This inspection took place on 26 and 28 July 2016. The first day of the inspection was unannounced which meant the registered provider and staff did not know we would be visiting. The second day of inspection was announced. Stainton Way is a residential home situated in Hemlington. It provides accommodation for people who need assistance with personal care or people who may be living with a dementia. Stainton Way can accommodate up to 67 people in rooms that have en-suite facilities. The home is a purpose built building with surrounding gardens and car parking. It is close to local bus routes. At the time of inspection there was 62 people using the service.
There was a manager in place, and they were in the process of applying to be the registered manager. 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.
People and their relatives told us they felt safe. Risk assessments were in place for people who needed these, however, some risk assessments had not been regularly reviewed and some required updating.
Accidents and incidents were monitored to identify any patterns and appropriate actions were taken to reduce the risks. Falls were also monitored to identify if any trends were occurring.
Staff we spoke with understood the procedure they needed to follow if they suspected abuse might be taking place and the registered provider had a policy in place to minimise the risk of abuse occurring. Safeguarding alerts had been raised or incidents accurately recorded if a referral to the local authority was not needed.
Emergency procedures were in place for staff to follow and personal emergency plans were in place for everyone. A robust procedure for recording fire drills had been implemented.
Medicines were managed appropriately. The registered provider had policies and procedures in place to ensure that medicines were handled safely. Medication administration records were completed fully to show when medicines had been administered and disposed of. People we spoke with confirmed they received their medicines when they needed them.
Certificates were in place to ensure the safety of the service and the equipment. Maintenance and fire checks had been carried out regularly.
A safe recruitment process was followed to reduce the risk of unsuitable staff being employed. All new staff completed a thorough induction process with the registered provider.
Staff performance was monitored and recorded through a regular system of supervisions and appraisal. Staff had received training to support them to carry out their roles safely; however some training had expired and was overdue and some certificates were not available in staff files. These certificates were produced following the inspection. A training plan to ensure all staff had up to date training had been developed.
People were supported to maintain their health. People spoke positively about the nutrition and hydration provided at the service. Staff understood the procedures they needed to follow if people became at risk of malnutrition or dehydration.
Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and knew what action they would take if they suspected a person lacked capacity. However, documentation was not always in place to support best interest decisions.
Each person was involved with a range of health professionals and this had been documented within each person care records. From speaking with staff we could see that they had a good relationship with health professionals involved in people’s care. People’s care records contained evidence of appropriate referrals to professionals such as falls team, tissue viability nurses and dentists.
The service was clean and neutrally decorated throughout but was not always adapted to support people living with a dementia. People were able to bring their own furniture and personalise their bedrooms.
People spoke highly of the service and the staff. People said they were treated with dignity and respect.
People, and where appropriate their relatives, were actively involved in care planning and decision making. This was evident in signed care plans and consent forms. Information on advocacy was available and displayed throughout the service.
Care plans detailed people’s needs, wishes and preferences. However, some care plans lacked person centred information in areas such as best interest decisions. The manager told us that all care plans were to be reviewed so they have a consistent level of detail. Care plans had been regularly reviewed and we saw evidence that relatives had been invited to these reviews.
The registered provider employed two activities coordinator. We saw a range of activities that were on offer; however, on the day of inspection we saw no organised activities taking place. We did see people helping the activities coordinator, watching television and speaking with staff. People were able to tell us about the activities on offer and told us they enjoyed the activities provided.
The registered provider had a clear process for handling complaints. There had been two complaints received in the past twelve months which had been managed appropriately. A copy of the complaints policy was displayed in the reception area of the home. People we spoke with confirmed they knew how to make a complaint.
Staff told us they enjoyed working at the service and felt supported by the management and that standards had been significantly improved by the manager. Staff told us they were confident any concerns would be dealt with appropriately. We could see from our observations and speaking with people that the manager had a visible presence at the service.
Feedback was sought from people, relatives, staff and visiting professionals. Feedback questionnaires had recently been sent to people and relatives. The manager told us this information would be evaluated and action plans produced where needed.
The service worked with various healthcare and social care agencies and sought professional advice to ensure that the individual needs of people were being met.
The manager understood their role and responsibilities and was able to describe when they would be required to submit notifications to CQC.