Archived: St Judes

St Judes is a residential care home and was providing personal care to 25 people aged 65 and over at the time of the inspection. The service can support up to 27 people. The care home accommodates people in one adapted building over two floors.

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

People felt safe living at St Judes and felt at ease to approach staff with any concerns. Staff had completed safeguarding training so that they knew what signs to look for of potential abuse.

There were enough staff on duty to keep people safe. Appropriate recruitment checks had been completed to ensure staff were suitable to work with people. Staff had completed training considered essential to support people’s needs and to work safely. Staff spoke positively about the training and support they received. They knew about risks associated with people’s care so they could manage these appropriately. People received the medicines they were prescribed to maintain their health and medicines were stored safely.

The home was clean, tidy, and well maintained and staff followed safe infection control practices to reduce the risk of the spread of infection.

People had individual care plans detailing their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice and refresher training was planned to remind them of the principles of the Mental Capacity Act.

People enjoyed the food provided and menus showed choices were available each day.

People told us the staff were kind and caring and treated them with dignity and respect. All interactions we observed were respectful and professional. People were supported and encouraged to join in with daily activities that took place within the home.

People, visitors and staff had opportunities to share their views of the home in either meetings or satisfaction surveys which showed positive outcomes. The provider had a system in place for responding to complaints and people knew who to contact if they had any concerns.

An electronic care planning system had been implemented at the home to help improve records management and to support staff in their work. However, records relating to risks were not always fully detailed to show they had been responded to. Audit processes had not identified areas needing improvement in regard to record keeping. They had also not identified potential risks related to the environment and equipment.

The management team were dedicated to improving the ongoing care and support people received and spoke of plans to further improve the service. Both people and staff had confidence in the management team and staff felt valued and well supported. This had resulted in a positive, encouraging and supportive culture within the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was Good (17 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

During our last inspection on 5 and 6 May 2015, the provider was not fully meeting the standards required. This applied to the standards related to “Safe” and “Well Led”. We found medicines were not managed safely, and quality monitoring was not effective in identifying areas needing improvement. This meant we allocated an overall rating of “Requires Improvement”. We asked the provider to take action to make the necessary improvements. We found action had been taken to make some of the improvements required, but further action was required to ensure people consistently a high standard of care.

The home has a registered manager. 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 told us they felt safe living at St Judes and felt at ease to raise any concerns with staff if they needed to. People were protected from the risk of abuse because staff had attended training in safeguarding people and understood the provider's policies and procedures for raising concerns.

The provider's recruitment process ensured risks to people's safety were minimised. Records showed new staff underwent an application and interview process so the registered manager could check their skills and experience. Staff were required to complete induction training when they started at the home and completed ongoing essential training to maintain their skills.

There were sufficient numbers of staff to support people’s needs and people told us staff were available when they needed them. People were very positive about their experiences of the care they received and of the staff that supported them. We saw staff were caring in their approach to people and ensured people’s privacy and dignity was maintained. Staff responded promptly to any requests people made and always acknowledged people when they walked past them.

The processes to manage medicines had been reviewed to ensure people received their medicines as prescribed. Medicine records were regularly checked to identify any errors to ensure medicines were managed safely. However, staff competencies were not regularly checked to make sure they followed good practice when administering medicines.

The registered manager had some understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). They reported that all people in the home had some capacity and were able to make day to day decisions. They had therefore not needed to make any DoLS applications in regards to any restrictions placed on people’s care. Most staff understood they needed to gain people’s consent before delivering care. MCA training was planned for those staff who had not completed this or were unclear of their responsibilities.

People were assessed to identify any risks associated with their care and staff were aware of these risks and supported people to minimise them. People had care plans detailing how they liked to spend their day which included information about their wishes and preferences when staff provided support or care. Sometimes people’s care plans did not detail clear instructions to staff to ensure a consistent approach to their care.

Most people said they were not aware they had a care plan and did not feel involved in planning their care. However, people told us they were satisfied with the care they received and we saw care plans were person centred and described how people liked to receive their care and support throughout the day.

People were provided with choices of nutritious food that met their needs and told us they had enough to drink during the day. Where necessary, people were supported to eat their meals. Social activities were provided with the support of an activity organiser. Most of these were in accordance with people’s interests and choices but these were subject to review to ensure they were person centred and people continued to enjoy them.

There had been no complaints received by the service and people told us they had no reason to complain. People said the registered manager was approachable if they had any concerns they wished to raise.

The registered manager was committed to the ongoing improvement of the home. They acknowledged there were some improvements needed to care records. This was so they were sufficiently clear to demonstrate actions required or carried out by staff to meet people’s needs.

A system to implement regular staff supervisions and appraisals was in the process of being fully implemented.

There was clear leadership within the home and management support seven days per week. In addition to a registered manager, there was a deputy manager so that staff had the support they needed to effectively meet people’s needs. The provider carried out regular checks on the quality of care and services provided to identify any areas needing improvement. These checks included weekly visits to the home as well as undertaking quality satisfaction surveys with people, their representatives and staff. We saw responses from people and their representatives were very positive.

We spoke with nine people who lived at the home. People told us they were very happy with the care and support provided. Their comments included 'The food is good', 'They check on me regularly' and 'It's a good medical service.'

We spoke with four relatives who were at the home on the day of our visit. They were all full of praise for the home, the staff and the manager. One relative said 'It is an excellent service here' and added 'I would feel comfortable about complaining.' Another said that the manager had been quick to respond positively to suggestions. One person told us of the attention to small details and observed 'There are always nice napkins and table cloths.'

Other comments made to us were 'Very good staff', 'Very good manager', 'They listen' and 'No complaints.'

We also spoke with the manager and the four care staff on duty that morning. They were all able to demonstrate a good knowledge of the individual needs of the people at the home. They showed a commitment and ability to meet those needs in ways best suited to each individual.