St Catherines Nursing 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 the last inspection we rated this key question as good. At this inspection this key question has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 before moving to the service and they felt the staff were able to meet their needs. People and their relatives told us they had enough information and support to ensure the move into the home and the transition went well. A relative told us, “The Service Manager, [name] was great when we approached her about transferring my [person] to St Catherine’s. We were shown a couple of rooms and able to choose the 1 that would best suit my [person’s] needs. Manager arranged a date/time to carry out an assessment and was on time and very accommodating with my [person]. We were offered a move in date, and all went as planned. The staff were aware of our arrival, took us to their room and helped them settle in.”

Care plans were developed from a preadmission assessment, and through people’s involvement, which included important health, support information as well as people’s preferences and backgrounds. A staff member said, “A detailed admission care plan is completed by the manager or nurse doing the pre-admission assessment.” People and their relatives felt involved in this process.

The provider planned people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. However, care was not always delivered in accordance with plans, particularly in relation to mealtimes.

People and relatives said they had enough to eat and drink, sufficient choice and support. A person said, “Food is lovely, allergic to [food type] they all know that, can have something else if don’t like it.” However, another person told us they liked their breakfast done a certain way, but it wasn’t always done right. We did see this request noted on a menu form indicating staff were aware of and trying to accommodate this request but based on the person’s feedback, this was not happening consistently. A relative said, “[Person] needs their food cutting up which is done at mealtimes, and they say the food is very good.” Another relative told us they felt staff did not pay attention to their family member’s specific dislike and continued to serve it to them, and another told us the food could be bland.

We observed the mealtime experience to be task led. Staff were putting plates down and not telling people what the meal was. Drinks and cutlery were not at the tables ready for people. People were asked their main meal preferences the day before. During the visit, people were offered show plates showing them what was for lunch, however we were told this did not normally happen. We asked the registered manager about this who told us they were trying to introduce it. We discussed the need to make this more beneficial for people by having the food uncovered and slower explanations for people. Pictorial menus were available on tables. We also noted that extra helpings were not offered, even when a person cleaned their plate and was scraping it to make sure they had it all. We noted this was the person who ate food not suitable for them prior to lunch but had heard them expressing they were hungry 45 minutes before lunch and being told lunch was soon. We discussed with the registered manager the need for staff to provide appropriate snacks regardless of the time before or after a meal. We noted the person’s unsettled behaviour stopped once they had eaten.

When staff were supporting people to eat, some were chatting with people. We saw there was plenty of drinks offered throughout the day.

Where people were losing weight, there were plans in place to help improve calorific intake. Fortified meals were provided for those who needed them.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People, and their relatives, told us staff knew them well. They told us if they needed any health care input this was sought. A relative said, “[Person] is seen by GP on ward round as needed and staff keep me informed of any discussions etc. She was admitted with [skin condition] which [person] had District Nurses attend too for the past [multiple years] but with the excellent care by the Nursing Team, it has now healed and no longer requires a dressing.”

Staff told us they worked with health and social care professionals to ensure people had the right care and support. This included mental health teams, district nurses, Speech and Language teams, GPs and a Chiropodist. Feedback from a visiting health and social care professional stated, “The staff are polite and helpful, and my visits are always well organised and supported.”

People’s care plans included a record of information obtained on their admission to the home. This was transferred into and informed the care plan.

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.

People and their most relatives told us they felt their physical, emotional and social needs were met. They said they had plenty to do to fill their time. A person said, “We have exercises and bingo today.” A relative said, “When speaking to [Person] last they were well, happy and enjoyed participating in activities arranged by the staff.” However, another relative told us they were not happy with their family member’s dementia care or the lack of activities and going out.

Staff were familiar with signs of infection or changes and health and knew what action to take.

Some people had chosen to stay in bed or in their rooms. Staff were going in routinely to support people to check on them and see if they needed anything. A staff member said, “Staff visit residents in rooms regularly, activity person does 1:1 activities with those in rooms. All staff do ‘tools down’ at 3pm daily and visit a resident in their room for engagement.”

In the communal area people were joining in with a game of bowling and chair exercises. Bingo was planned for the afternoon; there was a discussion between people and a staff member about if it should be musical bingo. There were events planned based on seasons or important dates. There were opportunities for people to get out and about, there were also visiting entertainers.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People’s care needs were reviewed regularly and in between if needs changed.

Staff were able to explain how they monitored people’s health and wellbeing. They were aware of what action to take if needed.

There were systems in place to have overview of people’s care needs, wounds and infections for example, and this included progress updates.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us they were able to make their own choices. We observed people being asked by staff before they did something to support them.

Staff were aware of the Mental Capacity Act 2005 (MCA). They were able to tell us how the principles of the MCA were considered in their day-to-day roles. For example, ensuring choices were offered to people and respected by staff. A staff member said, “I do have MCA training and I always using this act while I am doing personal care or any task when I am doing with residents. Always gives them wide choices and chance to choose what they like let them speak. Asking them what they like to do, they like to get up? If they change their mind for food or something else giving them alternative options.”

People’s care plans included discussions relating to capacity assessments, which detailed how capacity for the decision was assessed. These included decisions relating to living at St Catherines, the use of bed rails and covert administration of medicines.

Plans stated where people had capacity to make day to day decisions, but more support was needed for more complex decisions. There was a record when Deprivation of Liberty Safeguards (DoLS) authorisations were requested. A DoLS authorisations tracker was in place so the progress of applications could be monitored. If anyone had conditions imposed for authorised DoLS these were recorded and staff made aware of how to comply with these. We saw a record of actions indicating conditions were being met in most cases. We discussed the need to monitor this to ensure the person’s conditions were always met and management put immediate actions in place.