St Josephs Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People told us the staff talked to them and knew them well. The registered manager said they assessed people’s needs when they applied to live at St Josephs, the registered manager told us they carried out the initial assessment with nursing staff completing care plans. However, the registered manager also told us the care plan system may be changed as there were some parts of the system staff found difficult such as recording specific goals for people. Staff talked with people about their plans should their health deteriorate and ensured this was noted in Recommended Summary Plan for Emergency Care and Treatment (RESPECT) forms.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People told us staff knew them well and staff confirmed this. People were encouraged to manage their own care where they could and were supported only when necessary. A person said, “The home arranges patient transport for my hospital appointments, and a staff member goes with me.”

The registered manager told us how she kept up to date with current good practice, including by being part of a local care home managers’ group.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

While staff at St Josephs knew people well, the care plans and the system in use made it difficult to share full and current information. Staff told us that while some important information such as risk assessments were available on the electronic system, the full care plan was not available there. Complete care plans were stored in paper files in an office. This meant printing or sharing a care plan if a person moved to another home was complex and information could be missed. Having two copies of a care plan was a risk not only for missing information within the service, but for missing relevant information if the person moved.

After our visit the registered manager acted to move all care plans completely to the electronic system and cease use of the paper plans.

Some people managed their own care with outside health care organisations, a person said, “I see a physiotherapist in hospital, but she rings me on my mobile. So, it’s my choice whether I do the exercises or not.” It was not clear if or how this care was recorded.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The registered manager and staff at the home ensured people’s independence was maintained. People with the capacity to make decisions about their care told us the staff were supportive. A staff member told us, “There are a couple of very independent people. We support people to be independent. We encourage before we assist.”

Staff ensured people had access to dental care and opticians. Some people chose to register with their own dentist.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Staff did not always monitor people’s care effectively. People who were at risk of constipation did not have appropriate monitoring or recording. Daily notes were intermittently recorded and there was no information for staff on how to act if someone had not opened their bowels for a specific period.

Care plans contained information for staff to manage people at risk of pressure injury, including liaising with other health care professionals. However, the information was sometimes inconsistent or contradictory.

After our visit the registered manager acted to move all care plans completely to the electronic system and cease use of the paper plans and told us registered nurses had been allocated to rewrite all care plans to ensure consistency.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the importance of people being treated with respect and having the right to refuse care. Staff obtained consent to care by talking to people, explaining how they would provide care and knowing people well. A staff member told us, “If someone lacks capacity to decide I will explain what I’m about to do, I do that anyway, it’s not right just to do things to people. I don’t rush. Everybody slows down as they get older, so I take time to explain, and if a person doesn’t want to do something, you still listen. I give people choices” and a person told us, “I have my meals in my room, that’s my choice. I like to watch television when I'm eating. If you want something, they are accommodating.”