St Clair House

People’s experience of using this service and what we found

The provider had systems in place to protect people from the risk of abuse and people told us they felt safe.

Risk assessments were completed to help identify and minimise risks to people. Staff had been recruited safely and there were enough staff to respond to people's needs. Systems to manage medicines were judged as being safe.

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.

Incidents and accidents were managed safely. The registered manager took necessary action to keep people safe and minimise the risk of reoccurrence. Steps were taken to learn lessons if things went wrong.

Health and safety checks of the environment and equipment were in place. There were certificates in place to support this. Systems were in place to support people in the event of an emergency.

We looked at infection prevention and control and found we were assured that the provider was protecting people, staff and visitors from the risk of infection.

Staff told us they had received the training they needed to meet people’s needs safely and effectively. The training matrix tracked staff training, and this helped ensure all staff received the training and updates needed to provide safe consistent care.

Staff were supported in their roles through a plan of supervision. Staff told us they felt supported by the registered manager and senior staff .

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and social care professionals.

The systems in place to monitor the quality of care within the service were effective. The registered manager promoted a positive person-centred culture and fully understood their responsibilities as a registered manager.

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

We registered this service on 7 January 2021 and this was the first inspection. The previous provider rating for this service was good published (20 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Clair House Limited our website at www.cqc.org.uk.

Notice of inspection

This inspection was announced.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The service was clean throughout. There were appropriate procedures to ensure infection control risks were minimised. There were a few communal areas to ensure safe distancing seating arrangements. Regular discussions took place between staff and people to ensure they understood the reasons for social distancing. People who had limited capacity were sensitively encouraged to safe distance by staff.

The service was closed to visitors following government guidance and had constructed a temporary garden building to compensate for this. The building had a sealed Perspex divider with two separate entry points. PPE was offered and this enabled people to arrange appointments to see residents with the support of staff while protecting them from the risk of infection. Staff also helped people to stay in touch with family and friends through phone and video calls.

Clear signage and sanitiser dispensers were in place around the service. They were informative and highlighted what PPE was required to protect people.

The registered manager was communicating with people, staff and family members regularly to make sure everyone understood procedures and precautions being taken, and how to keep people safe. The registered manager worked with the whole staff team to ensure infection prevention and control measures were in place. This included introducing a dedicated staff area where they could access the service without walking through the home. The changing area included individual storage space for staff clothes and shoes. Uniforms were laundered on the premises to reduce the risk of cross infection.

Cleaning and infection control policies and procedures had been updated in line with Covid-19 guidance to help protect people, visitors and staff from the risk of infection. The registered manager kept up to date with appropriate training in infection control. The registered provider arranged and delivered training for staff to ensure they knew how to keep people safe during the COVID-19 pandemic.

People at high risk and those wishing to remain in their own rooms were supported by staff to occupy themselves. The service continued to offer and provide activities whilst maintaining people’s safety.

Further information is in the detailed findings below.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Clair House is a care home which offers care and support for up to 25 predominantly older people. At the time of the inspection there were 22 people living at the service. Some of these people were living with dementia. The service occupies a detached house over two floors with a passenger lift for people to access the upper floor.

There were systems in place for the management and administration of medicines. However, the systems for supporting people who self-administered their own medicines was not always appropriate. It was clear that people had received their medicine as prescribed. Regular medicines audits were being carried out on specific areas of medicines administration and these were effectively identifying if any error occurred such as gaps in medicine administration records (MAR).

The premises were well maintained. There was redecoration in progress at the time of this inspection. Whilst the service was not registered for dementia care, there was no pictorial signage at the service to support some people, who may require additional support with recognising their surroundings.

The premises were regularly checked and maintained by the provider. Equipment and services used at St Clair were regularly checked by competent people to ensure hey were safe to use. However, there were no recent records available to demonstrate necessary Legionella water checks had been completed at St Clair. The Health and Safety executive states that care homes should check hot and cold water temperatures monthly and shower heads should be cleaned quarterly. We have made a recommendation about this in the Safe section of this report.

We walked around the service which was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes. People were treated with kindness, compassion and respect.

Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.

Staff were supported by a system of induction training, supervision and appraisals. Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. People were supported by staff who knew how to recognise abuse and how to respond to concerns. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The registered manager had a record which provided them with an overview of staff training needs.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had no staff vacancies at the time of this inspection.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. Although capacity assessments had not always been completed before restrictions had been put in place in order to keep people safe. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff on an electronic system which was due to be replaced by a full electronic care plan system in the near future.

People had access to activities. An activity co ordinator was not in post but care staff co-ordinated a planned schedule of activities. On the day of this inspection a visiting musician came to entertain people. People were supported to go out wtih staff to attend appointments, have coffee or visit local attractions.

The registered manager was supported by the provider and a team of motivated and long standing staff. We were told there were plans to provide further management support to the registered provider so that the service could continue to improve the service it provided in the future.

We saw care plans were detailed and gave direction as to the care and support people needed. They had been regularly reviewed. We saw they were developed and reviewed with the person using the service and /or their relatives where appropriate.

There were robust systems in place for the storage, administration and disposal of medications.

We saw the house was well maintained and provided a homely atmosphere.

There were robust staff support systems in place and regular training opportunities. Meaning people were looked after people who were confident and trained to do their job.

We saw the quality of the service provided was monitored and the registered manager sought people's views about the service they received regularly.