• Care Home
  • Care home

Archived: Sister Dora Nursing Home

Overall: Requires improvement read more about inspection ratings

Brocton Road, Milford, Stafford, Staffordshire, ST17 0UH (01785) 661024

Provided and run by:
Leyton Healthcare (No 8) Limited

Important: The provider of this service changed. See new profile

All Inspections

10 December 2014

During a routine inspection

This inspection took place on the 10 December 2014 and was unannounced.

At our previous inspection in June 2014 we found the provider did not keep protect people from the risks associated with the unsafe management of medicines. People’s care and welfare needs were not always met. The provider’s quality monitoring systems were not effective and staff were not supported to fulfil their roles. Due to the seriousness of the issues relating to the safe management of medicines we issued the provider with a warning notice. We conducted a follow up inspection in August 2014 to look to see if improvements had been made in this area and found that although some improvement had been made the provider was still not managing people’s medicines safely.

Sister Dora provides accommodation and nursing or personal care for up to 47 people. At the time of the inspection 34 people were using the service.

The home has a registered manager although they had been absent from the service since May 2014 and the deputy manager was acting as the manager in the interim. 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.

At this inspection we found that the provider continued to not ensure that people’s medicines were managed safely. Medicine were not administered safely and people were at risk of receiving medicines that were out of date.

The provider was not following the principles of the Mental Capacity Act 2005 and The Deprivation of Liberty Safeguards. The Deprivation of Liberty Safeguards are for people who cannot make a decision about the way they are being treated or cared for in a hospital or care home, where other people are having to make this decision for them. Not all people had not been involved in the decision making about their own care, treatment and support. We raised a safeguarding referral with the local authority for one person who may have been restricted of their liberty.

People told us and we saw that people who used the service were treated with dignity and respect and their privacy was ensured at all times. Activities were on offer dependent on people’s individual preferences.

Staffing levels were sufficient to meet the needs of people who used the service. People did not have to wait to have their care needs met.

Staff had received a period of induction and training to become competent in their role.

People received health and social care support when they needed it. When people’s needs changed or they became unwell the relevant professional advice was gained in a timely manner.

People who used the service and their relatives were kept informed and involved in the running of the home. There was a complaints procedure and we saw that formal complaints had been managed appropriately.

4 August 2014

During an inspection looking at part of the service

We visited Sister Dora Nursing Home on a responsive inspection to check compliance with the warning notice issued in June 2014. The warning notice was in relation to the management of medicines when we found concerns at the inspection. This inspection was unannounced which meant that the service did not know we were coming.

Below is a summary of our finding based on our observations, speaking to people who used the service, the staff supporting them and from looking at care and medication records. We considered our inspection findings to answer the questions we always ask '

Is the service safe?

Improvements have been made to certain aspects of the management of medicines. Record keeping in this area has improved.

We saw that there were still areas of concern with the use of some prescribed medication, the safe storage arrangements and out of date medication. We have asked the provider to tell us how they are going to improve their service in relation to medication

practices.

Is the service responsive?

People who used the service have benefited from a medication review. Amendments have been made to their prescribed treatments and some treatments have been discontinued.

Is the service caring?

One person told us told us they had their medication on time and creams applied when they were supported with personal care. They said: 'I am very comfortable and they [the carers] are very caring'.

Is the service effective?

Information is available for the use of occasional medicines, so that people can have medication such as pain relief when they require it. Further information would be beneficial to support the administration of these occasional medicines for people who have limited verbal communication.

Is the service well led?

Staff have received training and updates in medication management. However they now need to put the theory into practice with regard to the safe storage and disposal of medication.

3 June 2014

During a routine inspection

We visited Sister Dora Nursing Home on a planned unannounced inspection which meant that the service did not know we were coming.

Below is a summary of our finding based on our observations, speaking to people who used the service and visitors, the staff supporting them and from looking at records. We considered our inspection findings to answer the questions we always ask:

Is the service safe?

Some people cannot make decisions because of frailty or ill health. Professionals and relatives were involved in taking and making decisions to ensure they were in the person's best interests.

The service places people at risk because of unsafe handling of medication, so people do not always receive their medicines as prescribed and intended. We have asked the provider to tell us how they are going to improve their care in relation to medication practices.

Is the service responsive?

We saw staff were available in areas throughout the home; they supported people in an appropriate way. Some people who used the service told us there were times that they had to wait for support when they requested help.

Staff were aware of people's needs but did not always respond in a timely way. For example, there were delays in making referrals to other health and social care professionals. Staff tell us that some delays were caused by time and workload constraints. We have asked the provider to tell us how they are going to deal with this.

Is the service caring?

Most people who used the service told us that the staff were good and they were satisfied with the care and support provided.

Visitors told us that they were satisfied with the care provided to their relative.

Is the service effective?

A visiting health care professional told us that improvements had been made recently with referrals for their service being appropriate and that staff had a better understanding of mental health issues and behaviours.

Care records identify people's needs, choices and preferences but some were not reviewed or updated on a regular basis or when a change was identified. We have asked the provider to tell us how they are going to improve the recording and reviewing of people's care needs.

Is the service well led?

The service had systems in place to review the quality and safety of the service. These were not always completed when they were required to be. We have asked the provider to tell us how they are going to improve the quality of the monitoring of the service.

The manager of the service is currently away from the service. The Deputy Care Home Manager is currently acting up in the absence of the Care Home Manager.

Improvements were needed to ensure that records were accurately completed, maintained and provided the necessary information to meet the needs of people who used the service.

15 October 2013

During an inspection looking at part of the service

We visited Sister Dora's Nursing Home on a planned unannounced inspection to follow up on the improvements that were needed following out previous inspection.

We spoke with or observed everyone that lived at the home. We spoke with managers and the majority of staff at the service.

People we spoke with were happy with the care they received. One person said: "I like it here. The staff are very kind and do what they can to help me". Relatives we spoke with were pleased with the care provided.

Some people were unable to speak with us either because of frailty or personal preference. We saw that staff were available to help and support people when assistance was needed.

Staff gave a detailed account of the specific individual needs of people. We looked at the care records for four people who used the service and found that the recorded information was up to date and corresponded with what staff had told us.

We spoke with a visiting healthcare professional. They told us that at the time of this inspection they had no concerns with the care provided to people.

Staffing levels had improved since our last inspection. A member of staff told us they were still very busy but now had additional time to attend to their tasks, provide the care that people needed and did not feel so rushed.

We saw that improvements had been made to records and the documentation required, ensuring that people received the support they required in a consistent and effective way.

11 July 2013

During a routine inspection

We visited Sister Dora's Nursing Home on a planned unannounced inspection to follow up the improvements that were needed.

We spoke with the majority of the people who used the service. We spent time in the lounge and dining areas and observed the interaction between people and staff. One person told us: "The staff are very nice, they look after me and they wash and dress me".

Some people were unable to speak with us because of ill health or frailty, but they smiled and nodded when we asked about their welfare.

We spoke with staff about the care and support they provided each day. They gave a detailed account of the specific individual needs of people. We saw staff supported people in a caring and helpful way.

A relative we spoke with had some concerns that there were not enough staff and about the lack of mental stimulation. They said: "My relative is very happy here and cared for well physically but there is nothing to stimulate him mentally, he just seems to sit all day with nothing to do".

We observed that some people had to wait for support because staff were not available. People we spoke with told us about the shortage of staff.

Records that were required to be kept to protect the safety and well-being of people were missing, incomplete, lacking information and guidance.

26 February 2013

During an inspection looking at part of the service

At the time of this inspection 40 people used the service. Nineteen people required nursing care. We spoke with 17 people and three visitors who were able to tell us about their experiences. We spoke with all grades and disciplines of staff. Some people were unable to speak with us, so we spent time in the communal area and observed the activity and interactions between people and staff.

We looked at the care planning documentation of six people to see how their care was provided and managed. We talked with staff who were aware of and able to discuss people's care needs. The information recorded in four of the plans did not accurately correspond with what staff had told us. Some records were incomplete and did not give information of people's assessed care and support needs.

People told us that they enjoyed the food that was provided. One person who used the service told us, "I like the food, plenty of choice. Nice meals. Good breakfast, all I could wish for. Food seems to have got better recently and is better than the previous home I was in".

Staff told us their understanding of safeguarding vulnerable people and confirmed they had received training in this.

People told us the staff were friendly, helpful and supportive. Visitors told us that the staff were kind and caring. One person told us, "Staff work very hard but there are just not enough of them".

16 October 2012

During a routine inspection

Some people told us they and/or their family were involved in the planning of their care. Some people were unable to be fully involved but staff had received training in how to assess care when people do not have the capacity to make decisions for themselves. As yet this training has not been put into practice.

Some people had their care needs fully met others did not. One person told us " I like living here, the staff are very good to me and all the other people. They try their best and nothing is too much trouble. It's marvellous, there is no other place like it".

We saw some very frail people who were fully dependent on staff to help them with everyday life.

Some people told us the food provided is lovely and they could have alternatives to the menu if they wished to do so. We were unable to determine if the dietary requirements for some frail people was sufficient for their needs as this information was lacking on the monitoring documents. Some staff were unsure of some dietary requirements of some people.

People who used the service told us they would speak with the staff or their family member if they had any concerns. Staff told us they were aware of the procedures to report any concerns they may have. We saw some omissions in staff working practices that have the potential for placing people at risk of harm.

Some records were incomplete and did not give information of people's assessed care needs.

11 April 2012

During a routine inspection

We spent time during this inspection talking to people about their care, treatment and support. They told us the felt respected by the staff who support them.

We looked at care records and spoke with staff who showed us they understood the care needs of the people who used the service.

We saw the home had appropriate arrangements in place to protect people who used the service from abuse.

There were systems in place to monitor the quality of the service provision. People who used the service were involved in this process.