Archived: Simonsfield Residential Care Home

Updated 31 July 2018

We carried out this 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.

This inspection took place on 4 July 2018 and was unannounced.

The inspection team consisted of an adult social care inspector 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, in this case, caring for a person living with dementia.

Prior to the inspection we contacted the local authority quality monitoring team to seek their views about the service. We were not made aware of any concerns about the care and support people received. We checked to see whether a Health Watch visit had taken place. Health Watch is an independent consumer champion created to gather and represent the views of the public. They have powers to enter registered services and comment on the quality of the care. They told us their last visit to the service was positive.

Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This is a form that we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. We also considered information we held about the service, such as notification of events and incidents which occurred at the service which the registered provider is required by law to send to CQC. We used all this information to plan how the inspection should be conducted.

As part of the inspection, we spoke with the registered manager, deputy manager and three members of care staff. We spoke with 11 people who used the service and one relative. We spoke to a domestic supervisor, the activities co-ordinator, the chef and two visiting health professionals. We reviewed care plans for four people who used the service, three staff personnel files, Medicines Administration Records (MAR) for five people, staff training and development records as well as information about the quality assurance and management of the service.

We observed the lunchtime service and staff interaction with people who lived at the home at various points during the inspection. We carried out a Short Observational Framework for Inspection (SOFI). SOFI is a methodology we use to support us in understanding the experiences of people who are unable to provide feedback due to their cognitive or communication impairments.

Updated 31 July 2018

Simonsfield Residential Care Home provides care and accommodation for 36 older people, some of whom were living with dementia. Accommodation is provided in single bedrooms situated on three floors. At the time of our inspection, there were 36 people living in the home.

At the last inspection on the 16 November 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. The service was meeting all relevant fundamental standards. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Medication was recorded accurately and stored securely. Staff received training and regular competency checks to ensure safe administration.

Risk assessments were completed to consider any potential risk to people and accompanying support plans were evaluated regularly. Procedures were in place to monitor and analyse accidents and incidents for future learning and prevention.

Staffing numbers were maintained at a suitable level to support people in a timely manner according to their needs as assessed through a dependency tool. Some people told us they thought the service would benefit from more staff and we raised this with the registered manager at the time of our inspection.

The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely. Staff had received training in 'Safeguarding' to enable them to act if they felt anyone was at risk of harm or abuse and understood the reporting procedures.

Everyone we spoke with felt staff were competent. Staff received relevant training to equip them with the skills and knowledge to complete their job role effectively. Staff felt well supported with their learning and development and felt they could raise any issues both formally and informally.

We spoke to two health professionals during our site visit who spoke positively about the care offered at the home. One visiting health professional approached us to commend staff on their intervention with one person whose well-being had markedly improved since being admitted to the home.

Most people we spoke with were happy with the food served at the home and a variety of drinks was served throughout the day to ensure their hydration needs were met. The dining experience was pleasurable with beautifully laid tables and background music.

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 supported this practice.

People were complimentary about staff and told us that staff treated them with dignity and respect. Comments included, “The staff are marvellous” and “They’re always polite and courteous, they treat me very well.” We observed a variety of kind and caring interactions between staff and people who lived at the home. People told us they could have a laugh with staff and this was evident during our inspection.

Care was planned and delivered in way that responded to people's assessed needs. Care plans contained important information on people's personal preferences and monthly evaluations were completed to ensure the service remained responsive to people’s evolving needs.

People enjoyed a range of activities, including days out in the local community using the service’s minibus and theatre trips. The activities co-ordinators catered the activity programme to meet people’s individual preferences and people spoke positively about them. One person commented, “The activities co-ordinator is very good, I like the activities.”

The registered manager had been employed at the home for over 10 years and maintained an active and visible presence at the service. People told us they were approachable and dealt with problems quickly. One commented, “She’s brilliant, everyone loves her. I could talk to her without a doubt. She’ll say, ‘I’ll have a look right now’ and gets things sorted.” Staff also echoed this positive feedback. One commented, “[Registered manager] gets stuck in, they aren’t scared to get their hands dirty, they interact with residents, they are fantastic.”

Opportunities were available for people and their relatives to provide feedback and contribute to service delivery through the use of quality assurance surveys and regular ‘resident and relative’ meetings.

There was a series of audit systems and processes to monitor the quality of the care and improve service delivery. These included a variety of self-assessment tools and an electronic reporting system to ensure managerial oversight of areas such as care plans, medication, accident and incidents and untoward events.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with our statutory requirements.

Further information is in the detailed findings below.