Archived: St Stephen's Care Home

There was a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People lived in a safe environment as staff knew how to protect people from harm. We found staff recognised signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks.

There were sufficient staff on duty to meet people’s needs. People told us that staff helped them when they needed assistance. Regular reviews of people’s care and deployment of staff meant staffing levels were reflected the needs of people who lived at the home. People’s medicines were administered and managed in a safe way.

The registered manager supported staff by arranging training so staff developed the skills to provide care and support to people which was in-line with best practice. People and relatives told us of the positive benefits this had on the care and support received. We found that staff provided people’s care with their consent and agreement.

People were supported to eat a healthy balanced diet and with enough fluids to keep them healthy. People had access to healthcare professionals, such as the chiropodist and their doctor when they required them and where supported to attend hospital appointments.

We saw people were involved in the planning around their care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.

People were supported to continue with their hobbies and interests. People felt the general activities and entertainment in the home was good, with aspects they enjoyed doing. People were supported to go to church when they wanted. Where people wanted to spend time in their rooms staff respected their decision.

We found people knew how to complain and felt comfortable to do this should they feel they needed to. We looked at the providers complaints over the last 12 months. We found nine complaints had been received, all of which had been responded to with satisfactory outcomes for the complainants.

The registered manager demonstrated clear leadership. Staff were supported to carry out their roles and responsibilities effectively, which meant that people received care and support in-line with their needs and wishes.

We found the checks the registered manager and regional manager completed focused upon the experiences people received. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve staff practice.

The home is registered to provide accommodation and personal care for older people. A maximum of 51 people can live at the home. There were 42 people living at home on the day of the inspection.

The home had been without a registered manager since 18 September 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had been appointed and was applying to become the registered manager at St Stephen’s Care Home. The provider will need to ensure that an application to register the manger is submitted to meet the registration regulations.

We carried out an unannounced comprehensive inspection of this service on 7 April 2015. Two breaches of legal requirement were found. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to having sufficient numbers of staff based on people’s assessed needs, and in relation to the need for people’s consent to care and treatment. The provider told us action would be taken by September 2015. During our inspection on 12 January 2016 we found the provider had followed their plans and now met legal requirements. We found that people’s consent to care and treatment was now considered and recorded where needed and the provider had addressed the breach of regulation in respect to having sufficient numbers of staff based on people’s assessed safety needs. However, further improvements are required to ensure staff are deployed in a way so people can receive the care they want at the times they want to receive it.

People managed risks to their safety with support from staff. Staff were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met. People were supported by staff to have their medicines, but there were occasional delays in people receiving pain relief when they wanted it. The new manager was working with other health professionals so people would receive the medicines they needed in a safe way.

People’s rights and freedoms were respected by staff. Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them. There were good links with health and social care professionals and staff sought and acted upon advice received, so people’s needs were met.

People were supported by staff to have enough to eat and drink. Staff encouraged people to have things they enjoyed to eat and drink so they remained well. Where people needed help to maintain their health and well-being, plans were put in place and people’s health was monitored. People had regular access to healthcare professionals and told us staff acted quickly when they asked to see their GPs.

Staff had developed caring and supportive relationships with people living at the home, and encouraged people to make decisions about their daily care. Staff considered people’s need for privacy and dignity in the way they looked after them. People were supported to keep in touch with people who were important to them.

People had more opportunities to do things they enjoyed within the home. People knew what to do if they needed to make a complaint or raise a concern. Where a complaint had recently been made prompt action had been taken by the manager to address the concern and improve the service further.

The manager was making some positive changes at the home, which relatives, staff and external health professionals recognised. People were encouraged to make suggestions about the care they received through questionnaires and residents’ meetings. The manager and provider had undertaken regular checks to monitor the quality of the care which people received and looked at where improvements were needed. The provider and manager had implemented recent improvements. The manager planned to check further areas of people’s experience of living at the home over the coming months.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

Safeguarding procedures were robust and staff we spoke to told us they had received relevant training. This meant they understood their roles and responsibilities related to keeping people safe. During our inspection, we spent time in communal areas and observed people being treated with dignity and respect.

The recruitment process at the care home was thorough. All staff were required to undergo all appropriate safety checks before starting work at St Stephens Care Home. This meant all people living at the care home had their safety and welfare protected at all times.

Deprivation of Liberty Safeguards (DoLS) become important when a person living at the care home is judged to be lacking the capacity to make an informed decision related to their care and support. The registered manager informed us that a DoLS application had been submitted within the last twelve months. We observed all the required paperwork had been completed.

We walked around the care home and observed it was clean and safe, both inside and outside. All equipment was well maintained and serviced regularly and meant people were not put at any unnecessary risk.

Is the service effective?

People who lived at the care home and/or their families were involved in writing up their care plans. This meant that their choices and preferences were being listened to and respected. People`s needs were taken into account with relevant signs being placed around the care home. This meant people were able to move around the care home freely and safely. The care home also met the needs of people with physical impairments, for example, wheel-chair users.

Is the service caring?

People were cared for by patient and attentive staff. We saw people being helped and supported in all areas of the care home. This included staff members assisting with people`s personal care needs. At meal times, people were also helped to eat their meals if required which meant they received the nutrition they required.

We spoke to several people who lived at the care home. One told us, "The care is second to none here - it is really good." Another person told us, "Oh yes, everything is excellent here and nothing is too much trouble."

Is the service responsive?

People living in the care home were encouraged to become involved in a range of social activities. These took place both within the home and around the local community. Day trips had also been planned to places of interest that had been identified by different people living in the care home.

Regular meetings were held for people and their families. We observed the results of several surveys and questionnaires that had been completed by family members. We noted several suggestions that had been made in response to the surveys had been acted on by the provider.

A copy of the complaints procedure was displayed on the wall at the entrance to the care home. We saw the results of a recent survey which indicated that people knew who to talk to if they had any concerns related to their care and support. We saw the report of a recent complaint and noted it had been addressed without delay and within the required time frame. This meant people`s concerns were listened to and looked into in an appropriate manner.

Is the service well led?

St Stephen`s Care Home worked well with other agencies. We noted a professional survey had been recently completed. One person said, `the care home liaise really well with us and keep us informed.` A community nurse was at the care home and told us, "I enjoy coming here - it is a lovely caring place, one of the best I go to."

The provider had a quality assurance system in place. This included regular internal and external audits. This meant that any identified concerns were addressed immediately. The provider told us these audits were aimed at continually improving the quality of service being provided to the people living in the care home.

Staff members we spoke to were clear about their roles and responsibilities. They had a good understanding of the needs of people living in the care home and had the skills to help them meet those needs. This meant that people received a good quality of care at all times.

People we spoke with were complimentary about the care and support that they received. One person said: "Care is perfectly alright'. A relative told us: "Staff are good and hard working and sociable. I am quite impressed, X is well looked after". We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People told us they felt safe. We found that systems were in place to keep people safe. Staff had received training in safeguarding people and knew how to respond to concerns.

We found that regular checks had been carried out to ensure that their were enough staff available to meet people's needs.

A system of audits had been put in place and annual surveys carried out. Comments received had been acted upon to ensure that people were not placed at risk of receiving inappropriate care.