Care service description

Stroud House is a residential care home which provides accommodation and care for up to 25 older people, who may also be living with dementia. The home is in a rural location near Petersfield. There is access to gardens. At the time of this inspection there were 22 people living at the home.

Rating at last inspection

At the last inspection, the service was rated good.

Rating at this inspection

At this inspection we found the service remained good.

Why the service is rated good

People were kept safe because arrangements were in place to protect them from risks to their health and welfare, including the risks of abuse. Arrangements were in place to manage medicines and comply with guidelines relating to the prevention and control of infection.

Staff received training and supervision to maintain and develop their skills and knowledge to support people according to their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to maintain their health and welfare.

Staff had developed caring relationships with people they supported. People were encouraged to take part in decisions about their care and support and their views were listened to.

Care and support were based on assessments and plans which took into account people's abilities, needs and preferences. People were able to take part in leisure activities which reflected their interests. The service was responsive to people’s concerns and ideas.

There was a warm, friendly and home-like atmosphere. Formal and informal systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided. The provider worked in cooperation with other agencies, and had an improvement plan to sustain the quality of care provided.

Further information is in the detailed findings below

At the time of our visit there were 22 people using the service. We spoke to three people who used the service, two relatives, two staff and the registered manager.

Each person we spoke to told us that they were satisfied with the service provided by the home. People told us they were happy and that they were supported by staff to receive the care they needed.

One person told us “the staff are very good and give you help when you need it.” Relatives we spoke with told us that staff knew people’s needs well and tried to maintain their independence.

We found that the environment was comfortable, arranged to meet people's needs and well maintained.

We found that people were supported by staff that were suitably qualified, skilled and experienced because appropriate checks were undertaken before they commenced work.

We found that the home regularly asked people for their views of the home and developed action plans based on this feedback to make improvements.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by 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 service.

Some people were unable to tell us about their experiences due to their medical conditions. To help us to understand the experiences of people, we used a Short Observational Framework Inspection tool (SOFI), which is a specific way of observing care to help us understand the experience of people who could not talk to us.

On the day of our inspection there were 17 people living at Stroud House.

People who lived at Stroud House told us they were happy living at the home and that they were able make their own choices about their daily lives. We were told about how staff at the home supported people to maintain as much independence as possible. One person living at the home told us “I have a bath three times a week. The carer sees me into the bath; they very much try to keep me independent. I am allowed to bathe and then a carer helps me back to my room, nothing is too much trouble. I could probably have a bath more often if I wished”.

We saw that people who lived at the home were encouraged and supported to maintain skills that they had acquired during their working life This included for one person asking people what they wanted for supper. This person told us “I used to work in an office so I am quite happy to fill in this menu”.

People told us that they enjoyed the meals provided by Stroud House. But for the two people who lived at the home who chose to have a vegetarian diet there was no choice of menu for them at lunch times, but they believed that the management of the home was addressing this issue. They told us that we: “don’t get a choice of meals at lunch times, but the cook in evening is much better. Apparently a new cook for lunchtime is arriving shortly and we are hoping the food for us at lunch time will be better”. However they were always provided with a vegetarian meal.

People knew who to address any concerns or complaints to. One person told us “I have never had to complain, but I would tell the manager if anything happened and I would complain if I saw someone being badly treated”. A second person told us “I feel perfectly safe here. If I needed to complain I would tell the senior carer. If I saw something I did not like happening to some one else in the home I would complain for them as well”.

The inspection took place on 13 and 14 May 2015 and was unannounced.

Stroud House provides accommodation and care for up to 25 older people, some of whom may also be living with dementia. The home is in a rural location, near Petersfield. There is access to gardens.

Stroud House has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 said they felt safe. Staff had received safeguarding training and were able to explain how to protect people from abuse and how to report suspected abuse.

People’s individual risks were appropriately assessed and care plans were in plan to mitigate against known risks. The service used good communication methods to ensure that staff were knowledgeable about risks to people and what actions needed to be taken to keep people safe.

There were sufficient staff on duty. People’s needs were met whether they were in communal areas or being cared for in bed.

Staff recruitment and induction practices were safe. Relevant checks were carried out to ensure that suitable staff were recruited.

Medicines were stored and administered safely. Records in relation to medicines were accurate and staff had received training in medicines administration, and had their competency checked regularly.

Staff had received appropriate training to meet people’s needs. Records showed that staff had received training in key areas such as infection control, fire training, moving and handling, food hygiene and health and safety. Staff were supported to study for health and social care vocational qualifications. Staff told us they felt supported in their role.

Staff were knowledgeable about people’s needs and how to support them. Staff said they knew about people’s needs from handovers, care plans, risk assessments, people themselves and their families. We saw that staff interacted with people appropriately and kindly, appearing to know them well as individuals, and treating them accordingly.

People were asked for their consent before care or treatment was provided and the provider acted in accordance with the Mental Capacity Act 2005 (MCA). People made their own decisions where they had the capacity to do this, and their decision was respected.

People were supported to have sufficient to eat and drink and maintain a balanced diet. Drinks were readily available throughout the day and staff encouraged people to drink. For lunch a main meal was offered, with a second choice and a vegetarian option. The chef was knowledgeable about people’s individual requirements such as those people who required a pureed diet, a soft diet or a diabetic diet. We saw that staff maintained a presence in the dining room during lunch, checking that everyone was managing and offering support if needed.

People were supported to maintain good health through access to ongoing health support. Records showed that district nurses, speech and language therapists and the community psychiatric team had been involved in people’s care and referrals were made where appropriate.

Staff were kind and patient with people, using gentle persuasion and encouragement to support them. They took time to listen to people and understand how they were feeling. People’s dignity was respected, staff took time to make sure that little things which were important to people were respected. For example staff checked that hairbrushes were kept clean and people’s clothes were named. Staff had an understanding of people’s abilities and supported independence as much as possible.

People were involved in decisions about their care and were offered choices in all aspects of their daily life. Where they had capacity, people had signed their care plans showing that they agreed with the plan of care.

Staff were able to respond appropriately to people’s needs because they knew them well and understood their care needs. Staff had taken the trouble to get to know people personally so they could respond to their preferences, likes and dislikes providing personalised care. Care plans were reviewed monthly and updated where necessary to ensure that staff were always aware of people’s needs.

The home had been recently renovated and people appreciated and commented on the new décor. A wall had been knocked down to create a large living space which suited people’s needs more effectively. The provider had responded to the need to improve the environment within the home and this had had a positive outcome.

People were able to engage in different activities, such as scrabble, bingo or arts and crafts. Harp therapy was available for people as a soothing activity.

The provider had a complaints procedure which detailed how complaints should be dealt with. There were a small number of complaints and all had been dealt with appropriately.

The atmosphere in the home was friendly and easy going. The registered manager was passionate about the home and keen to make improvements. There was a family feeling amongst staff who were united and keen to ensure people were happy and well cared for. Staff felt valued and involved in decision-making and this reflected in the care delivered.

Feedback was sought regularly from people, staff and relatives and was responded to, ensuring continuous improvement to the home.

The registered manager demonstrated good management and leadership. She ensured she was visible ‘on the floor’ on a daily basis. People knew and trusted her.

Policies and management arrangements meant there was a clear structure within the home which ensured the service was effectively run and closely monitored.

The quality of the service was closely monitored through a series of audits of care plans, the kitchen, infection control, health and safety, falls and medicines.