About the service:

Stonecross Care Centre is a residential care home that provides accommodation and personal care for up to 32 older people, some of whom are living with dementia. At the time of this inspection there were 28 people living there. The home is a period property that has been suitably extended and adapted for it’s purpose and there is a large secure garden.

People’s experience of using this service:

There were sufficient numbers of suitably qualified staff to meet people’s needs in a timely manner. People and their relatives told us there were always enough staff available to assist them. One person told us, “There’s plenty of staff about and they come when you need them to.” Staff had completed training that enabled them to deliver good care and support to people effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Medicines were stored and managed safely and people received their medicines as they had been prescribed.

People’s privacy and dignity was respected. One person told us, “If I don’t want to go downstairs, staff pop up and check if I need anything.” We saw kind and caring interactions taking place. We were told, “The staff are very nice, very helpful, good mannered and very polite.”

There was a varied and individualised activity programme in place that ensured people lived a fulfilled life of their choosing. The service has strong community links including hosting a regular mother and toddlers’ group.

There was a particularly strong emphasis on continuous development and improvement of the service with staff gaining additional qualifications and the implementation of electronic care records.

A variety of audits were in place that demonstrated the service was monitored and safe for people to live in. Feedback about the service was consistently good especially from health professionals we spoke with. One health professional said, “They [staff] work exceptionally hard with people they have referred to us. They follow our instructions and it shows in that those people no longer require our service.”

Rating at last inspection:

At the last inspection the service was rated good (published October 2018).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received we may inspect sooner.

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

This comprehensive inspection took place on 24 August 2016 and was unannounced. We last inspected Stonecross Care Centre on 3 and 11December 2015. At that inspection we found two breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 and a breach of Regulation 18 of the Care Quality Commission (CQC) (Registration) Regulations 2009. At this inspection we found that the provider had complied with the requirement notices in relation to those breaches.

Stonecross Care Centre is a residential care home that provides personal care and accommodation for up to a total of 32 people. Accommodation can be provided over three floors and there is a lift to access each level. The home is located close to the town centre of Kendal. There is a large accessible outdoor area which is well furnished for people who wish to spend time outside. There is a raised bed gardening area that was being developed by people who live at the home and ample car parking space. There were a variety of communal areas available throughout the home and these were well equipped with items of interest to the people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the (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. On the day of the inspection visit the registered manager was on annual leave and the home was being overseen by the deputy manager.

When employing fit and proper persons the recruitment procedures of the provider were not always followed.

We made a recommendation that the provider follows their own policy and procedures when employing people to ensure that all the checks of suitability made were robust.

Medicines were being administered and recorded appropriately and were being kept safely.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety.

Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities and we could see records of the actions taken by the home to protect people.

People’s rights were protected. The management team was knowledgeable about their responsibilities under the Mental Capacity Act 2005. People were only deprived of their liberty if this had been authorised by the appropriate body and was required to maintain their safety and welfare.

Staff had completed training that enabled them to improve their knowledge in order to deliver care and support safely.

People were supported to maintain good health and appropriate referrals to other healthcare professionals were made.

There was a clear management structure in place and staff were happy with the level of support they received.

People living in the home were supported to access meaningful and individually tailored activities and pass times of their choice.

More formal audits and quality monitoring systems had been implemented to allow the service to demonstrate effectively the safety and quality of the home.

This unannounced inspection took place on 3 and 11 December 2015. This was the first inspection since the home was registered in August 2015.

There was a registered manager in post. A registered manager is a person who has registered with the (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.

During this inspection we found breaches of Regulation 12 Safe care and treatment and of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that some of the incidents should have been reported to us (CQC) but the provider had not done so. This is a breach of Regulation18 of the Care Quality Commission (Registration) Regulations 2009. The failure to notify us of matters of concern as outlined in the registration regulations is a breach of the provider's condition of registration and this matter is being dealt with outside of the inspection process.

Stonecross Care Centre is a residential care home that provides personal care and accommodation for up to 32 people. Accommodation is provided over three floors and there is a lift to access each level. The home is located close to the town centre of Kendal. There is a secure garden that was being developed at the time of the inspection for people living there to use and some car parking.

There were sufficient numbers of suitable staff to meet people's needs and promote people's safety. The level of staffing observed on the day of the inspection ensured that people had their needs met in a timely manner.

Medications and the management of them was not always done in a safe manner.

People living in the home and relatives spoke highly of the staff and were happy with their care and support.

Staff displayed a caring and interactive approach with people and they were treated with respect. People dignity and privacy were promoted.

Some staff had commenced working without all of the required training skills to meet peoples needs safely. We recommended that the induction training was delivered in line with the company’s training policy and procedures. We also recommended that further training on the requirements relating to the MCA and DoLs is provided.

Assessments made prior to people being admitted to the home lacked vital information about peoples individual care needs.

Care plans and risk assessments made were not always accurate about the needs of people’s health and support that they required.

People were supported with their nutritional needs but where someone had significant weight loss referrals to healthcare professionals were not always made.

People were given opportunities to be involved in hobbies and interests that were important to them.

The provider had a complaints procedure available for people who used the service. People who used the service and their families felt able to raise any concerns they might have with the registered provider, registered manager or any other staff members.

‘You can see what action we told the provider to take at the back of the full version of the report.’