St Lukes Care Home

Updated 8 August 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

This inspection was completed by 2 inspectors, a medicines inspector, a nurse specialist advisor and 2 Experts 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 Lukes 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 Lukes 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. A new manager had recently been recruited and was in the process of completing their application to become registered with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used the service and 16 family members to gather their views about the service provided. We spoke with 6 care staff, 3 nurses, the manager and clinical development lead. We also spoke with the designated GP for the service.

We looked at care records for 12 people and medicine administration records for 11 people. We looked at 4 staff files in relation to recruitment and a range of other records associated with the overall management of the service.

Updated 8 August 2023

About the service

St Lukes Care Home provides accommodation and nursing/personal care to up to 56 older people across 4 units; some of whom were living with dementia. There were 42 people living in the home at the time of our inspection.

People's experience of using the service and what we found

Risks to people's health, safety and well-being had been assessed and staff mostly had access to relevant information and guidance to support people safely. However, some care plans lacked detailed and person-centred information about people's identified risks and needs. Some charts used to monitor people's identified risks and needs, such and food and drink and hygiene charts, had not been completed consistently and some lacked detailed information to evidence the support people received.

Whilst quality assurance systems were in place, they had not always been effective at identifying issues and driving improvements to the overall quality and safety of the service.

We received mixed feedback about the staffing levels within the home. People and family members told us staff were often rushed, and that at times there were not enough staff available to support with tasks such as meals in a timely manner. We have made a recommendation regarding staffing levels.

Medicines were managed safely. People told us staff gave them their medicines when needed and family members told us they were kept informed of any changes or updates to medicines. However, records relating to the administration of topical creams, fluid thickeners and medicines used to reduce anxiety had not always been completed accurately. We have made a recommendation regarding this.

Accident, incidents and safeguarding concerns were recorded and acted upon appropriately by staff. Records showed that where needed, appropriate referrals were completed to health and social care professionals. However, we identified a lack of managerial and provider oversight of accidents and incidents. This meant there could be missed opportunities to learn from incidents and prevent them occurring in the future.

People told us they felt safe living at St Lukes and all family members we spoke with told us they were confident their relatives were safe and well looked after. One family member said, "[Relative] is safe here. He was wandering day and night and now I can sleep peacefully. They [staff] work so hard. They are always kind and patient no matter how busy they are." Another told us, "It’s absolutely brilliant, couldn’t have been better. It’s the care, the staff never seem to get flustered about anything, they are always on it."

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.

The new manager demonstrated a thorough understanding of their role and responsibilities and provided evidence of changes they planned to make to improve the overall quality and safety of the service. Staff and family members spoke positively about the manager; they told us the manager was approachable, supportive and not afraid to challenge issues where needed. One staff member said, "[Manager] is better equipped and prepared to guide staff in the right direction."

The overall feedback about the service and staff was positive from all people and family members we spoke with. They told us; “The atmosphere is always pleasant and staff are always so welcoming. I would recommend this home to anyone, they [staff] love [relative] and he loves them," "It’s like a little family to my day in St Lukes. The staff have comforted me" and "The care workers are caring and know each person personally. They are aware of people’s needs.”

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

Rating at last inspection

The last rating for this service was good (published 4 February 2022).

Why we inspected

This inspection was prompted in part due to concerns received about falls management, personal hygiene and the overall quality of care people received. In addition, we received notification of an incident following which a person sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risks associated with falls. As a result we undertook a focused inspection to review the key questions of Safe and Well-led only.

The overall rating for the service has changed from good to requires improvement based on the findings from this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. However, we have found evidence that the provider needs to make improvements. Please see the Safe 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Enforcement and recommendations

We have identified breaches in relation to records and quality assurance. 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.