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St Heliers Hotel Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 October 2021

About the service

St Heliers Hotel is a residential care home providing personal care to up to 30 older people most of who were living with dementia. At the time of our inspection 20 people were living at the service.

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

People were happy and content living at St. Heliers Hotel. They were complimentary about the staff and the support and care they received.

Governance and performance management was not always effective. Concerns identified in the previous three inspections had not been prioritised and improvements had not been implemented effectively. The quality of information in people's care plans varied, and some records did not include information about individual risks.

There continued to be shortfalls in the staff recruitment process. The systems used to monitor the quality and safety of the service had failed to pick up and address the areas of concern we found during the inspection. Some audits and safety checks had been completed. Action had been taken in some areas of the service and improvements had been made. Other areas needed more work and development to ensure improvements were embedded and sustained. There was a new registered manager in post who joined the service in May 2020.

People were not always fully protected from risks. Risks to people had been identified, however, guidance for some risks had not been fully recorded and some information was contradictory. There was not always clear guidance for staff regarding risks relating to choking, when people became distressed and health conditions. Further improvements were needed to ensure people were kept as safe as possible and staff were consistent in their approach. Risks concerning the environment had been addressed. Re decoration had taken place in bedrooms and hallways.

People and their relatives told us they or their family members felt safe and well supported at the service. People were protected from abuse and avoidable harm and were treated with respect and dignity. People were supported to have day to day choice and control of their lives and staff supported them in the

least restrictive way possible and in their best interests. Staff helped to maintain people's independence by encouraging them to do as much as possible for themselves.

When accidents or incidents occurred, learning was identified to reduce the risk of them happening again.

When people were unwell or needed extra support, they were referred to health care professionals and other external agencies. People's medicines were safely managed.

There were enough staff available to make sure people received the personal care and support that they needed. The registered manager was reviewing the staffing levels following feedback from people.

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

At this inspection enough improvement had not been made and the provider was still in breach of regulations. There continued to be shortfalls and breaches of the regulations. The last rating for this service was Requires Improvement. (published 30 July 2019) and there were three breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

Our previous inspection found shortfalls at the service in relation to, the management of risks to people, staff recruitment and the failure to effectively audit, monitor and improve the quality and safety of the service. As a result, we undertook this focused inspection to check they had they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 Heliers Hotel on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk management, staff recruitment and the effective monitoring and improvement of the service at this inspection.

We imposed a condition on the provider's registration.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 7 October 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 7 October 2021

Caring

Good

Updated 7 October 2021

Responsive

Good

Updated 7 October 2021

Well-led

Requires improvement

Updated 7 October 2021

The service was not always well-led.

Details are in our well-Led findings below.