St Catherines Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. The provider was previously in breach of the legal regulation in relation to nutritional and hydration needs. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to their admission to the home. Staff used specific assessment tools such as the Cornell Depression Scale or Malnutrition Universal Screening Tool (MUST) to assess and monitor people’s specific health needs. Care plans were developed from the assessment and were in the process of being audited and reviewed. They contained person-centred information to guide staff, including emotional support care plans. We spoke with a person who told us staff had discussed their care needs with them.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Since our last inspection, some improvements had been made to the way people’s care and treatment was provided. People were positive about the food on offer and the presentation of food, especially where people required a pureed diet, which was much improved. People told us, “The food is quite good, and I often have a banana. There are 3 choices at lunch” and “The food is very good. I get plenty to eat and drink.”

However, recording processes to ensure effective oversight of how people’s needs were being met were not always effective. Records for one person suggested they had not been supported with a drink all the previous night, however, staff said they had provideda drink in the morning. We saw another person’s cold cup of tea left on the side, but the records suggested they had drunk this. In another example, a visiting professional had found staff were not routinely recording they had inspected a person’s skin condition, however, evidence suggested they had been doing so. Managers told us they were continuing to monitor and guide staff in relation to accurate record keeping requirements. We saw gaps in records to demonstrate people had been supported with oral health care. Some toothbrushes appeared dry and unused. In response to our feedback the management team agreed they would arrange further training in this area.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. The management team had been working to ensure the staff team shared relevant information and were kept up to date. ‘Daily huddle’ meetings and ‘flash meetings’ were held to update and share information and changes. However, some staff said these weren’t always effective, because information discussed at flash meetings wasn’t always shared with the whole staff team. For example, a person’s dietary needs had very recently been reviewed and slightly amended by a speech and language therapist. Whilst their care plan had been updated, kitchen staff were unclear about the change and records in the kitchen had not been amended.

In general, staff feedback indicated there had been improvements in how the staff team worked together. One staff member commented, “I feel we’re headed in the right direction. There’s more team work with staff.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff referred people to various health and social care professionals for input and support where necessary. For example, people saw occupational therapists or specialist nurses. One person told us, “A chiropodist comes in to do my toenails.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.Since our last inspection, the management team had focused on ensuring people needs were monitored and to ensure positive outcome managers maintained a clinical risk register which was kept up to date. The registered manager was knowledgeableabout people’s needs, for example, if people had any wounds or may be at risk of losing weight. A relative told us staff were good at keeping them up to date about any changes.

Staff reviewed people’s needs using a ‘Resident of the day’ system, where all departments took part in a review of the person’s needs. Staff told us people, and their relatives were involved in these, however, we noted records relating to their involvement in this needed to be clearer.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The provider guided staff to undertake mental capacity assessments for everyone moving to the service, in relation to their care and treatment. However, The Mental Capacity Act (MCA) says if a person has no impairment, it would not be necessary to undertake an assessment. Therefore, it may not be appropriate to always undertake these assessments. The Head of Quality told us this approach was already under review and staff would be receiving further guidance about this.

Staff had been focused on ensuring MCA assessments and best interest decisions were completed and recorded where required. However, we found certain best interest decisions still needed to be recorded and, in some cases, assessments needed to be more decision specific. For example, the registered manager told us room sensors used to monitor people’s movement to help prevent falls, were assessed under the general heading of equipment. However, as these resulted in close monitoring and supervision for some people, this decision needed a more specific assessment. We found records needed to be clearer to demonstrate how staff were following the conditions in place as part of a person’s DoLS authorisation.

Overall, we saw staff sought consent from people and respected their rights when providing care. One person told us, “I have no restrictions placed on me, I can do what I want with regard to my limitations.”