Background to this inspection
Updated
17 January 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 checked 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 inspection took place on 5 December 2017 and was unannounced. The inspection was carried out by two inspectors 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.
Before the inspection, we viewed the information we held about the service. This included statutory notifications received. A notification is information about important events which the service is required to send us by law. We also looked at a Provider Information Return (PIR). The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the safeguarding alerts raised regarding people living at the care home.
During our visit we spoke with five people living at the home and two relatives. We also talked to the regional manager, three team leaders, activities leader, three staff members and the chef. We reviewed people’s care records. We looked at seven care plans, including risk assessments, four staff records, medicine administration records and other records related to the management of the service. We observed care and support provided in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection we contacted five health and social care professionals involved with the people who use the service for their feedback about the service.
Updated
17 January 2018
This inspection was carried out on 5 December 2017 and was unannounced.
St Johns House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The home provides care and support for up to 23 older people, some of whom have dementia and physical disabilities. On the day of our visit there were 18 people using the service.
At the last inspection, the service was rated overall Good, with Requires Improvement in safe. At this inspection we found the service was overall Good, with Requires Improvement in responsive.
The service had a registered manager in place. 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.
Staff had knowledge and followed service policies and procedures to protect people from potential harm and abuse. Staffing numbers were appropriate to meet people’s needs in good time. Staff undertook appropriate recruitment checks which meant they were suitable to work with vulnerable people. Medicine management records were accurately maintained to ensure people had their medicines as prescribed. Staff followed safe infection control procedures. Incidents that occurred were regularly reviewed by the registered manager to ensure that causes were identified and dealt with as necessary.
People’s care records lacked information on the support people required and the guidance for staff on how to meet people’s individual needs. We made a recommendation about this.
Staff were trained appropriately for their role. Systems were in place to monitor the attended training courses which ensured that the registered manager was notified when staff were due for a refresher course. Some people told us the food provided was not always meeting their preferences. Staff supported people to meet their dietary and nutritional needs as necessary. The service provided important information about people to other agencies quickly when required. People had access to healthcare services as necessary. The provider was working to improve the premises for people living with dementia. People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible.
People told us that staff were kind and respectful towards their care needs. People’s religious needs were known and supported by the staff team. People had a say in how they wanted to be cared for and staff encouraged people to make decisions regarding their care and support needs. Staff maintained people’s dignity and respected their right to see their family when they wished to. The service encouraged people’s independence which meant they carried out activities by themselves where possible.
Staff followed guidance on how to use moving and handling techniques. This meant that people were provided with appropriate support to move around when they wished to. People and their relatives were aware of the complaints procedure and felt confident to raise their concerns if necessary.
Activities provided at the service had not always suited people’s care and support needs. We made a recommendation about this.
Staff felt well supported by the management team and approached the registered manager for advice when they needed it. People said the registered manager was responsive and attentive to their care needs. Staff were aware of and followed their responsibilities in relation to safe information sharing. Regular audits were carried out to monitor the quality provision at the service. The registered manager had shared information and updates with external agencies to improve the care delivered for people.