St Catherine's Care Centre Limited

Updated 19 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 4 inspectors, a pharmacy specialist and a regulatory co-ordinator.

Inspection activity started on 16 November 2023 and ended on 23 November 2023. We visited the home on 16 and 17 November 2023.

Service and service type

St Catherines Care Centre Limited 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 Catherines Care Centre Limited is a care home with 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 a registered manager in post, although they were not at the home during our inspection.

Notice of inspection

The first day we visited the home was unannounced. The second day we visited the home was announced.

Before the inspection

We reviewed information we had received about the service since the last inspection, including notifications of significant events and concerns raised by professionals. 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 8 people who lived at the home, 2 professionals who worked with the home, and 11 members of staff, including care staff, ancillary staff, and a nurse. We also spoke with the clinical lead, the regional manager, and the provider’s quality assurance and compliance manager. 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 5 relatives to hear their feedback about the care their family members received at the home.

We looked at care records for 8 people, including their risk assessments and support plans. We checked records of accidents and incidents, health and safety records, 4 staff recruitment files, the staff training record, quality checks and audits, surveys, and the arrangements for managing medicines.

Updated 19 December 2023

St Catherine's Care Centre Limited is a care home with nursing for a maximum of 34 people, including people with physical disability, sensory impairment, and people living with dementia. There were 29 people living at the home at the time of our inspection.

People’s experience of using this service:

There were not always enough staff available to meet people’s needs. Some people told us they often had to wait for care when they needed it, and several relatives said staffing levels were not sufficient to ensure their family members received support in a timely way.

Staff told us they found it difficult to respond to people promptly when they needed care. Three of the 7 relatives who returned satisfaction surveys in 2023 said the home was not well-staffed. Call bell records showed people sometimes had to wait a significant period of time for staff when they needed them.

Risks to people were assessed but not always managed effectively. We found no action had been taken when weight charts demonstrated a person had lost a significant amount of weight. Some people’s care plans stated they needed to be repositioned regularly as they were at risk of pressure damage. However, care records did not demonstrate that repositioning was being carried out as often as it should be.

Medicines were not always managed safely. Guidance regarding the administration of ‘as required’ and variable dose medicines lacked sufficient information to support staff when administering these medicines. There was no guidance for staff about how often emollients should be applied and body maps were not in place to show where barrier creams should be applied.

Professionals had raised concerns about standards of hygiene in the home in October 2023. We found some improvements had been made in relation to this, however concerns around cleanliness remained. Some communal toilets and the sluice rooms were not adequately clean, and some people’s bedrooms smelled of urine.

Quality assurance systems had not been effective in identifying shortfalls. The management team had not always worked effectively with other professionals to ensure people received safe, high-quality care. Some relatives and staff told us their views and suggestions were not listened to or acted upon, including if they raised concerns.

Some risks were managed effectively, including where people had been identified as at risk of aspiration and people with diabetes. Staff used nationally-recognised tools to identify if a person’s health was deteriorating and made referrals to healthcare professionals when necessary.

Staff were recruited safely and understood their role in safeguarding people from abuse. People told us the staff who supported them were kind and caring. Relatives said staff understood their family members’ needs and demonstrated a caring approach in their work.

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 provider had developed a service improvement plan (SIP) in response to concerns raised by professionals in October 2023. This detailed the actions the provider planned to take to address the concerns, and timescales within which improvements would be achieved. In addition to responding to the concerns raised, the SIP outlined plans to improve communication amongst managers and staff, review and update people’s care plans, and to develop risk management plans where necessary.

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 good (published 29 March 2022).

Why we inspected

Professionals had raised concerns in October 2023 regarding staffing levels, moving and handling practice, cleanliness, medicines management, and a lack of responsiveness from the management team.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement. This is based on the findings at this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Catherine's Care Centre Limited on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing and 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 request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.