22 March 2022
During an inspection looking at part of the service
St Michael’s Court is a nursing home providing personal and nursing care to up to 86 people. The service provides support to older and younger people, some of whom may be living with dementia, a physical disability or sensory impairment. At the time of our inspection there were 38 people using the service.
The care home accommodates people across three separate floors, each of which has its own facilities, for example, dining room and lounges.
People’s experience of using this service and what we found
Medicines management required improvement. There was poor medicines administration practice seen and poor guidance in the records on how people would like to take their medication.
There was a lack of staff training with staff not receiving all required training. There were also no competency assessments to check staff’s understanding or spot checks to review care delivery.
There were times when the service appeared to be short of staff so the care provided was task-focussed more than person centred. People spoken with acknowledged at times there could be a shortness of staff in the mornings and around meals times, which could mean a wait.
The management oversight of the service needed improving and audits developed to monitor the quality of care and environmental issues to drive improvements.
People had choice about what they would like to eat and had enough. There were concerns people were not consistently being offered sufficient fluids.
Most staff were clear about escalating safeguarding concerns. People felt safe living in the service. They said, “Yes, I’m happy. I do feel safe. It’s because I don’t have to worry about anything.” They were complimentary about the choice of food and its availability.
People said they received their medication on time and there was not a long wait for pain relief. People said staff noticed if they were not feeling well and contacted the GP. They said they had visits from a chiropodist, physiotherapist as well as the hairdresser.
People spoken with said they felt the home was clean and staff wore appropriate personal protective equipment (PPE) when providing care to them and during the pandemic.
The manager was new and responded to our inspection in a positive way and was open about the shortfalls. There had been a lack of reporting of incidents to Safeguarding and CQC. However, since the new manager has been in post this has been addressed and these are now being completed appropriately and in a timely manner.
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.
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 (report published on 12 May 2021).
Why we inspected
We received concerns in relation to the management of medicines and care of people who lived in the service, staffing, and environmental safety issues. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Michael’s Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment, staffing support and training and governance at this inspection.
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.