Archived: St Patricks Care Home

Updated 17 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 15 March 2018 and was unannounced.

Before our inspection we reviewed the information we held about St Patricks care home. We contacted the Local Authority quality monitoring and safeguarding teams to ascertain if there were any areas of concern that we should be aware of. We were not made aware of any concerns about the care and support people received. We reviewed the latest Health Watch report which was completed following a visit in September 2017. Health Watch is an independent consumer champion created to gather and represent the views of the public. They have powers to enter registered services and comment on the quality of the care. We also considered information we held about the service, such as notification of events about accidents and incidents which the service is required to send to CQC. We used all of this information to plan how the inspection should be conducted.

The inspection was undertaken by two adult social care inspectors, a registered mental health nurse and 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 care service, in this case, the care of someone living with dementia.

During our inspection we spoke with the registered manager, the deputy manager, a general nurse, an assistant practitioner, five carers, a student nurse, the cook and the activity coordinator. We spoke to three people living in the home and six relatives. We case tracked three people who used the service and also looked at care records for a fourth person who used the service. We reviewed three staff personnel files, medication administration records, staff training and development records as well as information about the management and governance of the service. We observed the lunchtime service and care at various points throughout the day.

Updated 17 April 2018

St. Patricks is a purpose built establishment in a residential area in Widnes. It provides care and support for up to 40 people diagnosed with dementia. The home provides care over two separate units depending on their level of need; Ashley unit and Maguire unit. Each unit has its own lounge, dining room and utility kitchen. All bedrooms are single with en-suite toilet facilities. The home is operated by Community Integrated Care. At the time of our inspection, there were 36 people living in the home.

At the last inspection on the 5 March 2015, the service was rated Good. At this inspection we found the service remained Good.

The registered provider had taken action in accordance with recommendations we made at the last inspection regarding the development of the environment to make it more dementia friendly. An outdoor theme was created through the use of imitation ‘bus stops’ and benches alongside brick effect wallpaper. This provided a means of facilitating relief for people who have dementia and may want to leave the home. A mock shop and café with prices displayed in pounds and shillings provided a village feel. A new sensory room had been installed in the home to provide a relaxed environment where people could retreat to when they became agitated or wanted some quiet time.

There were a variety of activities in place provided by two activities co-ordinators employed by the service to promote social stimulation. This included baking, arts and crafts and bingo. People also had access to the on-site bar which was equipped with optics, bar stools and a dartboard. The registered provider worked with community partners such as the Widnes Vikings to enable people to access a dementia café at the grounds.

There was a registered manager in post at the service. The registered manager had worked at the home in a variety of different roles over 20 years, including as a staff nurse, before becoming registered manager in 2016. 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.

Our observations and review of staff rotas showed sufficient numbers of staff were deployed to meet people’s needs. Some staff and relatives thought that staff could be stretched at specific times throughout the day. We brought this to the attention of the registered manager during our inspection.

Staff were recruited safely and pre-employment checks were carried out before they started work at the organisation to ensure they were suitable to work with vulnerable people. Staff had received training in ‘safeguarding’ and understood the different types of abuse and the local reporting procedures.

Medicines were managed safely and effectively. Medication was administered by registered nurses and staff who had received the relevant training. Medication Administration Records were completed accurately and PRN guidance was in place for people who were prescribed ‘as required’ medication. People told us they were happy with how their medication was managed and received this when they needed it.

Risk assessments were detailed and contained sufficient information to guide staff on how to minimise the risk of harm for people who lived at the home. Fire procedures in the event of an evacuation were clearly marked out and regular mock fire drills were completed. Checks were completed to ensure the environment was free from hazards.

The training records showed staff had received relevant training to ensure they had the skills to support people effectively. Our discussions with staff showed that they had a good knowledge about the people they supported and understood people’s individual needs.

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. The service operated within the principles of the Mental Capacity Act 2005 (MCA). Our review of records showed that processes were in place to assess people’s capacity and make decisions in their best interests.

People were supported to maintain good health and well-being. The home had a good relationship with a local GP practice through the GP alignment initiative and had regular dialogue with the local community mental health team. Referrals were made promptly to health professionals such as SALT, the dietician and tissue viability nurses. Staff followed guidance that was implemented to achieve best outcomes.

People told us they enjoyed the food served at the home. Staff knew, and catered to, people’s individual dietary needs and preferences. Nutritional risk assessments were completed and diet and fluid charts were in place for those who required them.

We observed kind and compassionate interactions between staff and the people they supported. Staff offered tactile reassurance to people in distress. People told us they liked the staff that supported them.

Care plans were personalised and evaluated monthly. We noted that any changes in people’s needs were documented and actioned appropriately.

A complaints policy was on display in the home which contained details for the local authority and Local Government Ombudsman. People told us they would not hesitate to raise concerns with the registered manager if they felt they needed to. Complaints were documented and managed in accordance with the registered provider’s complaints policy.

Quality assurance systems were effective and measured service provision. Regular audits were completed for different aspects of the service such as medication, care plans and accident and incidents.

Opportunities were provided for people and their relatives to provide feedback on their experience of the care provided and contribute to improving the service delivery. This included quality assurance surveys, a suggestion box and family meetings.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with statutory requirements.

The ratings awarded at the last inspection were displayed at the entrance to the home.