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St Teresa's Home for the Elderly Good

Reports


Inspection carried out on 18 January 2018

During a routine inspection

St Teresa’s Home for the Elderly is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. There were 25 people using the service at the time of our inspection.

A registered manager was in post at the time of this inspection. 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.

This inspection visit took place on 18 and 24 January 2018. Our first visit was unannounced. This meant the service did not know we would be visiting. The last inspection of St Teresa’s took place in December 2015 when we found the service was meeting legal requirements.

The service was exceptionally caring. People using the service told us they were treated in a kind and caring manner by staff who knew them well. People and their relatives commended the quality of the care they received. They said that St Teresa’s had a warm, caring and compassionate approach underpinned by a strong Christian ethos.

People were supported to stay safe by the systems and practices in the home. Any identified risks to people were assessed and checks of the home environment and the equipment in use regularly took place.

People were supported to take their medicines safely and as prescribed. They had good access to external health services such as the GP and were supported to stay healthy. People said they liked the food provided to them. They were given choice and could eat the meals they enjoyed.

There were enough staff to meet people’s needs. A consistent established core team of staff provided continuity of care to the people staying there.

Individual care and support needs were fully assessed, documented and reviewed at regular intervals. Care plans reflected people’s whole lives and helped staff to deliver personalised care. The service was particularly skilled at helping people and their families or carers to explore and record their wishes about care at the end of their life.

People were supported by staff who were trained and well supported in their job roles. Staff members had been safely recruited and had received an induction to the service. They had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern.

Staff we spoke with were confident of the service provided to people and said they would recommend St Teresa’s to others. Staff said they felt valued and had access to supervision and additional support when required.

People and their relatives felt able to raise any concerns or complaints. There was a procedure in place for people to follow if they wanted to raise any issues. Staff also said they felt comfortable in raising any concerns should they have any.

The service understood and complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff worked in people’s best interests and understood the importance of gaining people’s consent before assisting them.

The service was well led. The registered manager and her team monitored the quality of the service and made changes to improve the service provided when required. People who used the service and their relatives found the management team to be caring, approachable and responsive.

Inspection carried out on 10 December 2015

During an inspection to make sure that the improvements required had been made

This inspection took place on 10 December 2015 and was unannounced. At the last inspection of this service we judged the provider was meeting all the regulations we looked at.

St Teresa’s Nursing Home provides accommodation, nursing care and support for up to twenty eight elderly people some of whom were living with dementia. The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 with the service they received. Relatives also told us they considered St Teresa’s to be safe and that people were well cared for. We saw there were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place that informed the registered manager and staff as well as people who used the service about how to report suspected abuse.

People had risk assessments and risk management plans to reduce the likelihood of harm to them. Staff knew how to use the information to keep people safe and work with them positively to help them be as independent as possible.

The provider ensured there were suitable recruitment practices to help protect people from the risks of being cared for by staff assessed as unfit or unsuitable. There were enough staff on duty to meet people’s needs.

Medicines were stored, managed and administered safely. People had individual medicines profile which had been reviewed every six months. An appropriate risk management plan was in place that related to the administration of medicines to people.

People received effective care because staff were appropriately trained and supported to do their jobs.

Staff had received appropriate training and had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way.

The registered manager told us applications to deprive some people of their liberty had been made to the local authority for them to carry out assessments under the Mental Capacity Act 2005. We saw records that confirmed appropriate applications had been submitted and the assessments carried out. Best interest meetings had occurred and care plans incorporated conditions where authorisations have been granted.

People were supported to have a varied and balanced diet and food that they enjoyed. They were enabled to eat and drink well and stay healthy.

People and relatives we spoke with told us the service was very caring and they spoke highly of the care and support that was provided for them. People felt they mattered and they said they felt understood by staff.

People were encouraged and supported by staff to maximise their abilities through the activities programme that they told us they enjoyed.

When people needed care and support from healthcare professionals, staff ensured people received this promptly. Advocacy services were well advertised so people could use their services if they wished to support them in making decisions if this was required.

From our observations we saw that staff respected people’s privacy and treated them with respect and dignity.

People had care plans outlining the goals for their care that they had contributed to and what support they required from staff to achieve them. People were involved in planning their care and their views were sought and planned for as a central and important part of the process. The service regularly monitored people’s changing needs and involved them in discussions about any changes that needed to be made to their care plans.

People were encouraged to maintain relationships with the people that were important to them. Relatives and other visitors were made to feel welcome and told us they were free to visit people at St Teresa’s.

There was a complaints process in place, well-advertised so that people knew how to raise any concerns they had and felt confident they would be responded to in a timely manner.

People gave positive feedback about the management of the service and the staff group providing the care and support to people. We found a calm, relaxed atmosphere in the home on the day of our inspection, yet we were aware the service was well organised and purposeful. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. There were systems in place to continually monitor the quality of the service and people were asked for their opinions via feedback surveys. Action plans were developed where required to address any areas that needed attention. publication

Inspection carried out on 9 July 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

When we visited St Teresa’s Home for the Elderly there were 25 people using the service. We spoke with four of the people using the service, two relatives, the registered manager and three members of staff. We reviewed six people's care plans and two staff files.

Was the service safe?

People who use the services were treated with respect and dignity by the staff. They told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. This meant that people were safeguarded as required.

The manager had ensured there was sufficient staff on duty, appropriately qualified to meet the support needs of people who used the services. This all helped to ensure that people’s needs were met.

Was the service effective?

People’s health and care needs were assessed together with them, and they were involved in their care and support planning. People told us that they had been involved in their care and support plans and that the plans reflected their needs. We inspected six people’s care files. They included essential information about the person, needs and risk assessment information, care plans and records of health care appointments. Relatives told us that the care and support that their relatives received was good. One person said about their relative’s care, “It covers all their needs and when the needs change the care plan is updated”.

Was the service caring?

People who use the services were assisted by kind and supportive staff. We saw that staff showed patience and professionalism and gave appropriate encouragement when supporting the people who use the services. The people we talked to said the staff treated them well and respected their wishes, dignity and privacy. We observed that staff knocked on the people’s doors before entering their rooms and asked if it was convenient for them to go in. This reflected the caring environment that we found on the day of the inspection.

Was the service responsive?

Relatives of people who use the services told us that if a person’s needs changed, their care and support would be tailored to those changed needs. We saw that care plans were reviewed regularly and changed appropriately. This was important as this helped staff understand what people wanted or needed or how they were feeling.

All the people who use the services we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and discussions we had with relatives and staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

We saw that the service worked well with other agencies and services to make sure that people were supported in a co-ordinated way. It was clear that the main objective was to support people in the most appropriate way to meet their assessed risks and care needs.

The manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to by the manager. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home. This helped to ensure that people received a good quality service.

Inspection carried out on 23 July 2013

During a routine inspection

At the time of our inspection there were 24 people residing at St Teresa’s Home for the Elderly.

On the day of our inspection we met with four people using the service and observed how staff supported and cared for individuals. We saw that the registered manager and staff respected people's privacy and dignity, and took account of what people expressed and said in relation to the way their care and support was provided.

We used different methods to help us understand the experiences of people who use the service as not everyone who lived at the home was able to communicate verbally with us in a meaningful way. To help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

The people who did speak with us all said that they were happy living at the home. One person told us that they had stayed at the home previously to convalesce but liked it so much they later returned to stay on a permanent basis when they could no longer manage at home. Another person told us that they enjoyed the range of activities that the home provided on a daily basis.

People were given all the information they needed to make an informed decision about their care and were asked to provide their consent to such care. We saw people were cared for effectively and care was planned for the individual.

Inspection carried out on 24 September 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practising professional.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke to nine people using the service during our unannounced visit. Comments included ‘very nice’, ‘no doubt this is the best place in the area’, ‘wonderful’, ‘I don’t dislike it here’ and ‘there is a different feeling about it here – very good’.

Three relatives or visitors were spoken with during our visit. Feedback included ‘I cannot think of anywhere which looks after people as well as here’ and ‘I’m very grateful for my relative being here’. One person talked about the home ‘going the extra mile’ for their relative and said that ‘they didn’t give up on them’.

Reports under our old system of regulation (including those from before CQC was created)