St Anthony's Residential Home Limited

Updated 21 December 2022

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 one inspector.

Service and service type

St Anthony’s residential home limited is a 'care home'. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at on 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.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. This information helps support our inspections. We used all of this information to plan our inspection.

The provider was 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 the registered manager, nominated individual and deputy manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 3 people 3 care staff, the cook and a visiting professional.

We reviewed a range of records. This included 3 people’s care records. We checked 3 people’s medicines records and looked at arrangements for administering, storing and managing medicines. We looked at records in relation to staff training and supervision. A variety of records relating to the management of the service, including audits, policies and procedures.

Updated 21 December 2022

About the service

St Anthony’s residential home limited is a care home that provides personal care for up to 16 predominantly older people. At the time of the inspection 13 people were living at the service. Some of these people were living with dementia.

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

The inspection was prompted following concerns raised to the Care Quality Commission in relation to the governance of the service, risk for the safety and welfare of people using the service, kitchen environment, food portions and lack of choice in meals.

Prior to the inspection we had received concerns that the service was not being governed effectively. At the inspection, there was no evidence of how the registered manager was running the service. There was no evidence of the registered manager making decisions about the future growth and development of the service. There were gaps in audits, people’s views were not sought or considered. The registered manager had not identified issues we found during the inspection.

Medicines were not being managed safely. An unsecure box of medicines ready for return to the pharmacist was left outside the locked cupboard, where it should have been stored. This meant there was a potential risk to people. Where people were administered medicines ‘when required’, staff had not recorded the reason they were administered or whether they were effective.

The service had begun the transition from a paper care planning system to an electronic recording system. Some care records were not complete. One person had been in the service for four months on a respite basis. However, there had been no formal care plan put in place. Staff understood the person’s needs and daily records were kept. Falls and incidents were being recorded as well as advice from professionals involved in the person’s care. However, not having a detailed care plan meant staff did not have the necessary level of detail to respond to the person’s needs.

The service did not have effective systems to monitor equipment and utilities. There was no current gas service certificate and the stair lift had not been serviced. This meant there was potential for risk. The nominated individual took action to arrange the gas system service the same day. Other service certificates were in place.

Not all people had emergency plans in place outlining how to support them should they need to evacuate the building in an emergency.

Recruitment records were generally satisfactory with checks evident. However, one member of staff did not have references in place to support the providers decision to employ them. This meant they may not have been suitable to work with vulnerable adults.

Prior to the inspection we received concerns the kitchen area was not hygienic; portions of food were small and meal choices were limited. We spoke with the cook, observed the kitchen area and looked at portion sizes. These concerns were unsubstantiated. The lunch was observed, portion sizes were good, and consideration was given for people’s individual choices and appetites. The service had a 5-star food hygiene rating and the kitchen area was clean.

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 supported this practice.

There were enough staff to meet people's needs and ensure their safety. Staff told us, “Not been here long but yes, there are enough staff” and “We have time to do our jobs”.

People made choices about where and how to spend their time. People told us they were happy with the care they received and believed the service was a safe place to live. Where people were unable to tell us about their experiences, we observed they were relaxed and at ease with staff.

Staff told us that they had received the training they needed to meet people’s needs safely and effectively. The deputy manager maintained oversight of training to ensure staff had the necessary training, knowledge and skills to provide consistent care.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

The building was clean, and there were appropriate procedures to ensure infection control risks were minimised. Some parts of the environment were cluttered. A vacant room was being used to store equipment. The nominated individual told us additional storage was being created by erecting an outhouse. Some walls in the lounge and entrance had outdated newspaper articles and dated information leaflets.

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 good published (19 November 2019).

Why we inspected

The inspection was prompted in part due to concerns received about governance, medicines, staffing and people’s choices. A decision was made for us to inspect and examine those risks.

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.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

Enforcement and Recommendations

We have found breaches in relation to the management of risk, management oversight and incomplete records at this inspection.

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

Notice of inspection

This inspection was unannounced.

Follow up

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