Archived: St Thomas Residential Home

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found.

Is the service safe?

We contacted the local authority commissioning team which commissioned services from the home. They told us they had visited the service earlier this year and found that staff supported people where required and care records were up to date though could be more 'person centred', which means they could have been more personalised where they described people's individual needs. They also told us they found that staff were given support and supervision and overall no major concerns had been found.

Earlier this year, we learned the provider and manager had failed to inform the relevant authorities about an allegation of abuse made to them. This meant a timely investigation could not be carried out. The police subsequently investigated this allegation but their investigation was inconclusive. Since then, the provider and manager have recognised and accepted that they must immediately report any allegation of abuse.

During our inspection, we checked how people were cared for and whether they felt safe. We saw that people were treated well and that there were warm, friendly relationships between people and the staff team. Most of the people who lived at the home were unable to tell us their opinions because of their condition, however one person who could tell us their opinion said, 'I feel perfectly safe here. Everyone's friendly.'

One person we spoke with raised a concern. We explored this with the manager and were satisfied with the way their care was being provided. We also discussed their care with their social worker who was going to visit to discuss their concerns.

We spoke with four visitors to find out whether they considered their relatives were safe using the service. They made complimentary comments about the service. All relatives who commented, informed us that they felt that their family member was safe at the home. Their comments included, "Yes, I do," and "I can't give you one negative." Another told us, 'My relative is fairly safe here. There's someone on call all the time.'

We found that staff had been trained about safeguarding people from abuse. When we spoke with staff, we found that they understood the types of abuse that could occur in a care home environment and they were clear about the action they had to take if they had concerns. Staff were confident that any concerns they raised would be taken seriously by management and also understood that they could report any concerns to other bodies if they felt they were not being listened to.

Overall, we considered that people were protected from the risk of abuse because the provider had taken reasonable steps to prevent abuse from happening.

Appropriate arrangements were in place to manage medicines and we considered that people were protected from the risks associated with their use.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The provider had made seven applications under these safeguards where appropriate and notified CQC about this. These applications had been approved by the responsible local authority.

We saw that risks to people's safety had been identified and assessed to ensure that appropriate care and support was provided to keep people safe. For instance, some people, who were at risk of falling, had sensory mats placed by the beds to alert the staff if they got up during the night. When we asked a visitor if they felt their relative was safe living at the home, they told us, 'Yes I do. She's now got a sensory mat if she gets up through the night. That's brilliant.'

Appropriate checks were undertaken before staff began work which helped ensure that the staff were fit and proper people to work with vulnerable people.

Is the service effective?

We found that people who were using the service received the care and support they needed. The staff we spoke to had good understanding of people's care needs. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Visitors, who commented, told us they were happy with their relative's care. Their comments included, 'The staff are very helpful. My mam needs full care. She gets the help she needs. I have no qualms about that.'

Is the service caring?

We saw that people were treated with dignity and respect by staff, who were friendly and considerate. They were attentive to people and spent time talking with them and doing activities, such as drawing with them. Many of the people using the service could not tell us their opinions. However, one person said, 'I can't fault it. Everybody listens to everything you say, especially the carers.' A visitor told us that when their relative spoke about the staff, she always said, 'They're canny.'

We spoke with relatives who were satisfied with the quality of care. Their comments included, 'I can't fault the girls. I've found them all pleasant."

Is the service responsive?

We found that the service identified people's care needs before they moved into the service so that they could be sure staff could provide the support people needed. A visitor told us, "(name of staff member) was very informative for me about how to address my relative's problems."

We found that staff acted on any changes in people's wellbeing and sought advice and guidance from other health and care professionals when appropriate. A visitor told us, "They notice if (my relative) is confused and possibly has an infection." This showed that the staff responded to people's needs as they changed.

Is the service well led?

A manager was in place who was registered with the Care Quality Commission. Staff felt supported by her and people we spoke with felt the service was managed effectively. A relative told us, 'Everything is spot on." Another commented, "It's canny here. It's a nice little home. I would recommend it."

Relatives told us the management and staff were open and friendly and they felt confident about raising any issues or concerns with them. A relative commented, 'Whenever I've had a problem, I've told them and they have sorted it."

There were effective quality assurance systems in place. Audits were carried out to check people were cared for appropriately, for instance, to make sure medicines were managed safely.

We found that people received the care and support they needed and staff supported people in a sensitive and engaging way. People told us they felt safe at the home and we saw that staff were trained in how to identify and protect people from abuse.

Staff were fully supported to meet people's needs because they received regular supervision sessions and training and there were sufficient numbers of staff on duty in order to meet the needs of people using the service.

We found that the service had an effective complaints policy in place.

During the inspection the staff were speaking to people in a pleasant and respectful way. We also observed that the people were clean and well groomed.

A person living in the service told us they were confident they would be looked after; they said of the staff "They make sure I am okay, but you could make it better if you could get more men living in here'. One of the relatives we spoke with said they were happy with the staff and the manager, they told us 'Any problems would be sorted out' and they believed any complaint or concern would be taken seriously.

We saw there were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

Patient, staff and service records such as the safety of the building were detailed up to date and gave the staff information on how they could meet their needs. They were person centred, this means written in a way that describes how a person would want their needs to be met and focused on them as individuals.

We carried out this visit in response to some anonymous information we received. This information raised concerns about the care people were receiving at the home and the staffing levels. The concern raised about the staffing levels was that four staff were on duty each day, which was insufficient to meet people's needs.

We spoke to the people who were using the service and two visitors. They all made positive comments about the care in the home. One person commented, 'I've lived at this home for some time and they have always looked after me well' and another person commented, 'The food is always nice'. One relative commented, 'There always seems to be plenty of staff about'.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We spoke with all of the care staff who were on duty. They made positive comments about the support they received at the home and told us that there were always sufficient staff on duty at the home to meet people's needs.