St Clare's Care Home

Updated 8 February 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 2 inspectors and an Expert 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.

Service and service type

St Clare’s 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. St Clare’s Care Home 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.

Notice of inspection

This inspection was unannounced. We visited the location’s service on 10 January 2023 and 12 January 2023.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from Healthwatch, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 with 5 people who use the service and 15 relatives of people who use the service about their experience of the care provided. We spoke with 1 health care professional who regularly visits the service and 12 members of staff including the registered manager, members of the management team, registered nurses, care workers and the chef.

We reviewed a range of records. This included 12 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 8 February 2023

About the service

St Clare’s Care Home is a residential care home providing personal and nursing care to up to 60 people living with dementia and age-related frailties, some people had a learning disability. At the time of the inspection, the service was supporting 59 people.

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

Quality assurance processes were not routinely documented to ensure effective management oversight of the running of the service. Audits did not always identify concerns found at this inspection, such as, conflicting care plans and omissions in care records.

People’s health risks were not always appropriately assessed with plans to reduce risks. Care plans were not always consistent to guide staff on how to meet people’s needs. This included providing safe support with swallowing difficulties and pressure area care.

People with a learning disability were supported well by staff, however, their planned care was documented in an outdated manner. Care plans did not always guide staff on how to support people when they showed distress or anxieties. Care plans did not always consider people’s communication needs when they were unable to verbalise their wishes.

People were protected from the COVID-19 pandemic and other infectious diseases by good staff practices. People were kept safe by staff who understood their responsibilities to recognise and report safeguarding concerns. People received their medicines in a person centred and timely way, staff were trained and assessed as competent before administering people’s medicines.

People spoke highly of the support they received. People told us there were enough staff to support them and our observations confirmed this. Comments included, “They are very nice to me the staff, they look after my health very well, they call the doctor for me if I need that.” And, "Having the staff around is a blessing, they come on your beck and call."

People were treated with dignity and respect, and their independence was promoted by staff. A staff member said, “The best thing about working here is looking after the residents here, it can be really rewarding and lovely. I always think if it was my own family member, I would want them treated well.” We saw staff speaking with and interacting with people in a dignified and respectful way throughout the inspection.

People were supported by staff who were trained and skilled appropriately. Staff spoke highly of the learning opportunities on offer. One staff member said, “The training here is brilliant, can’t fault that. I have had a lot of training, more than other workplaces. We had interactive dementia training recently, it was amazing, so worth doing.” There was a high retention of staff, many of whom had worked at the service a long time. A relative commented, “Stable core staff and team leaders, their workers’ eyes look around and are quick to spot what is going on.”

People and their relatives told us they knew how to complain and felt comfortable to so do if necessary. The registered manager was highly regarded by people’s relatives and staff. They told us they were able to approach the registered manager with suggestions and felt listened to. Comments included, “[Registered manager], along with [deputy manager] are amazing. Very amenable. They both get out and about, they engage with the teams and the residents.” And, “If you have any concerns about the residents we can talk to [registered manager], they listen to us and asks us for suggestions, we can talk to them any time and they consider what we say.”

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.

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.

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

Rating at last inspection

This service was registered with us on 4 January 2022 and this is the first inspection. The last rating for the service under the previous provider was good, published on 4 June 2019.

Why we inspected

This is the first inspection for this newly registered service.

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.

Enforcement and recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

We have made a recommendation about person-centred care planning.

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.