Shardlow Manor Residential Home

We found the following examples of good practice.

The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread COVID19.

During our visit, the home was calm, and staff were well organised. We observed staff responded promptly to people’s needs.

Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

We observed staff wearing the required PPE correctly whilst supporting people at the home.

The service had plentiful supplies of PPE and stocks were carefully monitored.

Shardlow Manor Residential Home is a residential care home that was providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 28 people. The home accommodates people across two separate floors, each of which has separate adapted facilities and a stair-lift. Some of the people living in the home had a diagnosis of early stage dementia. The home is situated in the village of Shardlow in Derbyshire.

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

People were supported to be safe and said they felt safe. Staff received safeguarding training and had a good understanding of the principals involved in acting when abuse was suspected.

Medicines were managed and administered safely and this meant people received their medicines as prescribed by healthcare professionals.

Staff told us they received good support from senior staff including the registered manager and providers. This support extended to regular supervision of staff and annual appraisals. We noted that staff received comprehensive training that was up to date, thorough and practical in nature.

People were happy with the level of staff in the home and we observed a good staff presence at the inspection.

People's needs were met through assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met.

The provider had a recruitment process. There were some checks that had not always been completed before staff started work. This was resolved after the inspection. Any issues with staff were dealt with promptly using a fair and thorough disciplinary process.

People's needs were met through robust assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met. We saw good examples of when people had been supported to maintain a healthy and balanced diet.

People told us staff were compassionate and kind and during the inspection, we observed this to be the case. Providers, management and staff knew people well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and their best interests; the policies and systems in the service supported this practice.

People received care and support that was person-centred. We saw examples of how the care and support people received enriched their lives through meaningful activities. The service had a robust complaints policy and people said that they were confident that if they raised issues, they would be dealt with quickly.

The values and culture embedded in the service ensured people were safe and at the heart of the care and support they received. The registered manager and senior staff planned and promoted holistic, person-centred, high-quality care resulting in good outcomes for people.

There was an end of life policy that could be used if appropriate. Staff members had been trained around this and were able to ensure best practice was applied during times when people were at the end of life.

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 good (published 23 March 2017).

Why we inspected

This was a planned inspection based on the previous rating of the service.

Follow up

We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received, we may inspect sooner.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support for people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and ongoing professional development that they required to work effectively in their roles. We saw people were supported to maintain good health and nutrition.

People had developed positive relationships with the staff who were caring and treated people respectfully, with kindness and courtesy. People had personalised plans of care in place to enable staff to provide consistent care and support. We saw this was in line with people’s personal preferences.

People told us they knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may had received.

The provider had a positive ethos and an open culture. The registered manager was a visible role model in the home. People, their relatives and other professionals told us they had confidence in the managers and provider’s ability to deliver consistently high quality managerial oversight, and effective leadership to the home.

The home had a registered manager in place. 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.

Our last inspection took place in February 2014 and at that time we found that two of the essential standards we looked at were not being met. We asked the provider to put actions in place to ensure that these standards would be met in the future. We asked them to make improvements in how the recording and handling of people’s medicines took place. We also asked them to have an effective system in place for dealing with comments, concerns and complaints. During this inspection, we found that the provider had made improvements in both these areas.

People chose how to spend their time and staff sought people’s consent before they provided care and support. However some people did not have capacity to make certain decisions. It was not clear how some decisions had been made and whether people should have made the decision for themselves. We saw some people may have had restrictions placed upon them as they were not able to go out alone and may not have had the capacity to make a decision about their safety. Applications to ensure these restrictions were lawful had not been made. You can see what action we told the provider to take at the back of the full version of the report.

People told us that they felt safe living in the home. The staff knew how to support people in a safe way. We found that people’s medicines were administered safely and we saw that potential risks were assessed and managed. There were sufficient staff numbers in the home to meet people’s needs and keep them safe. There were safe recruitment procedures in place which were followed when appointing new staff.

We found that people were supported to have their assessed needs, preferences and choices met. People told us the staff helped them in the way they wanted. Staff showed they were aware of individuals support needs and how to help people living with dementia. People were supported to eat and drink enough and maintain a healthy and balanced diet. Health professionals regularly visited the home and provided healthcare services when needed.

People told us and we observed that positive caring relationships had been developed with the staff. We saw that people were involved in making decisions about their day to day lives and they were encouraged to be independent. People had regular care plan reviews with their carer which they found helpful. Relatives were also involved with these plans.

People who used the service and their relatives told us they knew how to raise any comments, concerns or complaints. We found that when issues had been raised, they had been dealt with and people had been listened to. We saw that people were able to personalise their rooms as well as the communal areas. They were also able to make choices about the activities they wanted to participate in.

People told us that the manager and provider were supportive and approachable. The staff also told us that they enjoyed working at the home and were given opportunities to develop their knowledge and skills. We found that there were systems in place to review the quality of the care at the home.

We saw that people's needs were assessed, and care plans were in place. This meant they received support in a way that met their needs.

People told us they enjoyed their meals and said that they received enough to eat and drink. Comments from people included 'The food is very good' and 'We always get plenty to eat and there is always a choice.'

The provider did not have appropriate arrangements in place to manage medicines, for example safe practices were not in place when administering medication.

The provider had carried out sufficient pre-employment checks on staff members.

Whilst checking complaint records during the inspection visit we identified a safeguarding incident, which had not been shared with the relevant authorities. This showed that the provider did not have an effective system in place for identifying, receiving, handling and responding appropriately to complaints and comments made by people using the service, or persons acting on their behalf.

Staff told us that they worked well together as a team, and felt supported by senior staff.

People we spoke with told us they were very happy with the support they received from staff. They told us that their needs were met and confirmed that staff were available to support them when needed. Comments included 'the staff always listen to me and they understand my needs' and 'staff are always around.'

One person at the service told us 'there is no place like home, but I am content here.'

People we spoke to confirmed that staff respected their privacy and dignity when supporting them with personal care. Comments included 'staff always knock, before entering my room' and 'all the staff are extremely polite.' This ensured people's dignity was maintained.

People told us that they felt safe living at the service, and were able to report any concerns they may have to staff or the manager.

We saw that people's needs were assessed, and care plans were in place. This meant they received support in a way they preferred and met their needs.

Not all areas of staff training were up to date. This did not ensure people's health and welfare needs were met by a competent staff team.