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Archived: St Josephs Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 24 August 2016

During a routine inspection

The inspection took place on 24 August 2016 and was unannounced. The previous inspection of 27 July 2015 found the service required improvement. There were breaches in regulation that related to staffing levels, the environment and the systems in place to oversee quality and drive improvement. We followed up these areas at this inspection.

Since the last inspection there has been a change of provider and the new management team had begun to introduce new systems and procedures. We found substantial progress had been made but the service was not yet providing safe and effective care for all the people who lived there. The environmental issue raised at the last inspection about access to and from the annex was not yet resolved. Therefore the requirement from the previous inspection remains outstanding. The provider has told us that there was a risk assessment in place to reduce the likelihood of harm and no admissions were planned to this part of the service. People living there had the opportunity to move into the main building and they were planning to undertake changes to the building to improve access although this requires approval from the planning authority. Therefore we plan to monitor this matter going forward, but will not escalate our powers of enforcement.

St Josephs is a care home for 60 older people some of whom are living with a diagnosis of dementia. The unit that accommodates people living with dementia is called Gainsborough and has twenty seven bedrooms and a separate living space. The service also has an annex with a separate living area which adjoins the main home. On the day of our inspection there were 46 people in total living in the service.

A manager was new post and had commenced employment three months prior to the inspection. The manager told us that they had made an application for registration to become the registered manager for St Josephs. 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 that they liked living in the service and that they felt safe and well cared for. Staffing levels had been identified as problematic at the last inspection but we found improvements had been made. People were supported by a stable staff team and there were sufficient numbers of staff available to respond to people’s needs and keep them safe. Robust recruitments systems were in place to check on new staff suitability for the role.

Medicines however were not consistently well managed and while we found examples of good practice we also found omissions in the management of controlled medications and topical creams. The manager had already identified the issues about creams and had a plan to address this. They took steps to immediately address the other issues by undertaking supervisions and increased auditing.

Risks were identified and there were systems in place to ensure that people at risk had access to equipment to protect them, such as hoists and pressure relieving mattresses. Checks were undertaken to make sure that equipment was working effectively and the environment was safe.

A programme of training was underway to ensure that staff skills and knowledge was up to date. While this was not yet complete and there remained some shortfalls, there was greater oversight and more effective planning.

People had good access to health care professionals when they needed support or treatment. However we found that the support provided to people with specific health conditions such as diabetes needed to be strengthened and staff provided with clearer guidance to prevent harm.

People liked the food and the meals served looked nutritious and nicely presented. People told us that they had good relationships wit

Inspection carried out on 27 July 2015

During a routine inspection

This unannounced inspection took place on 27 July 2015. The previous inspection was completed in July 2013 and the service was all compliant with that legislation.

St Josephs is a care home for 60 older people, some of whom are living with dementia. The unit that accommodates people living with dementia has 27 bedrooms and separate living space. This unit is known as Gainsborough.

The registered manager was present throughout the day. 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.

St Joseph’s is a friendly home with a manager that is known and well-liked by everyone. There is a consistent staff team, a core who have been there for some time. People experienced a home that met their physical care and health needs.

There were some good examples of care and support to individuals that we saw and were told about by people, but there was a lack of consistency for all. Staff liked where they worked, but were not consistently provided with the training and supervision that they needed. Staffing numbers were not adequate. They did not take into account peoples support needs as well as the numbers of people resident. The impact of this was that people felt their physical care needs were met. Some people had their social and emotional needs met but others did not.

The environment at St Josephs was well maintained and a pleasant setting for people, but we found that due to peoples disability the environment was not suitable for everyone and posed risks to individuals.

The manager was accessible to people but the arrangements in place to listen and learn from peoples experience were not well developed. There were some monitoring and audit systems in place, but these were not thorough or comprehensive. They were not used to drive improvement or for the provider to have clear oversight of how the service was being managed and developed. This was found to be a breach of regulation.

You can see what action we told the provider to take at the back of the full version of the report.