group and the registered manager. They told us they a good rapport with staff and described the peace of mind it gave them knowing the staff group’s commitment to provide a high standard of care and support.

We met with staff who held different roles within the home; they were passionate about providing a high standard of care and support to the people living at the home. Communication amongst the staff team was strong which meant the staff group was kept up to date with people’s care needs. People were supported with their health and had access to health and social care professionals, when necessary. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and demonstrated through their practice an understanding of how this impacted in the way they worked.

People said they did not have any cause for complaint, but that they would be able to raise concerns with staff or the registered manager if they needed to. Complaints and concerns

During this inspection we spoke with 10 people who lived at the home, the manager, two staff and one visitor. We looked at the care plans for four people who lived at the home and three staff files.

Staff supported people to be involved in their care and treatment. For example staff told us and people confirmed that each monthly review of the care plan was completed with the individual.

People told us 'staff are really good', 'staff look after us really well' and 'staff are there to help when needed'. One person's relative told us that they felt their relative was 'so well cared for' and the home had 'been a godsend for the family'.

We saw that people were protected from the risk of abuse because reasonable steps had been taken to identify the possibility of abuse and to prevent abuse. For example there were policies and procedures in place for staff to follow if they suspected abuse had occurred.

We looked at three staff files which showed us there were effective recruitment procedures in place. For example criminal records checks had been completed.

We saw evidence that new staff undertook a thorough induction period and worked with a 'buddy' for two to three weeks until they felt confident.

The provider had effective systems to assess and monitor the quality of the service that people received.