This inspection took place on the 17, 20 and 21 June 2016 and was unannounced. Sutton Manor Care Home provides nursing and personal care for up to 38 older people including those who have a sensory impairment or physical disability. At the time of our inspection there were 30 people living in the home. The home is located is Sutton Scotney on the outskirts of Winchester and is situated within private parklands and gardens. People were accommodated in single rooms or suites with en suite facilities. Communal areas included; a drawing room, library and dining room.
The home has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People told us they felt safe with staff and the staff we spoke with demonstrated their understanding of how to safeguard people and report their concerns. People were protected from the risk of abuse.
People had risk assessments in place that detailed their individual areas of risk and how these should be managed to keep people safe. Risk management plans were not always evident for people who were assessed as at risk of falls. Falls were not routinely monitored to identify any developing trends so that remedial actions could be identified. Accident and incident reports did not always identify the actions to be taken to prevent a reoccurrence. This meant the system in use to review, manage and monitor the risks to people from falls was not consistently applied and could leave people at risk from recurring falls.
There were processes in place for the safe ordering, storage and disposal of medicines and medicines were administered to people by trained staff. It was not evident that reviews had taken place to evaluate the safe regular use of medicines that were prescribed to be taken ‘as required’. We found some unexplained gaps in the recording of people’s medicines. The registered manager took action to address these issues following our inspection.
There were sufficient levels of suitably skilled staff available to meet people’s needs. Agency staff were checked for their suitability to work with people and as far as possible the same agency staff were used to provide a continuity of care for people.
Staff completed an induction into their role to ensure they were competent to carry out their responsibilities. Staff were supported by the registered manager, group trainer and senior staff through a range of training courses, regular supervision and annual appraisal to develop the skills and knowledge they needed to meet people’s needs. Records showed staff had completed most of the provider’s mandatory training and were supported with their continuing and professional development.
The registered manager had identified a number of people who they believed were being deprived of their liberty and had made applications to the supervisory body for authorisation. Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and people’s consent was sought prior to care and treatment being provided. People rights under the MCA were upheld.
People were offered choice by staff regarding the support they required and where people had made decisions, these were respected by staff. Staff were knowledgeable about people’s preferences and acted to ensure these were met.
People were supported with their nutrition and hydration needs and where people required assistance with eating and drinking this was provided. People told us and we observed the food was good quality and people were offered choice to meet their dietary needs and preferences.
People’s healthcare needs were attended to promptly and people were seen by a range of healthcare professionals as required.
People and their relatives spoke positively about the caring approach of staff and told us staff were caring, compassionate and thoughtful in their approach. Staff completed training in dignity and respect and we observed that staff treated people with dignity and respect. People’s decisions for their end of life care were known and respected.
People’s care plans were person-centred and included their preferences for how their care should be delivered. Care plans were regularly reviewed and updated with people’s changing needs to ensure they remained current and appropriate.
A range of activities was available for people to participate in if they chose to do so and people told us they enjoyed these. This included group and one to one activities if preferred.
A system was in place for people to raise their complaints and concerns and these were acted on quickly and appropriately.
Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home. This included feedback from people, their relatives and staff. Actions identified as a result of quality monitoring were taken to drive continuous improvement.
There was a positive culture in the home and staff were aware of and acted in accordance with the provider’s values to provide high quality care. Staff and people spoke positively about the management and leadership in the home and staff were supported to be clear about their roles and responsibilities through supervision, training and team meetings.