Archived: St Raphael's Care Home

Updated 18 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 March 2018 and was unannounced. The inspection was carried out by one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

As part of our planning for this inspection we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also considered statutory notifications received by the provider and previous inspection reports. A notification is information about important events which the provider is required to tell us about by law.

We looked at five people's care records which included risk assessments and other associated records, four staff files, records relating to the management of the service and policies and procedures.

We spoke to nine people who use the service, four relatives, three care staff, one RGN, an activities coordinators and three sisters of the Order of St Augustines. We also spoke with maintenance staff, the training manager, HR staff, the Care Director and the registered manager. We received feedback from one care manager from the local authority.

We also made observations of the environment and staff interacting with people.

Updated 18 July 2018

St Raphael's Care Home 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. The home is a registered location of The Order of St Augustine of the Mercy of Jesus, a registered charity.

The home is run by Sisters who oversee the care home taking an active part in the day to day running and pastoral care of the residents. The home is set in its own grounds which provides residential and nursing care for a maximum of 58 people. The home specialises in providing care to older people who may have physical or sensory impairments and people who have dementia related conditions There were 53 people at the home at the time of the inspection.

At our last inspection we rated the service good. At this inspection we found that the service had remained good.

People felt safe at the service and staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe. Risks were assessed and managed to keep people safe. Checks such as identity, professional registrations and criminal records checks were carried out on new staff as part of the recruitment process. People felt that staffing was suitable to meet their needs and was regularly assessed when people’s needs changed. Medicines were managed safely using an electronic system and staff were assessed to ensure they were competent to administer medicines to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had their needs assessed and care was planned taking account of their ability. People said they were involved in reviewing their care and relatives were invited to attend reviews. People’s relatives said “I’m always made aware of any changes”. Staff received training and support which allowed them to provide care to people in a safe way and developed their skills in areas relevant to the needs of people at the service such as in dementia and end of life care. Staff felt supported and able to develop their skills. Staff said they were able to ask for training and training was regularly reviewed.

Staff were observed treating people kindly and respecting their dignity and independence. People said that staff were kind and caring. Relative’s told us that they always observed staff being respectful to people which was observed during the inspection. Feedback received from people and their relatives was positive and they spoke highly of the service and staff. Staff communicated with people in a way that they understood and were patient with people. People told us they liked the staff and there was a nice and calm atmosphere within the home.

People's preferences and choices were reflected in their care plans. The service took account of people's individuality and supported them to maintain their individual interests and keep in contact with relatives via video calling. People said that they enjoyed the activities available and the home had introduced the use of virtual reality to enhance people’s sensory experiences. People knew how to raise concerns however said that they hadn’t needed to. The home received lots of compliments and positive feedback. The service was working towards an accreditation in the Gold Standards Framework for end of life care and people and their relatives were encouraged to express their wishes about how they would like to be cared for when they reached the end of their life.

People told us they liked the registered manager and staff and there was a positive friendly culture. Staff felt supported and their views were sought to drive improvements. There were governance structures in place for information to be shared and lessons learned to be fed back to services by the provider. People and their relatives were asked for their views and action plans were put in place to address any shortfalls in the quality of the service. The service had won an award for ‘Best employer of over 250 staff’ from Skills for Care and staff were proud to work at the service.

Further information is in the detailed findings below.