Saint Lawrence Residential Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified a breach of legal regulations. Systems and processes to assess, monitor and improve the quality and safety of the service were either not operated effectively or were not in place. The provider failed to ensure good governance systems were used effectively to assess, monitor and mitigate the risks to people, maintain accurate or up-to-date records of people's care or the management of the service. There was little evidence of continuous learning or systematic approach to improvement. Incidents were not reviewed for themes, patterns or for lessons that could be learned. People’s care plans and risk assessments had not been robustly reviewed and the oversight regarding this was lacking. Whilst we did not see any evidence of negative impact to people, the risk that incorrect care could be delivered was possible.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not have a clear awareness of the organisational values expected of them. However, staff had a clear understanding of what constituted good care. One staff said, “We make sure everyone is cared for and happy and healthy”. Feedback received evidenced there was a poor staff culture within the service. The manager was responsive to our findings and gave assurances this would be addressed.

Whilst the provider and both managers described to us some actions they were planning to take to make improvements, action plans did not always include up to date information to support service improvement. There were processes in place to gather feedback from people and their relatives. However, in the most recent survey only 3 had been completed. It was unclear what action had been taken following the feedback.

Staff told us the management team had improved and were accessible and approachable. Staff told us they felt supported and if they needed to speak to one of the management team, they were easy to contact. One staff member said, “[Manager] is doing really well as a leader and always tries and encourages us, I feel really supported”.

There was a manager in post who had applied to become registered with Care Quality Commission. The manager completed relevant statutory notifications. The manager had not received an appraisal and there were gaps in their training. More time and support was needed for them to continue developing their experience. They were though very knowledgeable about the people supported, committed to making improvements and very responsive to feedback. A 24/7 on call system was in place. Where the home had required additional support, the manager or provider attended on evenings, nights and weekends.

Staff told us they knew about the service’s whistleblowing policy and knew how to raise concerns. Staff were also aware they could report concerns directly to the Care Quality Commission and the local safeguarding team.

Policies were in place to guide staff on how to raise concerns.

Staff spoken with told us managers of the service were flexible in their approach to meeting staff needs and requirements. Staff we spoke to were happy working at Saint Lawrence Residential Care Home.

There were systems in place to enable the provider to identifying staff’s equality, diversity or inclusion needs. Staff had completed equality, diversity and inclusion training to raise awareness.

The service had a new manager in post who was in the process of applying to register with the Care quality Commission. Everybody spoke positively about the new manager and their commitment to improve the service. Staff told us they were informed of any areas identified for improvement through staff meetings. Staff and leaders could describe what good care looked like. The manager recognised area’s of improvement were needed. The manager said, “This could be better and I know we have to improve on this”.

A range of checks including audits were in place. However, these internal processes did not identify the concerns found during our assessment. Some recent audits lacked a consistent approach. Information checked was not effectively evaluated for themes and trends which meant required actions to mitigate risks were not always identified and responded to. A lack of robust checks led on to minimal evidence of lessons learnt and shared with the wider staff team after serious incidents and concerns. There had been occasions lessons could have been learnt for the benefit of people receiving the service. Examples included a lack of investigation and action associated with medication errors, falls, and the home environment. Care records were found to be inconsistently completed. There was no system in place for ensuring people received person centred care. Some surveys had been completed and these required further evaluation and response to evidence the importance of capturing the voice of people both involved with and receiving a service. There was no evidence of recorded provider oversight to ensure reporting mechanisms, systems, and processes remained fit for their purpose to evaluate the service, maintain standards and identify areas requiring improvement. Systems that were in place for the oversight of the premises and equipment had failed to ensure action was taken to ensure health and safety and maintenance checks were completed. There was no system in place for ensuring people received person centred care. There was no formal oversight of activities on offer for people or information about how people's preferences were being met. Medicines were not being managed safely.

People we spoke with were mostly complimentary about their relationship with staff and managers, but did comment of the lack of activities and engagement with community groups.

Staff could confidently explain how they support and promote joined up care. Staff told us they worked in partnership with other healthcare professionals to assess and met the needs of people they supported.

There were a number of health and social care professionals involved in people’s care to ensure the care they received met their health needs. One professional said, “If there was any issues, they [staff] would ring and ask us to come out. They have always contacted us when we have been needed even if it is just for advice”.

There were systems and processes in place to prompt partnership working with health and social care professionals such as when referrals were required to other health or social care professionals. The provider had engaged with the local authority provider development team to assist with driving improvements at the service.

We received mixed feedback around learning and innovation. Some staff said they required more support when things go wrong. Whilst others said, they feel involved in learning. The manager acknowledged this area needed improvement to support service delivery and positive outcomes for people.

There was little evidence of continuous learning or systematic approach to improvement. Themes and trends were not identified through systems currently in place. The provider was requested to provide an action plan after the last inspection detailing how they were going to improve their rating and meet their breaches of regulation. They have remained in breach regarding the governance at the service due to inconsistent quality assurance processes, leading to learning opportunities being missed.