St Joseph's Home

Updated 18 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 23 February 2022 and was announced. We gave the service 24hrs' notice of the inspection.

Updated 18 March 2022

About the service:

St Joseph’s Care Home is registered to provide residential and personal care for up to 36 people. At the time of the inspection there were 35 people living at the service. The service is a purpose built single story building consisting of three living areas and provides care to adults with complex physical needs and learning disabilities and/or autism. Each of the three areas has its own dining room, lounge and sensory room. There is a large garden area with outdoor seating. The service also operates a day care centre on site.

People’s experience of using this service:

In June 2017 CQC published Registering the Right Support. This along with associated good practice guidance, sets out the values and standards of support expected for services supporting people with a learning disability and/or autism. As part of our inspection we assessed the service in line with this guidance.

Current good practice guidance encompasses the values of choice, independence, inclusion and living as ordinary a life as any citizen. We found that St Joseph's did not always apply the values and principles of Registering the Right Support and other best practice guidance. This is because the guidance promotes that people should be cared for in smaller community based settings as opposed to larger congregate settings. We found that the service did not always actively explore and promote people moving on and transitioning into supported living settings. This meant that outcomes for people did not fully reflect the principles and values of Registering the Right Support. We have made a recommendation with regards to this.

Despite the service's size and layout, we saw that the ethos and cornerstones of practice which underpinned the service, was the deliverance of person centred care. The service was split into three areas each supporting 12 people. The lounge areas were situated next to the kitchen and this helped create a more social space and homely atmosphere. Staff did not wear uniforms and staffing arrangements meant it felt like less like an institution. Some people were supported on a one to one basis and so were actively involved with everyday choices such as having a bath or shower and activities within the local and wider community. The service involved people's relatives and encouraged them to have a say in how their loved ones care should be delivered. Most of the people at St Joseph's were not able to speak with us but we saw from our observations that people appeared settled and content. Relatives of people at the service told us they considered St Joseph's as a permanent home for their loved one.

At the last inspection we found that the service was not meeting legal requirements in relation to medication management. At this inspection, we found that medicines were administered and managed safely and that. Regular checks and audits were carried out to determine the quality of care and to achieve compliance with regulations.

People and their relatives told us they felt safe living at St Joseph’s. Staff understood their responsibilities in relation to safeguarding people from abuse and mistreatment.

Arrangements were in place with external contractors to ensure the premises were kept safe.

Effective recruitment processes helped to ensure new staff were suitable to work with vulnerable people.

The service/ registered manager analysed incidents and accidents monthly. This helped to identify any potential trends and to increase people's safety from harm.

Care records showed that people’s requirements and needs were identified and people were referred appropriately to external health professionals when required. Records contained information about people's preferred routines and information about how best to emotionally support and communicate with them. People enjoyed participating in activities which were meaningful to them both in the local and wider community. Some people had enjoyed holidays with family members and friends.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) to ensure people consented to the care they received. The MCA is legislation which protects the rights of people to make their own decisions.

Interactions between staff and people living at the service were warm and caring. Staff supported people in a person-centred and dignified way ensuring that people’s preferences were considered. Relatives of people living at the service told us that staff were compassionate and considerate.

All meals were home cooked on the premises using fresh ingredients. Innovate methods of cooking were utilised which helped to make food more appetising and increased people’s independence and dignity when dining.

We found the environment to be clean and spacious, this made it easy for people to navigate around. People could decorate their own room so that it was completely unique to them. Each area of the service had its own sensory room including lighting and music of the persons choice. People had access to a hydro pool which provided physical and therapeutic benefit.

There was an open visiting policy for friends and family. Relatives told us the service actively involved them in the care of their relative and made them feel welcome. For people who did not have anyone to represent them, the service supported them in finding an independent advocacy service to ensure that their views and wishes were considered.

Feedback about the management of the service was positive. Staff told us managers were supportive and promoted an open and transparent culture.

The service had displayed the latest rating on the premises and its website. When required notifications had been completed to inform us of events and incidents, this helped us the monitor the action the provider had taken.

More information is included our full report.

Rating at last inspection:

At our last inspection, the service was rated overall as "Requires Improvement.’’ This is because the registered provider was in breach of some legal requirements in the key questions of safe and well led. Our last report was published December 2018.

Why we inspected:

All services rated "Requires Improvement" are re-inspected within 12 months of our prior inspection. Our inspection was brought forward as we needed to consider any current risks to people and whether the provider remained in breach of legal requirements.

Following the last inspection, we asked the registered provider to complete a report detailing what action they intended to take to meet the breach in regulations. During this inspection we checked to see if the service had implemented their action plan. We found that significant improvements had been made and the registered provider was no longer in breach of legal requirements.

We have maintained our rating of ''Requires Improvement'' in relation to well-led. Our overall rating for the service after this inspection is "Good.''

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care and act on information received. Further inspections will be planned for future dates.