We carried out a review of the data available to us about The Sidcup Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Sidcup Care Home, you can give feedback on this service.
We found the following examples of good practice.
All staff had received training on COVID-19, infection control and the use of personal protective equipment (PPE). We observed staff wearing appropriate PPE throughout our visit on all floors. The provider told us they had access to sufficient supplies of PPE equipment. The home was very clean throughout. The home had a dedicated housekeeping team and staff also carried out extra cleaning of higher infection risk points such as handrails.
When people or staff showed symptoms of COVID-19 they were supported to self-isolate. Admissions policies and practice followed current guidance.
There were processes to reduce the risk of infection on entry to the home. The provider screened all visitors for symptoms of acute respiratory infection before they entered the home. Visiting professionals and contractors were also required to show proof of vaccination before they entered the home in line with guidance.
We observed visitors were supported with screening, testing and following the government's guidance on hand sanitising and wearing personal protective equipment (PPE) before entering the home.
The provider was working closely with the GP, health care professionals, the Clinical Commissioning Group (CCG), the Local Authority Commissioning Team and Public Health England throughout the pandemic. The registered manager and clinical lead commented on how supportive the local authority, health professionals and the local public health team had been during the pandemic.
The provider had a COVID-19 specific policy, risk assessments and contingency plans in place to support staff. These were revised promptly, as government guidance changed, to ensure staff had up to date guidance throughout the COVID-19 pandemic.
There were enough staff to meet people's needs. Where required dedicated agency staff were block booked to ensure they only worked at The Sidcup Care Home. The provider carried out checks on agency staff to make sure they had received training on infection control and they had been fully vaccinated. Agency staff were required to take part in the staff testing regime. Staff worked only on specific units to reduce the risk of infection spreading.
The Sidcup Care Home is a residential care home providing personal and nursing care to 77 people at the time of the inspection. The service can support up to 100 people.
People received care across three floors, the top floor was for people who did not have nursing needs. The building was purpose built with communal lounge and dining areas and garden spaces.
People’s experience of using this service and what we found
People told us they felt safe. Staff took action to mitigate risks to people and records in this area were up to date. We received mixed feedback about the food and actions were underway to make changes to improve people’s experience of mealtimes. Staff had received training to carry out their roles, including training specific to people’s needs such as training in dementia care. People with clinical needs received support from nurses who stayed up to date with current practice. The service worked with healthcare professionals to ensure people’s health needs were met.
People’s medicines were administered as planned and care plans were personalised. Care was planned around people’s needs, preferences and diverse characteristics. People received personalised and dignified end of life care and there was a wide variety of activities which people said they enjoyed. People said they were able to choose their activities. People knew how to raise a complaint and any issues raised had been responded to.
People said they were supported by caring staff who cared for them in a way that respected their privacy. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported in a way that encouraged them to be independent.
There were robust systems in place to check and audit the quality of care delivery and people were given regular opportunities to provide feedback. Staff felt supported in their roles and there were systems in place to enable communication and seek staff suggestions. The service worked in partnership with organisations and the community in a way that impacted positively upon people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 18 January 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on the 12,13 and 15 November 2018 and was unannounced. At the last inspection on 14 and 15 April 2016 the service was rated good.
This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.
At this inspection we found a breach of the Regulations as people’s diverse rights in respect of sensory impairment, culture and spirituality were not always respected or supported. People’s communication needs were not always addressed. You can see what action we told the provider to take at the back of the full version of the report.
Improvements were needed in relation to end of life care planning and training as well as further training on dementia awareness. Some aspects of the complaints and quality monitoring system were not always effectively operated to ensure issues were robustly managed and any learning shared.
We have made two recommendations; one in relation to end of life care recommending that the service identifies and consults guidance from best practice on end of life care. Secondly, that the service look to best practice and research in relation to dementia friendly environments to respond better to the needs of some people at the service.
At this inspection there was an experienced registered manager in place. The previous registered manager had left the service in 2017. A new manager had joined the service in July 2018 after what staff described was a period of some instability. They received confirmation of their successful application to register during the inspection. 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. The new manager had applied to register as the registered manager, they were aware of their responsibilities and had submitted notifications as required. They understood the legal requirement to display their current CQC rating which we saw was on display at the home and on the provider’s website. We had positive feedback from all the staff about the new manager and the changes they had introduced
People told us they felt safe from harm and discrimination. Staff knew how to recognise abuse and the action to take if they were concerned about this. Risks to people were assessed and guidance provided to reduce risks. Accidents and incidents were monitored and action taken to reduce the likelihood of them reoccurring. Medicines were safely managed. There were safe staff recruitment practices in place and appropriate numbers of staff to meet people’s needs in a timely way. People were protected from the risk of infection and the environment was clean.
Staff received training, supervision and appraisals. 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 gave consent to the care and support they received. There were systems in place which ensured the service complied with the Mental Capacity Act 2005. This provides protection for people who do not have capacity to make decisions for themselves.
People’s physical, emotional and social needs were assessed before they moved into the home to ensure their needs could be met safely. People were supported to eat a healthy, well-balanced diet and people told us they enjoyed the meals on offer at the home. The service worked with health professionals to ensure people were supported to maintain their health.
People told us staff were kind and caring and their dignity was respected. People were involved in decisions about their daily care and support needs and their relatives were involved where this was required. People had an individualised plan for their care which was reviewed regularly. People’s needs for stimulation and social activity was recognised and addressed.
Some aspects of the quality monitoring system did work effectively to ensure improvements were identified and made. People and their relatives were mostly positive about the new manager and the leadership at the service. The service worked with the local authority and other agencies to ensure effective communication.
Resident and relatives’ annual surveys had been carried out. Regular staff and residents' meetings were held and feedback was sought from people. The service had a ‘You said we did’ board to inform people of changes made as a result of feedback.
The Sidcup Nursing and Residential Centre is a care home service with nursing for up to 100 older people with dementia, mental health needs, sensory impairment and physical disability. There were 98 people using the service at the time of our inspection.
We last carried out an unannounced inspection of this service on 9 and 10 December 2014, and found breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not take adequate steps to ensure that, at all times, there were sufficient numbers of suitably qualified staff to meet people’s needs. Staff were not supported through training, quarterly supervision and annual appraisal in line with the provider’s policy. The service did not assess, monitor or mitigate risks to people by regularly assessing and monitoring the quality of the services provided.
We asked the provider to make improvements in these areas. The registered manager sent us an action plan telling us how they would address these issues and when they would complete the action needed to remedy these concerns. They also sent us the progress report of the actions they had taken.
At this inspection we found that significant improvements had been made in all these areas. There were enough staff on duty to help support people safely in a timely manner. Staff were supported through training, quarterly supervision and annual appraisal. The service had an effective system and process to assess and monitor the quality of the care people received.
The service had a registered manager in post. 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.
Staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks. There was an effective system to manage accidents and incidents and to prevent them happening again. The service had arrangements to deal with emergencies. The service carried out comprehensive background checks of staff before they started working and there were enough staff to support to people. Staff supported people so that they took their medicines safely.
The service had taken action to ensure the requirements were followed for the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.
People or their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.
Staff prepared, reviewed, and updated care plans for every person. They completed end of life care plans for people where this was necessary. The care plans were person centred and reflected people’s current needs.
Staff supported people in a way, which was kind, caring, and respectful. Staff protected people’s privacy, dignity, and human rights.
The service recognised people’s need for stimulation and social interaction. The service had a clear policy and procedure about managing complaints. People knew how to complain and would do so if necessary.
The service sought the views of people who used the services, their relatives, and staff to improve the service. Staff felt supported by the registered manager. The service used audits to learn how to improve the service and what action to take.
This inspection took place on 09 and 10 December 2014 and was unannounced. At our previous inspection on 04 February 2014, we found the provider was meeting the regulations in relation to the outcomes we inspected.
The Sidcup Nursing and Residential Centre is registered to provide accommodation for up to 100 people who have nursing or personal care needs.
There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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. There was a new manager and a deputy manager in post at the time we visited.
There were 87 people using the service on the day of the inspection. Most of the people told us they were happy and well looked after. However, staffing arrangement were not adequate to meet people’s needs and to keep them safe at all times. We observed good relationships between staff and people at the service and with their relatives. Staff took time to interact with people in a meaningful way.
Some staff had not received a range of training appropriate to their roles and not had formal supervision in line with the provider’s policy.
The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) were designed to protect people who may not have the ability to make decisions for themselves due to mental capacity difficulties. The service was reviewing whether any applications needed to be made in response to the recent Supreme Court judgement in relation to DoLS and was in contact with the local authority about what action it should take. People’s capacity to give consent had been assessed in line with the Mental Capacity Act.
The provider had systems in place to ensure that people were protected from the risk of potential harm or abuse. We saw the home had policies and procedures in place to guide staff in relation to the Mental Capacity Act (2005) and DoLS, safeguarding and staff recruitment. Risk assessments were in place and reflected current risks for people at the service and ways to try and reduce those risks. Care plans were in place and being reviewed to ensure care provided was appropriate for people. Equipment at the service was well maintained and monitored and regular checks were undertaken to ensure the safety and suitability of the premises.
Staff knew people’s needs and preferences well and interacted positively with people. The service was managing people’s care safely. People and their relatives were supported sensitively in end of life care.
People’s nutritional needs were met. People had access to a range of health and social care professionals when required. There were deficiencies with the system for assessing and monitoring the quality of the service. Audits were not carried out regularly and for some areas where issues were identified, action plans had not always been recorded to evidence that action been taken to ensure people’s welfare and safety.
We found number of breaches of the Health and Social Care Act 2008 (Regulated Activity) regulations 2010 in relation to carrying out quality assurance checks, the training and supervision of care staff and maintaining adequate staffing levels at all time. You can see what action we took at the back of the full version of this report.
We found the provider compliant with outcomes 2, 4, 11 and 21 and not compliant with outcome 13.
Relatives and some of the people we spoke recalled being involved in the decision to come to the centre. Most people and relatives were familiar with people's care plans and told us they agreed with what was in them.
All the people we spoke with were complimentary about the staff. For example one person said; 'The staff are brilliant, better than I'd expected and dedicated to the job.' However, most people also said they had to wait too long for assistance sometimes, and that agency staff did not provide as a good a service as the centre's own staff. A relative we spoke with told us they had on occasion seen staff taking a long time to attend to people calling for assistance.
People said they felt safe at the home, although one person told us they would feel more confident if they could always have the same key worker.
One person who used the service told us; 'They want double the amount of equipment', and described to us the impact of having too few hoists on their unit.
Some of the people we spoke with said they felt able to, or had raised concerns with the home manager. One relative we spoke with told us managers were doing lots of checks and audits, but that they needed to walk the floor more in order to see what the care being provided was really like.
Staff said that they felt they were provided with all the training required to do their jobs. They appeared to have a good understanding about safeguarding-related issues.
Staff told us that they had a senior member of staff as a supervisor who they met with periodically.
Although we were told that staff meetings for each unit were held every three months, some staff we spoke to could not recall a unit meeting being held in the last three months.
Staff said that they felt that there were enough people on duty to provide the level of care required although due to the dependency levels of some of the residents they were sometimes stretched for time.
People said that they were comfortable raising issues directly with staff and always felt safe using the service.