13 June 2023
During a routine inspection
Stone Gables is a care home without nursing care, providing accommodation for persons who require personal care for up to 40 people. The service provides support to older people, including people living with dementia. At the time of our inspection there were 23 people using the service. The care home accommodates people across 2 floors in 1 building.
People’s experience of using this service and what we found
The provider's oversight of the service was ineffective. Systems were not in place to support the monitoring and improvement of the service. Managers failed to provide evidential documents during the inspection process. There was a lack of measures in place to help drive improvements at the service.
Medicines were not managed safely. Guidance was not followed when changes were made to people’s medicines and time specific medicines were not given at the correct times. Risks were not being appropriately assessed and managed around challenging behaviours and people’s health. People’s risk assessments were not readily available for staff to read and follow. Referrals to the local authority safeguarding team had been made appropriately. However, follow up actions had not been completed by the provider.
People, staff and relatives did not feel there were enough staff on shift to meet people’s needs. We observed people at lunch time not receiving the support they required. Staff did not receive regular supervisions or appraisals. We were not assured that competency assessments were completed with staff. We observed staff to be kind and respectful to people, but they were very busy and task orientated.
We received positive feedback about the activities on offer and the activities coordinator. During the inspection, we observed people and their relatives participating in activities throughout the day. Relatives were complimentary about the care staff.
Assessments were completed with people before they moved in to Stone Gables and care plans included information on how to support people to meet their needs. People received health and social care support from a range of professionals including GP's, district nursing and social work teams.
People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 29 November 2019).
Why we inspected
The inspection was prompted due to concerns received about medicines and staffing. A decision was made for us to inspect and examine those risks.
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 that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to risk management, management of medicines, staffing and quality assurance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.