Archived: Sutton House Nursing Home

Updated 7 March 2018

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The comprehensive inspection site visit took place on 31 January 2018 and was unannounced. The team consisted of three adult care inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience had expertise in caring for an older relative who lived with dementia.

The provider had completed a Provider Information Return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We checked the PIR and also our systems for any notifications that had been sent in as these would tell us how the provider managed incidents and accidents that affected the welfare of people who used the service.

Prior to the inspection we spoke with local authority safeguarding, contracts and commissioning teams, and also health commissioners about their views of the service.

During the inspection, we observed how staff interacted with people who used the service throughout the days and at lunchtime. We spoke with three people who used the service and six people who were visiting their relative or friend. We spoke with the registered manager and the deputy manager (both qualified nurses), the nurse in charge of the shift, a senior care worker, four care workers, an activity coordinator, a cook and maintenance personnel. We also spoke with two visiting health care professionals and received further information from another health professional following the inspection. Following the inspection, we spoke with the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at five care files which belonged to people who used the service. We also looked at other important documentation relating to them such as 10 medication administration records (MARs) and monitoring charts for food, fluid, weights and pressure relief. We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held.

We looked at a selection of documentation relating to the management and running of the service. These included four staff recruitment files, training records, the staff rota, minutes of meetings with staff and people who used the service, quality assurance audits, complaints management and maintenance of equipment records.

Updated 7 March 2018

This comprehensive inspection took place on 31 January 2018 and was unannounced. At the last comprehensive inspection on 6 and 7 June 2017, the service had an overall rating of ‘Requires Improvement’ and a rating of ‘Inadequate’ in Safe. We had found concerns with medicines management, staffing numbers and overall governance of the service. Since the last inspection, the registered manager has kept the Care Quality Commission (CQC) informed and when requested, sent us an updated action plan.

Sutton House Nursing Home is registered to provide personal and nursing care to a maximum of 38 people, some of whom may be living with dementia or have physical disabilities. It is situated in the village of Sutton, close to local amenities. The home has three floors serviced by a passenger lift and stairs with single occupancy and shared bedrooms on the first and second floor. There is a large lounge area, a small quiet lounge and a dining room all situated on the ground floor. There is a garden at the front and the side of the building.

Sutton House Nursing Home 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.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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.

We found improvements had been made in the quality monitoring of the service delivered to people. The audits and checks highlighted when issues required addressing and were followed up by relevant staff. There were surveys, questionnaires and meetings in order for people to express their views.

There were improvements in the management of medicines and stock control was more effective. This meant that people received their medicines as prescribed and there were no delays when new prescriptions were issued.

Staff knew how to safeguard people from the risk of harm and abuse. They had completed safeguarding training and knew how to raise concerns and who to speak to about them. We saw people had assessments to help guide staff in how to minimise risk and keep people safe.

Staffing numbers had increased and were consistently maintained. There was a comment from health professionals about the difficulty in locating care staff, general oversight in the dining room and exiting the building at a peak time in the morning. Staff were busy supporting people to get up or administering medicines at this time. However, the registered manager told us they would resolve this by adjusting ancillary staff deployment at this peak time.

Staff recruitment was robust and employment checks were in place prior to new staff starting work. Staff had access to a range of training, supervision and appraisal which helped them to feel confident when supporting people’s needs.

People told us staff were kind and caring and their privacy and dignity was maintained. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were treated as individuals and their rights protected.

We found people’s health care needs were met. They had access to community health care professionals when required and referrals to them were made in a timely way.

People’s nutritional needs were met. The menus provided choices and alternatives and special diets were provided. Staff supported people to eat their meals in a sensitive way and the lunchtime experience was a calm and sociable event.

There were activities provided seven days a week to help prevent isolation and encourage social interaction. Although there was an outside area for people to sit in during the warmer weather, there were plans for this to be improved to makes it more secure.

The provider had a complaints procedure displayed in the service. People felt able to raise concerns and staff knew how to manage them so they were resolved as quickly as possible.

The environment was clean and safe. Staff had personal protective equipment and there were procedures for infection control. Equipment used in the service was checked and maintained. There was a business continuity plan to guide staff in dealing with emergencies such as utility failures or floods. Each person who used the service had a personal emergency evacuation plan although these were included in their care file. The registered manager told us they would ensure a copy was included with an emergency pack to provide information to professionals if required.