Summer Fields

We found the following examples of good practice.

• The service followed up to date guidance regarding safe visiting procedures. Visits were restricted to essential visitors only if there was an outbreak of COVID-19 within the home, which was occurring at the time of the inspection.

• However, there were also safe measures in place to facilitate visits for people receiving end of life care and where it had been assessed as being in the persons best interest due to their wellbeing.

• Appropriate visiting measures were also in place for those relatives who were essential care givers and supporting their loved ones living in the home.

• Appropriate vaccination status checks were completed on all staff and visitors.

• There was a dedicated procedure that accommodated people should they develop COVID-19 or show symptoms.

• Safe procedures were followed for admitting people to the service. People were only admitted following evidence of a negative COVID-19 test.

• Stocks of the right standard of personal protective equipment (PPE) were well maintained and staff used and disposed of it correctly. The manager shared good working practices and updates across the staff team.

• Staff had appropriate training and competency checks in regards to the use of PPE and other infection control procedures.

• People and staff had access to regular testing.

• Guidance on the use of PPE and current IPC procedures were clearly visible across the service.

• Staff reassured people throughout the pandemic and provided them with the support they needed to maintain regular contact with their family and friends through the use technology.

• Daily cleaning schedules were implemented by domestic staff.

Prior to our visit, Wirral NHS Infection Control team had also inspected the service. They identified that some improvements to infection control standards within the home needed to be made. At the time our visit, the manager of the home had started to action these recommended improvements.

During our visit, we found the following examples of good practice.

The service had appropriate infection control policies and procedures in place. These were developed in line with current government guidance. Regular checks were in place to ensure effective infection prevention and control practices were followed

There were sufficient supplies of personal, protective equipment (PPE) in place for staff to use, with dedicated PPE stations for staff to use.

There was a system in place to ensure that all new admissions to the service had a negative Covid 19 test prior to admission. An appropriate period of isolation was adhered to after the person’s admission to mitigate risks of any cross infection. Due to the current outbreak, no new admissions were being accepted.

At the time our inspection, visitation to the home was not permitted due to the outbreak, but there were appropriate procedures in place to enable safe visitation once the outbreak was over. In the meantime, people were supported to maintain contact with their loved ones via video and telephone calls.

Individual risk assessments had been conducted in consultation with people who used the service to mitigate risks to their health and well-being.

Risks to staff were also identified. This included risks of acquiring COVID-19 infection for staff from higher risk groups.

People living with the Covid 19 virus within the home, were being barrier nursed appropriately. Staff were allocated specific floors within the home to work on to mitigate cross infection. It was however difficult for social distancing and cohorting within the home to be rigidly applied due the needs of the people living there.

Further information is in the detailed findings below.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns, however Summer Fields had achieved a rating of requires improvement in the safe domain. We found medication procedures at the home were safe, however we identified a recording problem regarding medication.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We spoke with the people who lived in the home, relatives and visiting professionals who all gave positive feedback about the home and the staff who worked in it. The service had a relaxed and homely feel and people were supported to have maximum choice and control over their lives and participate in activities they enjoyed.

People told us they felt safe at the home and had no worries or concerns. From our observations it was clear that staff cared for the people they looked after and knew them well. People and relatives we spoke with said they would know how to make a complaint. No-one we spoke with had any complaints.

Care plans and risk assessments were person centred and detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required. Care plans showed that people's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. We saw the service had responded promptly when people had experienced health problems.

The registered manager used different methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service.

Staff were recruited safely and there was evidence that staff received a proper induction and suitable training to do their job role effectively. All staff had been supervised in their role. Staffing levels were consistent and were adapted to meet people’s needs following dependency assessments of people living in the home.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been followed. The registered manager told us that DoLS applications had been submitted to the Local Authority for some people.

Infection control standards at the home were good and standards were monitored and managed and the maintenance records were up to date and legible, this meant the home was a safe environment.

Further information is in the detailed findings below

The service had 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. There was a registered manager in post, they had been registered since March 2015.

We found that the service was safe and effective. People told us they felt safe and we saw that staff knew how to ensure they were safe. From our observations it was clear that staff cared for the people they looked after and knew them well.

The service was caring and people and their relatives confirmed this to us. The service was responsive to people’s individual needs and made sure any concerns were addressed. It was a well led service, with staff, relatives and most of all, people being happy with the way it was managed.

All medication records were completely legibly and properly signed for. All staff giving out medication had been trained in medication administration.

We had asked the people who used the service, their relatives and the staff who supported those people, what their views were. They confirmed our findings on the inspection, that the service was good and that the people who used the service, were happy with it.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been followed. The provider told us that DoLS applications had been submitted to the Local Authority for some people

People and relatives we spoke with said they would know how to make a complaint, none of the people or their relatives we spoke with had any complaints.

People and staff told us that the home was well led and staff told us that they felt well supported in their roles. We saw that the registered manager was a visible presence in and about the home and it was obvious that they knew the people who lived in the home well and that the staff were well supported to carry out their duties.

We saw that infection control standards in the home were monitored and managed appropriately. Audits were completed as necessary and maintenance records were up to date and legible.

At the time of the visit the person in charge of the home was not registered with the Care Quality Commission.

The focus of the inspection was to answer five key questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. When asked people told us, 'Yes, I feel safe'.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and the required authorisations had been obtained. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people's rights were upheld.

The registered manager resigned and had left her post. A new manager had been appointed, but had not submitted an application to be registered with the Care Quality Commission. This meant that the Commission had not been given the opportunity to assess whether the acting manager was fit to manage the home. The proposed manager set the staff rotas, making decisions about the numbers, qualifications, skills and experience required. A staff supervision structure was in place to ensure that people's needs were met.

Is the service effective?

All care files contained a range of care needs assessments, and where risks had been identified plans and assessments had been developed to minimise those risks. We saw care plans were regularly reviewed.

Files contained daily records and records from visiting professionals, one such visitor told us that staff were 'Pretty good'. We saw evidence that staff liaised with professionals such as, GPs and social workers.

Is the service caring?

We saw that care workers showed patience and gave encouragement when supporting people. One resident told us 'Staff are very attentive'.

The home offered residents and relatives the opportunity to comment on various aspects of the home throughout the year with meetings and questionnaires. Relatives had commented, 'All staff are pleasant and helpful'. 'I am extremely happy with the standard of care my husband receives'.

Is the service responsive?

The home had a complaints procedure. We looked at the records and saw that complaints were investigated thoroughly, processes were open and transparent and responses had been dealt with in a timely manner.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service well led?

We spoke with people living in the home, relatives and staff. People told us that the proposed manager was well liked, that he always had time for them and dealt with issues fairly.

The service had a quality assurance system and records seen by us showed that any identified shortfalls were addressed promptly.

Records demonstrated that people's needs were monitored and reviewed. We found that other health professionals were involved with people's care and support. We found that staff were knowledgeable about people's needs. One relative told us that they were "more a than satisfied" with their relative's care.

People living in the home told us that they felt safe and we found that staff had received appropriate training to safeguard vulnerable people.

Medicines were being managed and audited to ensure that people received them safely.

We found that the home was clean, tidy and fresh. Any risks associated with the refurbishment had been identified and addressed.

We saw that internal audits took place at appropriate intervals to ensure the home provided a quality service.