Saint Jude Care Home

Updated 21 December 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 3 inspectors.

Service and service type

Saint Jude Care Home 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. Saint Jude Care Home 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. The new manager had started the process of registering with the commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used all this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 2 people who lived at the home and 4 relatives to understand their experience of the care provided. 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. We spoke with 9 members of staff including the provider, manager, chef, care assistants and team leaders. We reviewed a range of records. This included 7 care plans and associated documentation and multiple medication records. We looked at 3 staff files in relation to recruitment. We reviewed multiple records relating to the management of the service, training data and a variety of policies and procedures.

Updated 21 December 2023

About the service

Saint Jude Care Home is a residential care home providing personal care to 18 people aged 65 and over at the time of the inspection, including people living with dementia. The home can accommodate up to 22 people. The home is a domestic style property located in the Blundellsands area of Liverpool. Accommodation is provided over three floors and people have access to two communal lounges, dining area and enclosed garden.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Governance arrangements were not always effective at identifying concerns. A range of audits were in place. However, they did not identify all concerns found during the inspection such as concerns found with care planning and medicines records and staff ability to competently apply the principles of the Mental Capacity Act (MCA).

At our last inspection, we made a recommendation for the provider to improve the analysis of accidents and incidents. The provider failed to meet this recommendation as concerns regarding the consistent analysis of incidents remained. The provider was reactive to safety related incidents and action was taken to reduce the risk of similar incidents occurring. However, due to the lack of analysis of themes and trends, the systems in place did not always promote a preventative approach to risk. The provider was responsive to the concerns and improvements to governance arrangements were made during the inspection.

People's individual risks were assessed, and measures were in place to reduce risk. However, records did not always reflect this. We raised our concerns with the provider who took immediate action to improve the records. Staff understood people’s needs and risks and knew what action to take to keep people safe from harm.

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. However, the policies and systems in the service did not always support this practice. We found systems were in place to assess, review and report on people's mental capacity and decision-making abilities. However, staff responsible for assessing people under the MCA did not have full understanding of the principles of the MCA.

Overall, we were assured people received their medicines as prescribed. However, multiple gaps on medication administration records (MAR) evidenced they were not always completed when medicines were administered.

Staff were knowledgeable about people's dietary needs. Most people provided positive feedback about the quality of the food and told us their preferences were met.

Staff were safely recruited and deployed in sufficient numbers to meet people’s needs. Staff received an induction and completed mandatory training to enable them to carry out their job roles. However, when additional training was required to meet people’s specific needs, such as training for managing periods of emotional distress, we noted completion rates were low amongst staff.

Safeguarding systems were in place and worked effectively to ensure people were protected from abuse. Environmental risks were identified, and systems were in place to carry out regular safety related checks on the environment and equipment.

The home was clean and hygienic throughout. Domestic staff were on site and worked hard to maintain a clean environment. The home was nicely decorated throughout. People's individual rooms were personalised with items of their choice.

The manager worked well with other healthcare professionals to ensure people achieved good health outcomes. When people's needs changed, records showed they were referred to external health professionals in a timely manner.

The manager demonstrated a commitment to ensuring people received person centred care. People, relatives and staff told us the manager and the provider were visible and felt they could approach them with any concerns they had. The provider understood the need to gather feedback from people and use this to improve the quality of the service.

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

Rating at last inspection

The last rating for this service was requires improvement (published 26 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

At our last inspection we recommended the provider strengthened their accident and incident analysis to ensure patterns, trends and themes were identified and used to improve the safety of the service. At this inspection, we found processes to analyse incidents was inconsistently completed.

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of falls. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe sections of this full report.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Saint Jude Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.