This inspection took place on 29 May and 04 June and was an unannounced inspection. At our last inspection in January 2014 no concerns were identified.
Stoke Knoll is a care home which provides accommodation and care for 25 older people, some of whom were living with dementia. At the time of our inspection they were fully occupied and held a waiting list for people who had requested to move into the home.
There is 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.
The provider had policies in place to provide guidance for staff in most topics. Whilst these had been reviewed recently, we found not all of the policies were amended to reflect legislation and care Practices. For example the provider’s safeguarding policy did not refer to the local authority’s latest safeguarding policy. There were no updates to the policies on the Mental Capacity Act or Deprivation of Liberties Safeguards.
People and their relatives felt safe with the support provided by staff in Stoke Knoll. Staff were aware of the local authority and provider’s safeguarding policies and guidance. They knew how to identify concerns and were aware of who they should report these to within the home and to external agencies. Recruitment processes helped ensure staff were suitable to work with older persons. There were sufficient numbers of staff to meet the needs of the people in the home.
People were supported to take their medicines safely by staff who had been trained to administer them appropriately. Staff were tested on their knowledge of the medicines they were giving and were observed by the registered manager for their competency in administering medicines. Storage and security of medicines was as stated in the provider’s policy. Appropriate actions and learning had occurred from a medicine error.
Staff received appropriate training to support the care they provided. There was an induction process in place for new staff which provided them with the necessary knowledge to support people in the home. Supervisions for staff occurred regularly and identified good practice and development needs for staff.
People’s needs were assessed and their care plans reflected the needs identified in the assessment. Where there were risks associated with care required, these had been assessed and measures were put in place to remove or minimise the potential risk of harm to people.
Staff and the registered manager worked in a personalised way and were aware of people’s individual likes, dislikes, histories and personal preferences. They found time to engage people in conversations and joined in activities with them. Staff treated people with dignity and respect and we heard terms such as ‘treated like one of the family’ and ‘this is their home.’
People were happy with the quality of the food and were able to request changes to the menu and options for their meals. Where people required it, food and fluid intakes were monitored and they were weighed regularly. Health support from GPs and other health care professionals was available and the registered manager worked closely with the local doctor’s surgeries to ensure people’s health needs were met.
People and their relatives had a good relationship with staff. There was a relaxed and friendly atmosphere in the home and people. People were happy with the care they received from staff. They were supported to express their views regularly by talking with staff and regular reviews of their care plans. People’s privacy and dignity was respected by staff who knew how people liked to be spoken to and were informed of how care was to be given.
The provider had a complaints policy which was accessible for people in the home. Complaints and concerns had been recorded and there were actions identified to alter aspects of care and the service following these. The provider acted within their policy in responding to a complaint and ensured a resolution to the complaint was to the person’s satisfaction.
The registered manager and provider were known to all people, relatives and staff. They were approachable and engaged in aspects of care which maintained their knowledge and understanding of people’s needs. They were aware of current trends and legislation changes within older person’s care and had taken action to adapt the environment to support people’s needs.