Simonsfield Care Home

The registered manager promoted an open and transparent culture where people, staff and others felt confident to raise safety concerns and report incidents. Concerns and incidents were thoroughly investigated, and learning was shared across the staff team to support continuous improvement and help keep people safe.

Safeguarding concerns were appropriately referred to the local authority and notified to Care Quality Commission (CQC). Although staff knew how to keep people safe, staff had limited understanding regarding how to identify certain forms of abuse, Further training was needed to improve staff understanding of safeguarding and what it means in the context of their roles and responsibilities.

Risk assessments for people were person centred, and staff used people’s histories and preferences to plan activities.

A system was in place to manage maintenance tasks, and staff were able to report concerns promptly. Some areas of the service required refurbishment due to the age and to better meet the needs of people living with dementia, including flooring in some people’s bedrooms. The registered manager had raised these issues with the provider, and plans were in place to carry out the necessary improvements.

Staffing levels were monitored by the registered manager, who regularly reviewed people's care needs. However, some people told us they felt additional staff were needed, as they sometimes experienced delays in receiving support when required. We raised this with the registered manager and regional manager, who assured us that a new process was being implemented to ensure staffing levels are regularly monitored and reviewed to meet people's needs.

People’s medicines were not always managed safely, and some people did not receive their medicines as prescribed. We found time critical medicines were not always administered at the correct times. However, staff followed appropriate procedures for the management of controlled drugs, including secure storage, accurate record-keeping and regular checks. Following the inspection, the provider gave assurances action would be taken to address these concerns and had sought support from relevant healthcare professionals to improve practice.

People’s needs were assessed and reviewed effectively using person-centred information and regular updates to ensure care reflected their current health, wellbeing and preferences. Some relatives told us they were involved in decisions about care and support where appropriate. One relative told us, “They [staff] call us and let us know if there are any changes to [Name]. We discuss the best way forward, as we know [Name]'s likes and dislikes.”

Staff worked well with local healthcare professionals who visited the home on a regular basis and provided staff with support. One visiting professional told us, “Staff will contact us regarding residents if they are concerned. They [Staff] are always prepared for our visits and they know people well.”

Staff monitored people’s health daily and knew how to escalate concerns if people’s condition changed. Family members agreed the staff and the registered manager were responsive to people’s health and acted quickly if they noticed a decline. One family member said, “[Name] has put on weight since they came to Simonsfield, it shows how much staff have encouraged [Name] to eat, which is good.”

The provider was meeting the requirements of the Mental Capacity Act. Records included assessments of people’s capacity, and best interest decisions where required. People told us they were encouraged to make decisions about routines, activities, meals and what to wear. Relatives said staff involved them in care planning and sought their input when decisions needed to be made.

People consistently described staff as caring and attentive, and observations showed warm and reassuring interactions. People said, “I Like it here, staff are always kind and caring. I enjoy the company” and “I feel safe here, staff are always reassuring me if I am worried about anything.”

People’s care was personalised and staff provided support in a person-centred way. They spent time with people to learn their likes and dislikes and were responsive to changes in people’s health. Care plans were written respectfully and described people’s needs.

Strong working relationships had been built between local professionals and the service. They told us staff were always helpful and the registered manager led the service with care and compassion. One professional said, “I enjoy coming here as it is well organised and there’s always a staff member available to us if we have questions.”

People told us staff understood their needs and preferences. Staff cared about people’s choices and checked with people about seating, activities and meal options to ensure choices were respected. People told us they felt comfortable raising concerns; however, one relative told us they had requested some changes to their loved ones care, and this had not been implemented. We raised this with the registered manager, who spoke with both the person and their family member. Following these discussions, changes were agreed and made to the person's care and support in line with their wishes and preferences.

Staff told us they were supported in their roles and could approach the registered manager at any time for help and advice. Staff said they worked well as a team and enjoyed working at the service. One staff member said, “The manager has an open-door policy. You can discuss anything without feeling intimidated.”

Care staff had undertaken equality and diversity training. People living with dementia were supported sensitively, with staff adapting communication and engagement styles to meet their needs.

Staff spoke positively about working at the service. Staff were open when things went wrong, respectful of the people and worked together to create an inclusive and calm environment. One staff member said, “Management are always available to us, we can talk to them about anything.” One relative told us they would, “Certainly recommend the home,” explaining their loved one’s health had improved since they came to Simonsfield Care Home.

Governance systems were generally effective, with audits identifying and addressing a range of issues. However, some concerns relating to medicines management and staff training had not been identified through existing quality assurance processes. Despite this, strong teamwork, a commitment to learning and improvement, and positive partnership working with healthcare professionals helped to support good outcomes for people. Further governance was in place from the provider who completed quarterly audits to ensure the service was running at a continued good standard.

The registered manager and regional manager were receptive to feedback and guidance to help learn and improve, acting quickly to implement new records to support safety in the service. There was evidence of continued improvement and review within the service and action plans were in place to show when issues had been identified and acted upon.