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Inspection Summary


Overall summary & rating

Good

Updated 9 May 2018

St Michaels is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Michaels Home provide accommodation and personal care for up to 21 older people.

At the time of our inspection visit there were 17 people living in the home. The inspection visit took place on 26 February 2018 and was unannounced.

At the last comprehensive inspection on 10 January 2017, we found the provider was not fully meeting the standards required. We identified three breaches of the Health and Social Care Act 2008. This was in relation to care and treatment not always being provided in a safe way, there being insufficient action to safeguard people from improper treatment, and there being insufficient systems to monitor the quality of service in relation to the health, safety and welfare of people. The service was rated as ‘requires improvement’ with an ‘inadequate’ rating for the key question ‘well led’. We issued the provider with a warning notice and asked them to take the necessary action to improve.

Following the inspection on 10 January 2017, we asked the provider to complete an action plan and met with the provider to confirm what they would do, and by when, to improve the service. We returned to the home on 15 June 2017 to complete a focussed inspection. This was to check actions completed in relation to the warning notice and to review the key question of ‘well led.’ We found sufficient improvement had been made to address the breach of Regulation 17 related to the warning notice related to the management of the service and the quality of care people received.

At this inspection we found the provider had continued to make improvements to the service since we had last visited. We also found sufficient action had been taken to address the remaining two breaches in the regulations so that the home was no longer rated ‘requires improvement’. However, there remained some areas within the key question ‘well led’ that needed to be improved.

The manager, who was in post at the last inspection, had registered with us. 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.

People’s needs were assessed before they moved to St Michaels so the registered manager could be confident those needs could be met. Risks associated with people’s care had been identified and documented in care plans so they could be managed. Care plans continued to be reviewed so they provided staff with sufficient information about people’s needs. Staff arranged for people to see a doctor where people had identified healthcare needs. Records confirmed visits had been undertaken and advice given.

The provider’s recruitment system required a series of checks to be made before new staff could work with people at the home. People told us they usually felt safe living at St Michaels Home and spoke positively of the staff team that supported them. They told us staff were caring and approachable and we saw enough staff were available to support people’s needs. Staff took time to get to know people and demonstrated this through their interactions with people. Staff respected people’s individuality and aimed to support their independence where possible.

Accidents and incidents were recorded and reported to us as required. One incident related to safeguarding people had occurred and we were told that it had been investigated and acted upon appropriately.

Staff who administered medicines had completed the necessary training to do this safely and people told us they received them as required. Ac

Inspection areas

Safe

Good

Updated 9 May 2018

The service was safe.

Staff understood their responsibilities to protect people from the risk of abuse. Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks. The registered manager checked staff’s suitability for their role before they started working at the home. Overall, people received their medicines safely and as prescribed.

Effective

Good

Updated 9 May 2018

The service was effective.

Staff completed training to ensure they had the right skills and knowledge to support people effectively. Staff understood about gaining people's consent and worked in people’s best interests if they lacked capacity. People found the food to be satisfactory and were provided with a choice. People had access to healthcare professionals to maintain their health and wellbeing.

Caring

Good

Updated 9 May 2018

The service was caring.

People and their relatives were positive about the staff. People were supported by a staff team who were patient and respectful towards them and aimed to support their independence. People’s felt their privacy and dignity needs were respected.

Responsive

Good

Updated 9 May 2018

The service was responsive.

People were asked about their hobbies and interests and had access to some social activities and outside visits. Care plans contained information about people’s backgrounds to assist staff in providing personalised care. People had some involvement in planning and reviewing their care. There was a complaints process in place. People felt confident to report any concerns and knew who to speak to.

Well-led

Requires improvement

Updated 9 May 2018

The service was not consistently well led.

People and relatives were positive about their experiences of the home. Quality monitoring systems required further improvement to demonstrate these were effective and both staff and people’s views were listened to and acted upon. Records were not always sufficiently clear to show the care people needed was provided. Staff felt supported by the registered manager and provider. Statutory notifications about notifiable incidents had been submitted as required.