Archived: St Clare's Care Home

Updated 4 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of three inspectors and two experts 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, their area of expertise included dementia care. On the second day of the inspection one inspector returned to the home.

Service and service type: St Clare’s Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Clare’s Care Home is registered to accommodate up to 60 people in purpose built premises.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was present during both days of the inspection.

Notice of inspection:

The inspection was unannounced on the first day. The inspector informed the registered manager that they would be returning on the second day of the inspection.

What we did:

Before the inspection:

We reviewed information we have received about the service. This included details about incidents that the provider must notify us about. We used information including complaints that we had received to help us to plan this inspection. The provider had completed a Provider Information Return (PIR). Providers are required to send us key information about their service, what they do well and improvements they plan to make. This information helps support our inspections.

During the inspection:

We spoke with 10 people living at the home, 11 relatives and one visitor. We spoke with 10 members of staff, the registered manager and the care and compliance manager.

We looked at 12 people's care records. We observed how medicines were administered and looked at medicine records. We looked at records of accidents, incidents and complaints.

We looked at audits and quality assurance records. We looked at four staff files, training records and rotas.

Updated 4 June 2019

About the service: St Clare’s Care Home provides residential and nursing care for up to 60 older people. The provider is a Christian faith based charity supporting people who were living with a range of conditions including dementia, mental health problems, physical disabilities and sensory loss. At the time of the inspection there were 59 people living at the home.

People’s experience of using this service: The rating for the service has improved to Good.

People were not always receiving personalised care that was responsive to their needs. People’s care plans were not always updated to reflect the care provided. The requirements of the Accessible Information Standards were not consistently met. Activities were organised but some people were at risk of social isolation. Not everyone had enough to do to keep them occupied and socially stimulated. We recommended that the provider finds out more about providing meaningful occupation, based upon current best practice in relation to the specialist needs of people living with dementia.

Improvements had been made in safeguarding people from abuse and improper treatment. Staff understood their responsibilities to keep people safe and to report any concerns. Notifications had been made to the appropriate authorities. People and their relatives told us that they felt safe.

Risks to people were assessed and managed. There were enough suitable staff to care for people safely and the provider had robust recruitment procedures. People’s medicines were administered safely and infection control procedures were robust. Incidents were recorded and monitored and lessons were learned when things went wrong.

Staff received the training and support they needed. Staff understanding of their responsibilities regarding the Mental Capacity Act 2005 had improved. 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. Communication was effective within the team and people’s needs were assessed in a holistic way taking account of people’s diverse needs and their preferences. People were supported to have enough to eat and drink and to access health care support when needed.

People and their relatives told us that staff were kind. One person said, “I find the staff caring, respectful and considerate.” People were supported to express their views and to make choices about their care and support. People’s independence was encouraged as much as possible. Staff understood the importance of maintaining confidentiality and protected people’s dignity. Staff were knowledgeable about end of life care. People and their relatives were supported to plan for end of life. Staff respected people’s wishes and their needs were anticipated to plan for a comfortable and dignified death.

People and their relatives knew how to complain and felt confident that any concerns would be dealt with appropriately. Complaints and their resolutions were recorded and this information had been used to make improvements at the home.

Improvements had been made in how the home was managed. Systems for ensuring quality and monitoring practice had improved. Governance arrangements were robust and provided the registered manager and the provider with clear oversight of practice. The registered manager was aware of areas of practice that needed to improve and when we brought issues to their attention they could demonstrate that work was already in progress to make improvements. People, their relatives and staff described visible leadership in the home and said they were included and involved in developments. Staff had developed positive relationships with other agencies and worked effectively in partnership to achieve good outcomes for people.

Rating at last inspection: Requires Improvement, the last inspection report was published on 30 March 2018.

Why we inspected: This was a scheduled inspection based on the previous rating. Following the last inspection, the provider had submitted an improvement plan on 23 April 2018.

Follow up: ongoing monitoring.

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