Stuart House

Updated 18 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Stuart House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Stuart House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave 24 hours’ notice of the initial inspection. Our second visit was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the provider had registered with us. We also sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We carried out a visual inspection of the building and we spoke to four people. We looked at care plans for six people. We reviewed various paperwork relating to the health and safety of the building and staff recruitment. We used technology and electronic file sharing to enable us to review documentation off site. We spoke with eight members of staff during the inspection, including with the nominated individual, registered manager, carers and seniors. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with three professionals who had recently visited the service. An Expert by Experience spoke with ten relatives.

After the inspection

We continued to liaise with the provider to discuss our findings and to gain reassurances on aspects of the inspection.

Updated 18 June 2022

About the service

Stuart House is a residential care home providing accommodation and personal care for to up to 19 people. The service provides support to adults living with dementia. At the time of our inspection there were 16 people using the service. The care home is made up of three Victorian houses which have been adapted to make one premise.

People’s experience of using this service and what we found

This was the first inspection under the new provider. The provider had identified various elements of the service which needed improving and had an action plan to monitor improvements. Although the provider had identified some concerns in relation to documentation and the safe management of medicines before our inspection, these processes were not yet firmly embedded. We could not be assured medicines were always being managed safely and people were receiving these as prescribed.

Records to support people to receive the correct care and support were being developed and monitored to ensure the correct information was recorded and regularly reviewed and updated. However, processes had not been consistently implemented and embedded; documentation was not always accurate and complete, and we could not always be assured people received safe care and treatment. Auditing systems had been implemented into the home, but these needed further work. We have made a recommendation about this.

During the inspection we identified some concerns in regard to risk management. The provider took immediate action to address this. We have made a recommendation regarding the management of risk.

We noted some areas of the environment were not always suitably maintained to ensure effective cleaning. The provider had already identified these concerns and had developed an action plan to address this. Decoration and refurbishment had started in the home, to improve the environment.

People, their relatives and staff told us the new provider was making positive changes at the service. Positive outcomes had been achieved for people in a short space of time. People were referred to external services and healthcare as required.

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.

Staff were kind, caring and knew how people preferred to be cared for. People and their relatives were involved in their care and treated people with compassion and respect. The provider and registered manager prompted a person centred, open culture which was driving improvements of the service. People who lived at the home were happy and felt safe. Relatives said they would recommend the home to others.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 27 January 2022 and this is the first inspection. The last rating for the service under the previous provider was good, published on 04 December 2017.

Why we inspected

We undertook a targeted inspection to look at infection prevention and control measures following an outbreak. When we inspected, we needed further reassurances around infection control, so we widened the scope of the inspection to become a comprehensive inspection looking at all the key questions.

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 and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

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 a breach in relation to the safe management of medicines and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.