Snowdrop House

We found the following examples of good practice.

People were chatting and engaging with staff and this did not appear to be impacted by staff wearing masks. People told us they felt lucky to be cared for so well.

Information was displayed about COVID-19 giving clear and accessible advice.

The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID-19.

The home was clean and there was cleaning ongoing during our visit.

The service had made arrangements to receive visitors with clear infection control procedures in place. Visitors were screened and had their temperatures checked on arrival. Visitors were required to wear personal protective equipment (PPE) and undertake a rapid test for COVID-19. Visits were scheduled to avoid potential infection transmission between visitors.

Staff had received training on putting on and taking off personal protective equipment (PPE), infection control and COVID-19. They told us they felt supported and had enough information to do their jobs.

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

The service provided end of life care. People’s care plans did not include the detailed information needed to keep people comfortable and pain free at this time. Peoples’ care plans lacked the finer detail to help staff provide consistent care. The provider’s quality auditing system failed to identify this lack of detail to support staff in providing consistent care and effective end of life care.

People said they felt their complaints were not always responded to and they did not always feel listened to. We received mixed feedback about whether the manager was seen around the home regularly. The manager told us of various methods they used to gain people’s feedback however, people were not confident that any changes resulted from them giving their feedback.

People and relatives said they were happy with the care provided and people enjoyed the activities provided. People, and their relatives where appropriate, were involved in planning care. People’s bedrooms were personalised, and communal corridors were wide and welcoming spaces. People were supported by external health and social care professionals and staff supported people to attend appointments as needed.

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.

Staff received an induction when starting at the service. Regular training, specific to their role, was delivered and refreshed when needed. Staff received supervision and felt supported by the management team. We received mixed feedback about the food, however, a new chef had been recruited and this was their first day at the service.

Some people gave mixed feedback about staffing levels however, we saw people received support when they requested it. Recruitment processes were robust. Staff had received training about safeguarding people from abuse and knew how to report any concerns they had to the management team.

People were protected from the risk of infections. People's medicines were administered, stored and recorded safely. The outcome of any ‘lessons learned’ was shared with the staff team. People’s individual risks were assessed, and staff supported people safely and patiently. Accidents and incidents were reviewed, and action taken as needed.

People were treated with respect and kindness. Staff were attentive and the atmosphere in the home was calm and relaxing. Visitors were welcomed into the home. People were asked for their views about the care as part of their care plan review. People’s choices were respected, and staff were mindful of people’s dignity when supporting them. People’s private and confidential records were stored securely.

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

Rating at last inspection

The last rating for this service was requires improvement (published 24 October 2018). At this inspection the service remains rated requires improvement. This service has been rated requires improvement for the second consecutive inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Snowdrop House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Snowdrop House is registered for a maximum of 70 people. The home opened in September 2017 and had only 35 people living in the home at the time of this inspection. Services provided included residential and nursing care, short-term respite care and specialist care for people who may live with dementia, have a physical disability or require mental health support. This was the first inspection of the service since it registered with the CQC on 20 September 2017.

People were accommodated in a purpose-built environment over three floors which was clean and well maintained. Bedrooms were personalised and had en-suite facilities whilst still providing specialist bathroom facilities, several communal areas, dining rooms, coffee shop, hairdresser room, quiet lounges so people could choose where they wanted to spend their time.

There was a manager in post who registered with the Care Quality Commission. 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 and associated Regulations about how the service is run.

People told us they felt safe at the home. People had mixed views about staffing levels in the home. People who lived on the ground floor told us they felt there were enough staff, although people on the first floor told us they at times waited longer for their calls to be answered. Staff told us on occasions they worked short staff and some of the managers on the units didn’t help much on the floor.

Staff received training and were knowledgeable in how to safeguard people from any risks of abuse. They could describe what constitutes abuse and the reporting procedure they would follow to raise their concerns. Every staff member employed went through a comprehensive training programme to ensure they could effectively meet people`s needs. Not every staff member we spoke with felt a valued member of the team and they felt that managers did not always listen to their concerns.

People signed consent forms to agree to their photograph to be taken or for their records to be shared with relevant professionals, however people told us they did not know what was in their care plan. The provider had electronic care planning in place and all the care plans were in electronic format. However, we found that care plans needed further developing to ensure that they were personalised to the individual and not generalised.

People told us staff were kind and caring towards them and they respected their privacy and dignity. People told us they had confidence that if they reported concerns to staff these would be addressed.

Activities provided to people were varied and based on people`s preferences. People told us they enjoyed the opportunities to socialise and pursue their hobbies and interests.

People`s medicines were administered by trained staff who had a good understanding of safe medicine management practices. The provider was using an electronic medicine administration records system developed by a pharmacy they worked with. This needed developing further to ensure that senior managers could easily identify the reasons if medicines were not administered. People told us they were seen by their GP regularly and staff were prompt in requesting a GP visit if they were in need.

People told us the quality of the meals they received improved greatly in the last couple of weeks and they were happy with the choices on offer. Staff monitored people`s weight and ensured that if people were identified at risk of malnutrition or dehydration they were referred to dieticians and received fortified diets.

The registered manager used a range of audits to ensure they monitored the quality and the safety of the care provided. We found that recently the provider introduced regular audits they carried out in response to concerns raised by staff that they did not feel listened and supported by the management in the home. There were regular opportunities given to staff to meet with representatives from the provider to share their concerns.