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Archived: St Nicholas Care Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 1 February 2020

About the service: St Nicholas is a residential care home that was providing accommodation and personal care to 10 people aged 65 and over at the time of the inspection.

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

At this inspection we found a continuation of failings at this service. Sufficient action had still not been taken to address the seven breaches of the regulations we found at our previous inspections in November 2018 and May 2019. At this inspection in November 2019, we found an additional breach of the regulations.

This will be the third consecutive inspection that this service will be rated as inadequate overall.

The provider had not ensured the manager for the service had registered with us as is required and there continued to be a lack of oversight of the service from the provider. Governance systems remained ineffective at identifying shortfalls within the service and improvements noted by relatives had not been actioned.

Risks relating to people’s health and wellbeing had not always been identified or plans put in place to mitigate these risks. People were not supported to maintain an adequate intake of food and fluid.

Staff practice relating to infection control remained poor and there continued to be several environmental risks identified in the home that had not been managed well.

Reviews of accidents and incidents remained poor and investigations to learn lessons from incidents did not take place. The provider continued not to report notifiable incidents.

We found an additional breach of the regulations. This was because the provider failed to report a safeguarding incident to the local authority and thoroughly investigate the concerns.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People continued to receive care that did not always uphold their dignity or respect their privacy.

Records of people’s care still lacked person-centred detail and were not reflective of people’s most current needs.

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

Rating at last inspection (and update)

The rating for this service was inadequate (published 26 July 2019) and there were multiple breaches of regulation. At this inspection we found sufficient improvements had not been made, and the provider remained in breach of seven regulations. We also found one new breach relating to safeguarding people from abuse and improper treatment.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 14 May 2019. Breaches of legal requirements were found in relation to safe care and treatment, good governance, meeting nutritional and hydration needs, need for consent, person-centred care, dignity and respect and notification of other incidents.

We undertook this focused inspection to check the provider had now met the legal requirements. This report only covers our findings in relation to the key lines of enquiry which relate to those requirements.

The ratings from the previous comprehensive inspection for those key lines of enquiry not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service is inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Nicholas Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, good governance, need for consent, person-centred care, dignity and respect, meeting nutritional and hydration needs, safeguarding people from abuse and notification of other incidents.

CQC used its powers to keep people safe, and a Notice of Proposal to var

Inspection areas

Safe

Inadequate

Updated 1 February 2020

The service was not safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 1 February 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 1 February 2020

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 1 February 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 1 February 2020

The service was not well-led.

Details are in our well-Led findings below.