St James Mews

Updated 31 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a specialist advisor who looked at medicines.

Service and service type

St James Mews is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St James Mews is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, there was a home manager who planned to submit an application to register as manager for this service.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to one person who lived at the service. Not everyone using the service was able to speak with us about their experiences. We observed staff interactions with people and observed care and support in communal areas. We spoke to one relative about their experience of the care provided. We reviewed feedback from relatives and people that had been gathered by the service. We spoke with seven members of staff including the quality improvement manager, home manager, deputy manager and care support staff. We reviewed a range of records. This included four people's care records and multiple medicines records. We looked at two staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 31 January 2023

About the service

St James Mews is a care home providing personal care and accommodation for up to nine people. The service provides support to autistic people and people with a learning disability. At the time of our inspection there were nine people using the service. The service is separated into two separate living parts, Mews 1 and Mews 2. The service was situated behind a secured gate on the same site as another service registered with the same provider.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did support this practice. The service was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

The model of the service did not follow the RSRCRC guidance. However, the provider had a plan in place as to how they are going to mitigate the effects to people in the service and how they were going to remodel the service. The provider had made improvements since the last inspection. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests, for example, one person loved horses and staff supported them to go horse riding regularly. Staff supported people to achieve their aspirations and goals, for example, monthly key worker reviews detailed what aspirations people had and then this was reflected in the following review as a completed action. The provider had made improvements regarding the environment to ensure people were supported in a clean and safe environment. The provider told us they were also continuing to improve other areas of the environment.

Right Care

People’s daily notes were not always being completed and reflective of the care and support people were receiving. The home manager had already identified this as an area that needed improving. However, people received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Relatives gave positive feedback about the staff and the support they give. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The provider had worked hard to ensure people were able to communicate in their preferred way, staff and the provider told us people were less frustrated now they were able to express their choices in a way that suited them.

Right Culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. People and those important to them, including advocates, were involved in planning their care. Relatives told us they were always informed if there were any incidents, accidents or if their relative was unwell. The provider had worked to ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 29 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 29 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 05 May 2022 and rated the service inadequate. Breaches of legal requirements were found. We imposed a condition on the providers registration for this service which required them to send us updates on the action they were taking to address the issues. The provider was complying with this condition. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St James Mews on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.