Archived: St Vincent's

St Vincent’s is a nursing home that can provide care up to 25 older people. On this inspection, 22 older people were living at the service.

A registered manager was employed to manage the service locally. 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.

On this inspection, we have continued to rate the service as Good.

Why this service remained Good:

On this inspection, we found that the home was rated Good in respect of delivering care that was safe, effective, responsive and well-led. Caring continued to be rated as Outstanding.

People continued to receive care from staff who were knowledgeable and had the skills required to support them. Staff were competent and trained well. People had the support needed to help them have maximum choice and control of their lives in the least restrictive way possible. Policies and systems in the service supported good practice. People's wellbeing and healthcare needs were monitored by the staff and people accessed healthcare professionals when required.

People, visitors and professionals all described the care in outstanding terms. One person said of the staff, “Diamonds, I call them. They do everything for the patients’ comfort.” People’s end of life care had been re-accredited by the local hospice and was described to us as of a ‘gold standard’ by staff specialising in palliative care. A relative whose mother had died in the home earlier this year said, “I could not fault the end of life care given to my mum and our family”.

We observed staff being patient, responsive and extremely kind. There was a calm atmosphere in the service. People's privacy was respected. People, where possible, or their representatives, were involved in decisions about the care and support they received. People new to the service were supported emotionally and involved in deciding how they wanted their treatment needs to be met.

Care people received was personalised and was responsive to people's individual needs. Each person was able to make choices about their day to day lives. Any concerns or complaints were quickly acted on and investigated. People were supported to take part in a range of activities according to their individual interests. People’s faith and cultural needs were respected and met.

The service is well led. People and staff told us the registered manager was approachable. The registered manager and provider sought people's views to make sure people were at the heart of any changes within the home. The registered manager and provider had monitoring systems in place which enabled them to identify good practices and areas of improvement.

Further information is in the full report which the registered manager will be available to give you a copy of or it can be found on our website at www.cqc.org.uk

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

This is a summary of what we found:

Is the service safe?

The service was safe because people had been protected against the risks associated with medicines. The provider had appropriate arrangements in place to safely manage medicines.

There were enough qualified, skilled and experienced staff to meet people's needs.

Systems were in place to make sure that the Registered Manager, Registered Nurses and care staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The Care Quality Commission [CQC] monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, policies and procedures were in place. The Registered Manager, Registered Nurses and care staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

The service was effective because we found that people's privacy was protected at St. Vincent's.

People's health and care needs had been assessed with them or their representative and they had been involved in compiling their plans of care.

Is the service caring?

The service was caring. We spoke with five people who lived at the home. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example; "Always enough staff'. One person said "When I press my call bell they always come as quickly as they can'.

When speaking with and observing care staff during this inspection it was clear they genuinely cared for the people they supported. They told us about people's health and social care needs and how these needs had been met in an individual way.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The service was responsive to people's changing needs. For example we saw that one person had been prescribed fortified drinks to supplement their diet when it had been noted the person had lost weight. We spoke with five people who lived at the home. We saw from records that planned care and treatment had been provided in line with people's individual care plans. Aspects of people's needs or care had been linked to risk assessments. Specialist health needs had been identified where required and appropriate health care professionals had been consulted and involved in providing care.

Is the service well-led?

The service was well led.

The Manager was registered with the Care Quality Commission on 20 February 2012. A Registered Manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

We saw there was an effective system in operation which had been designed to enable the provider to regularly assess and monitor the quality of the services provided. For example during April 2014 the Registered Manager had sought feedback from people who lived at the home. The Registered Manager told us and people who lived at the home confirmed that their opinions about the running of the home were sought on a daily basis. People we spoke with confirmed this.

We contacted the registered manager in November 2013 and requested how they had ensured our concerns had been addressed. They provided us with evidence to show us that progress had been made and the concerns had been addressed.

We contact the registered manager again on the 10 February 2014 and discussed how our concerns had continued to be addressed and how they had maintained the progress ensuring there was continual review.

We found that the issues in respect of the safety and suitability of premises and supporting workers had been addressed. This meant people were protected as a result.

We found the home to be a calm place where people were treated with respect and with kindness.

People had their care plan discussed with them, which they signed and they were supported to remain independent for as long as possible. Everyone we spoke to was positive about the staff, the home and their care.

We found the care plans were current and reflected the care given by the staff. W

We found the premises were clean and in good repair. We found that were concerns about the hot water taps and there was no risk assessment in place to deal with this situation.

We found that the staff were recruited safely and that training took place. We found the monitoring of the training of the care and nursing staff was not sufficiently robust to ensure the training was updated in a timely manner. There was no record of up to date supervision and appraisal taking place in respect of the care and nursing staff.

We saw the home had a clear complaints procedure in place that was publicly available to people and their relatives. People told us any concerns had been suitably addressed.

Most people had lived at St Vincent's for some time and knew each other and the staff well. People had clear assessments of their needs and plans and strategies were in place to meet them. People's care plans had been reviewed regularly.

We saw that staff interacted with people in a relaxed, friendly and respectful manner. Staff worked at the pace of each individual and encouraged their independence. People had made friendships within the home and had access to social activities such as morning communion, group games and quizzes.

During our visit we saw that people were offered choices throughout the day which supported their independence and provided a meaningful quality of life.

Staff had received training in safeguarding vulnerable adults and recognising abuse and knew how to report any concerns.

We saw evidence that the service carried out effective monitoring and assessment of the quality of care delivered through regular reviews and audits.

We found some information was missing in staff files. This included a lack of evidence of photographic identity and proof of address.