28 July 2022
During an inspection looking at part of the service
Summerley Care Home is a residential care home providing personal care for up to 21 people. The service provides support to older adults with a range of care needs, including frailty of old age, dementia and learning disabilities. At the time of our inspection there were 19 people using the service.
People’s experience of using this service and what we found
People, staff and relatives told us there was not always enough staff to deliver person centred care. Most of the feedback we received from people and relatives expressed concerns about staff availability to support people with meaningful activity. Staff confirmed they felt pressured to rush when supporting people.
People's medicines were not always managed safely, records of medicines were not always available or were in a disordered state, this increased the risk of medicines not being managed safely. People's associated health risks were not always appropriately assessed and planned for when discharged from hospital with additional health needs.
People who were living with dementia did not always receive support in line with current guidance. Incident records had identified potential shortfalls in staff practice supporting people when they were distressed. Monitoring audits had not always identified concerns about incident management, staffing levels, medicines or health risks.
Staff were recruited safely and received supervision where opportunities to develop and feedback about their practice were discussed. Their comments included, “I can't fault the [registered managers] support they have supported me with training.”
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, their relatives and staff gave positive feedback about the leadership and management at the service. One relative said, “The registered manager is a credit you can see their passion they are treated like family.”
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
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 12 January 2022) and there were breaches of regulation. 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 the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced focussed inspection of this service on 15 October 2021 breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Summerley Care Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment, staffing and good governance at this inspection.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.