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Archived: St Vincents Care Home Requires improvement

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Reports


Inspection carried out on 19 October 2017

During a routine inspection

St Vincents Care Home is a privately run care home registered to provide accommodation for up to 25 older people. The home is run by the Soldiers, Sailors and Airmen’s Families Association (SSAFA) and provides support to ex-servicemen and ex-service women. At the time of our inspection there were 22 people living in the home. The inspection was unannounced and was carried out on the 19 and 23 October 2017.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The risks relating to people’s care and treatment were not always identified and managed effectively.

Although, medicines were administered by staff who had received appropriate training and assessments they were not always managed safely and best practice guidance was not always followed.

Staff sought consent from people before providing care. However, people’s ability to make decisions was not always assessed in line with legislation designed to protect people’s rights. People were deprived of their liberty without the appropriate authority being in place.

There were systems in place to monitor quality and safety of the home provided, however, these were not robust and did not identify the concerns we identified during this inspection. People’s records were not always up to date and did not always reflect people’s needs.

There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner. However, the recruiting practices was not robust and did not always ensure that a full employment history for new staff was available or a written explanation for any gaps.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs.

People told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

Staff developed caring and positive relationships with people and were sensitive to their individual communication styles, choices and treated them with dignity and respect. People were encouraged to remain as independent as possible and maintain relationships that were important to them.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff encouraged people, when necessary in a patient and friendly manner.

People and when appropriate their families were involved in discussions about their care planning,

There was an opportunity for people and their families to become involved in developing the service. They were encouraged to provide feedback on the service through residents meetings and an annual survey. They were also supported to raise complaints should they wish to.

People told us that they felt the home was well led and were positive about the registered manager who understood the responsibilities of their role. The provider was fully engaged in running the home and provided regular support to the registered manager. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 17 & 19 June 2015

During a routine inspection

St Vincents Care Home is owned by SSAFA, the Soldiers, Sailors and Airmen’s Families Association and is registered to provide accommodation for up to 25 people who do not require nursing care. The home provides support to older ex-servicemen and ex-servicewomen. At the time of the inspection the home accommodated 21 people.

There was a registered manager in post. 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.

The inspection was unannounced and was carried out on the 17 and 19 June 2015.

People told us they felt safe; however, we found that risks relating to people’s health and welfare were not always recorded and managed effectively. We also found that the changes in people’s needs were not always identified and responded to appropriately. There were suitable arrangements in place for the safe storage and disposal of medicines and all medicines were administered by staff who had received the appropriate training to be assessed as competent. However, we found some medicine administration records were not completed correctly. By the end of our inspection the registered manager had taken action to resolve all of these issues.

People were supported by staff who had received the appropriate training, professional development and supervision to enable them to meet their individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

Staff and the management team had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People and visitors told us they felt that staff at the home was caring and positive relationships with them. Staff were sensitive to people’s individual choices and treated them with dignity and respect. People were encouraged to maintain their family relationships and their bedrooms were individualised to reflect their personal preferences.

People and when appropriate their representatives had been involved in the planning and review of their care. They knew the people they supported well and were knowledgeable about the types of activities they liked to do. People were allocated a member of staff to act as a keyworker whose role was to support the person to stay health.

People were complimentary about the food and were supported to have enough to eat and drink. Drinks were available throughout the day and people and visitors were encouraged to help themselves from a fresh fruit juice bar and coffee station.

People were supported to maintain good health and had access to healthcare professionals such as GPs, chiropodists, opticians and dentists when necessary.

There was an opportunity for people and the families to become involved in developing the service and were encouraged to provide feedback on the service provided. They were also supported to raise complaints should they wish to.

People and relatives told us they felt the service was well-led and were positive about the registered manager who understood their responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the service.

Inspection carried out on 12 September 2013

During a routine inspection

We spoke with six people who use the service. They all told us staff sought their consent before they delivered any care. They said they were very happy with the level of care provided and staff understood their needs. One person said “I am well looked after and my children can have peace of mind”. Another person told us “they look after me very well and if I have to press my buzzer they come immediately”.

We looked at six care plans and saw they were individualised and included the necessary information to inform staff as to the specific care people required. We saw these were reviewed and people had signed to say they had read them. We observed care in the communal areas of the home and saw staff interacting with people in a positive way.

We saw the home was clean and well maintained. The manager told us they were responsible for overseeing infection control. We spoke with three members of staff and the manager, all of whom said they had received infection control training. Everyone we spoke with told us the home was always clean. One person said “everywhere is always beautifully clean”.

Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place. We found the provider had an effective quality assurance system and sought the views of people who use the service and their families through regular surveys. We spoke with two visiting health professional who told us they did not have any issues regarding the quality of the service provided. One said “care here is absolutely spot on, a hundred per cent. It is a shining example”.

Inspection carried out on 20 December 2012

During a routine inspection

We spoke with three people and observed care throughout the home. People confirmed that they felt safe and that staff were available when they needed them. One person said “I am really settled here. My daughter has peace of mind because she knows I am settled”. They said that the food was good and a choice was available.

We observed staff providing care and saw that people looked happy and relaxed. We reviewed six care plans and associated risk assessments. Each plan was signed by the person and contained sufficient information to enable the appropriate care to be provided to people using the service. We saw that reviews of care were conducted regularly and the date of the review was included in their plan.

We spoke with three staff and confirmed that they had received appropriate training and had the skills necessary to carry out their duties. Staff had received safeguarding training and were able to say what action they would take if concerns were raised or observed. They told us that they felt there were sufficient staff available to meet people’s needs. We spoke with two external healthcare professionals, who told us they were happy with the care that was provided at the home. They told us that there was good communication and they were kept informed about any changes in people’s condition. They were positive regarding the care provided. One said “Staff here are brilliant. It is a home from home. Staff are always available to come with you when you need them”.