Saffron House

Updated 27 January 2024

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

This inspection was carried out by 2 inspectors and an 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

Saffron 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. Saffron 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 reviewed information we held about the service and spoke with local authority commissioners, responsible for funding care for some of the people using the service. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people and observed support and interactions between people and staff in communal areas. We also spoke with 7 relatives who were able to share their views about the service. We met with 8 staff including the deputy manager, operations manager, housekeeper, maintenance and care staff. We reviewed care plans and records for 5 people and reviewed a sample of medicine records. We also reviewed 3 staff recruitment files, staff training records and other documentation relating to the day to day management of the service, including quality assurance.

Updated 27 January 2024

About the service

Saffron House is a care home supporting people across two floors of accommodation. The service is registered to provide care and accommodation for up to 48 younger and older people, people with physical disabilities and people living with dementia. At the time of our inspection there were 29 people using the service.

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

Staff did not consistently follow the provider's procedures for the safe storage, return and disposal of medicines. People's medicine records did not always evidence people had received their topical medicines as prescribed. People's care plans did not include robust guidance and information as to how staff should support a person when they became distressed. Risks around people's distress were not well managed as staff lacked the skills and knowledge to support people safely and effectively.

Systems and processes to ensure good oversight of the service were not being used effectively by the registered manager. Improvements driven by the provider had not been fully embedded in staff working practices. There was insufficient oversight and monitoring of staff to ensure people always received safe care.

Although some improvements had been made around the assessment of people's mental capacity, further improvements were required. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not consistently support this practice.

The provider had made significant improvements to the environment to ensure people were protected from the risk of infections and some improvements were still in progress at the time of our inspection. However, we found improvements were still required around staff awareness of the risk of cross infection.

Most staff felt supported within their roles and told us they received regular supervision and meetings. Staff were recruited safely. Relatives did not always have confidence that staff received the clear direction and guidance they needed from the management of the service.

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 inadequate (published 1 August 2023) 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 6 June 2023. 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 safe care and treatment. safeguarding, consent and good governance.

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 inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Saffron House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the assessment and mitigation of people's risks and medicines, safeguarding people and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Special Measures

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.