Shearwater is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 60 people some of whom live with dementia. Accommodation is arranged over three floors with stair and lift access to all areas. There was a good choice of communal spaces where people were able to socialise and all bedrooms had en-suite facilities. At the time of our inspection there were 34 people living at the home.
The inspection was conducted on 9 and 14 May 2018 and was unannounced.
At the time of the inspection there was not a registered manager in post at the service, there was a manager who had taken over the overall running of the service and was planning to apply to become registered to manage the home.
At our last inspection, in September 2017, we identified breaches of Regulation 12; Safe Care and Treatment, Regulation 18; Staffing, Regulation 17; Good Governance and Regulation 9; Person Centred Care, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This resulted in the service receiving an overall rating of 'Inadequate' and being placed in special measures.
At this inspection the service received an overall ‘Requires Improvement’ rating and was removed from special measures. We recorded one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the Need for Consent. You can see what action we told the provider to take at the back of the full version of this report.
Improvements had been made in the quality assurance processes within the home and we saw robust audits were completed for most areas. However, we found further work was still required in some areas including working within the principles of the MCA and ensuring that all medicine was managed safety.
We found that in the main improvements had been made that had resulted in people receiving safer, more effective, person centred care. A range of processes and procedures had been put in place and were followed to help ensure staff followed best practice guidance when providing care and support to people.
People told us that they received their medicines safety and on time. However, medicines were not always stored safety and where people were prescribed topical creams there was not clear and robust systems in place to ensure these were given appropriately.
Risks to people were assessed and managed effectively. Staff were provided with clear guidance on how risks should be managed and demonstrated an understanding of specific risks to people.
Where accidents and incidents had occurred, these were clearly logged, reviewed and analysed to see if there were any common themes and if there could be any learning from these events.
There was enough staff deployed to meet people’s needs and keep them safe. The staffing level in the home provided an opportunity for staff to interact with the people they were supporting in a relaxed and unhurried manner.
Staff had the knowledge and confidence to identify safeguarding concerns and acted to keep people safe. Staff had received training in safeguarding, which helped them to identify, report and prevent abuse.
Appropriate recruitment procedures were in place to help ensure only suitable staff were employed. People's needs were met by staff who were competent, trained and supported appropriately in their role.
People were supported to have enough to eat and drink and had access to health professionals and other specialists if they needed them. Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.
Staff showed care, compassion and respect to the people. There was a relaxed and calm atmosphere within the home. People were cared for with dignity and respect and their privacy was respected.
People were encouraged to be independent and the staff supported people to meet there cultural and spiritual needs.
The service was responsive to people's needs. Care files were person centred and contained consistent and relevant information about people. Staff demonstrated that they know people well, understood their needs and had knowledge of their likes and dislikes.
People had access to a range of varied activities they enjoyed. People were listened to by staff and their views and wishes were respected.
People, their families and staff had the opportunity to become involved in developing the service.
There was an open and transparent culture within the home and people and families confirmed they felt able to approach the manager at any time.