Archived: St Benedict's Nursing Home

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five questions we always ask:

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service caring?

The service was caring. People who lived in the home spoken with said they were happy with the care and support they received. One person said 'I couldn't fault the care at all. The staff here really are good.'

People received care which met their individual needs or preferences. People's health care needs were monitored and responded to appropriately. Staff were responsive to people's needs where concerns had been identified.

We met with three visitors who were very complimentary about the care provided and of the staff who worked at the home. One told us 'you really can't fault it here. All the staff are so kind and pleasant. I feel my X is very well cared for.'

Throughout our visit we observed staff spending quality time with people. The atmosphere in the home was relaxed and welcoming. We saw staff had time to sit and talk with people and we saw they enabled people to maintain a good level of independence.

Is the service responsive?

The service was responsive to people's needs. We saw care plans contained information about people's individual support needs and personal preferences, such as their likes and dislikes. People were supported in line with these.

People who used the service, their representatives and staff were asked for their views about their care and treatment. Their views were acted upon. Changes or improvements were made where possible and practical.

Is the service safe?

The service was safe for people. We saw care plans included a range of individual risk assessments and control measures, such as equipment and care guidelines for managing these risks.

People were cared for in a clean, hygienic environment. The systems in place to reduce the risk and spread of infection were effective. We saw that all areas of the home were clean and there were no offensive odours.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant 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. People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well.

Staff knew how to ensure that people's rights were respected. They demonstrated a very good understanding of how to support people to make decisions. They knew the procedures to follow where an individual lacked the capacity to consent to their care and treatment. Procedures were in place which meant that decisions about the care and support people received would be made in their best interests.

People enjoyed a range of activities including painting, reading, knitting and trips out of the home. One person told us 'the activities girl is wonderful. She is always about and there is always something or other going on.'

People said they were provided with a choice of meals and drinks; they liked the food served in the home. People were able to choose where to eat their meals. Some people used adapted cutlery to enable them to eat independently. Where people require help to eat their meal they were well supported by a member of staff.

Is the service well led?

The service was well led. The owner employed a registered manager who was in day to day charge of the home. There was a clear staffing structure in place with clear lines of reporting and accountability. The manager was supported by senior care staff and qualified nurses who supervised the work of the care staff.

The manager audited different aspects of care to help improve the service. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Risks to people's health and welfare were well managed. Regular environmental audits and maintenance were carried out to ensure the home was a safe place to live and work in.

There was evidence that learning from incidents took place and appropriate changes were implemented.

We observed staff acting in a respectful and professional manner when assisting and supporting people. Staff demonstrated an understanding of respect and dignity and were observed putting this knowledge and skill into practice. We saw staff responding to behaviour in a non judgemental and supportive way.

People told us they were happy with the care they received. There were improved arrangements for the monitoring of people's weight and the provider was effective and responsive to any concerns about people's health needs. There was a range of activities available. However there was little to stimulate people or provide an activity for those who were seated in the lounge areas of the Deanery.

There had been some improvement in the management of people's nuitritional needs. People were not always enabled to make an informed choice about their meals, where they ate and had their meal.

The service had taken action to address the non compliance with regard to the management of the laundry. We found a number of areas in the Deanery where there was risk of infection or cross infection because of poor hygiene practice.

The provider had taken the necessary steps to address the area of non-compliance related to how the service had responded to a safeguarding concern.

The provider had put in place a robust system for the use of "as required medicines". There was detailed and clear guidance in care plans where the individual had been prescribed such medicines. The provider had taken the appropriate steps to address non-compliance in relation to use of such medicines and making sure people's medicines were regularly reviewed.

Following a review of the staffing arrangements in the home there were the appropriate levels of staffing to support people. People received the one to one support they needed to maintain their safety and wellbeing.

There were comprehensive systems to monitor the quality and safety of the service. However there were shortfalls and failures to identify through these systems risks to people's health and welfare. There was not effective and robust measures to make sure actions were completed where identified through quality and monitoring audits.

People were at risk of not receiving adequate nutrition to ensure their health and welfare were protected. We observed differing practice of staff in enabling and supporting people to have their meals. There was a failure to take the necessary action and report an allegation of abuse to the appropriate authorities to ensure a robust investigation could take place.

Staff had the necessary knowledge to ensure people's health and welfare were protected from risk of infection. Effective arrangements were not in place to maintain the cleanliness of the laundry environment and management of laundry items.

Medicine care plans did not provide adequate guidance and information about the use of "as required" medicines.

Staffing arrangements did not provide the necessary support at a time of people's choosing.

Some people who lived at St Benedict's Nursing Home were unable to comment on the care and support they received. However those people who were able to comment all told us they were very happy living at the home.

One person said, 'This is a very nice place to stay, they look after you very well'. Another person told us, 'I am really happy with the care my relative receives'.

We observed staff treated people who lived in the home with respect and dignity.

We found that care planning was person centred and agreed by the individual, a family member or an advocate. Regular reviews were carried out and involved the individual.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the registered manager.

The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.