Shandon House

People and their relatives told us they felt safe at Shandon House. Staff demonstrated a good knowledge of safeguarding and when to recognise and report concerns. Documentation around safety required improving. For example, risk assessments were not always fully detailed or reviewed. Best interest decisions had not been fully documented and accident and incidents lacked details and action plans to aid learning and prevention of reoccurrence. The registered managers were receptive to our feedback and had already begun proactively working with other agencies to drive these improvements. Staff training was up to date and relevant. Staff told us they felt supported and enjoyed their job. The home was clean and tidy, with good maintenance management in place. Medicines were administered safely, and regular checks were undertaken to ensure processes around medicines were robust.

People told us that staff were supportive and met their needs well. We observed people being given regular choices, staff asking people’s consent before supporting them and activities undertaken which promoted healthier lifestyles. The care that staff provided was in line with best practices and encouraged good outcomes for people, however the documentation around this needed to be improved. This was especially pertinent around mental capacity assessments and best interest decisions. The registered managers had already identified this and were taking proactive steps to address the matter quickly. Staff worked well with each other and external professionals to provide good, effective care for people.

People were supported by kind and caring staff who treated them with dignity and respect. Referrals to external professionals had been made appropriately however the documenting of these needed improvement. People had choice and control in their lives, however best interest decisions, where made, were not always fully documented. The registered managers were receptive to this feedback and started implementing changes immediately. People were treated as individuals, by staff who knew them well. Where safe to do so, people were encouraged to be as independent as possible.

People received person-centred care which was shaped around their individual needs. Staff and registered managers had a good relationship with external agencies and made referrals when necessary to ensure people had good access and continuity of care. The documentation of these referrals and professional input needed to be improved but the registered managers were receptive to this and were working to improve this matter. People told us that staff knew them well and they were involved in their care. They also reported confidence in raising any concerns they had with staff and management. Where needed, people’s future wishes had been considered.

Improvement was required in relation to the governance and managerial oversight at the home. Quality assurance processes were not always robust enough to identify and address gaps in documentation. Accident and incidents were not routinely analysed, and this meant learning was not always provided to staff following events. We identified one significant event which had not been reported to CQC. Staff spoke positively about the registered managers and felt supported in their roles. There was an open culture at the service where people, relatives and staff all reported feeling confident to approach management should they have any concerns. The registered managers had begun to work on driving improvements within the service, working alongside external agencies, and these changes needed time to embed and be fully effective.