Archived: St Raphael's Care Home

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.

People we talked with were happy with the service they received. One person told us 'It's well organised. There's a very good atmosphere.' We saw that recent written comments on the service had included '(This is) a special place where the residents and their families can feel at home', and '(My relative) could not have had any better care'.

Staff we talked with told us that they were asked for their views. A member of staff said 'The views of staff are listened to, at meetings and handover meetings.' We were told that a member of staff had suggested how one person's care could be changed to support their nutritional needs, and that the new arrangements put in place had worked very well. Records of a recent staff meeting showed that a member of staff had suggested people would enjoy the opportunity to have hand massage. We observed on the day of the inspection that hand massage was offered to people. This showed that the provider listened to the views of staff in how the service was run.

We saw that the provider had arrangements in place to monitor the quality and safety of the service provided. Medication audits were regularly carried out and we saw records which showed that lessons to be learnt from the audits had been discussed with staff. We looked at an audit of care plans which the provider had carried out in January 2014. We saw that the audit had identified for one person that part of their care plan had not been completed, and the provider asked for this to be acted on. At inspection we found that the care plan was now complete. This meant that the provider had regularly audited the safety and quality of the service, and that action had been taken to make improvements in a timely manner.

There was evidence that learning from incidents had taken place and appropriate changes were implemented. We looked at the records for five incidents of falls. We saw that where people had had falls a written evaluation had been carried out to consider how the risk of falls could be reduced. Care plans seen provided guidance for staff on how the risk of falls should be minimised for the person.

There had been no complaints recorded since our previous inspection. The people who used the service told us that they had not had any concerns or complaints about the service. People told us that if they did have any concerns or complaints they felt they could approach the manager or deputy manager. One person told us 'If I had any concerns I would talk to the deputy manager.' This meant that people felt they could use the complaints process as necessary.

People who were able however told us they were happy with the care they received. Relatives visiting the home were also very complimentary about the care at the home.

We looked at the care people received and found that they were well cared for and consistently supported with their needs. We observed that people were supported in a sensitive and dignified way by the staff. We also saw that staff were respectful and positively engaged with individuals.

We looked at the care records and found that assessments and care plans were in place. We saw that they were regularly reviewed to make sure that people's needs were met.

We also looked at staff support and training. We found the staff were well trained and there were good systems in place to ensure they were well supported in their work.

We found that people had good information and support to make decisions about their care or air their views about the home. We also found that good systems were in place to support people living at the home and the staff to raise concerns or complaints.