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Inspection carried out on 12 August 2019

During a routine inspection

St Saviours Care Home is a residential care home providing personal care and accommodation for up to 58 people in one purpose-built building. At the time of the inspection 57 people were supported, some of whom were living with a dementia.

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

There was no manager registered with the commission. During the inspection the manager and provider had confirmed that an application to register had been submitted and the manager was waiting for a registration interview. There was no record of an application having been received and the provider was unable to provide us with evidence by way of a reference number to confirm the application had been. This limits the rating of well-led as the registered managers condition has not been met. Since the inspection site visit we have received an application to register however it was returned due to being incomplete.

The management team were aware that some areas such as documentation and care planning needed to be further developed. During the inspection we identified additional areas, including the recording of some medicine applications and documenting night staff involvement in fire drills. There was no direct impact on people however we have made a recommendation about the management of medicines and a recommendation about quality assurance procedures.

People told us they felt safe and were supported by kind and caring staff. Staff knew people well and had developed warm, caring and compassionate relationships with people. People were treated with dignity and respect; their independence was encouraged and were possible people were involved in decision making about their care.

Staff told us they were well supported and had access to a range of training which meant they were able to meet people’s needs. Healthcare professionals involved in supporting the home commended staff in relation to supporting people nutritionally with fortified meals and drinks before making a referral for prescribed supplements and also in relation to end of life care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Communal areas were themed which provided people with the opportunity for reminiscence. People could personalise their rooms and benefited from fully accessible, beautifully maintained garden areas.

A range of activities were available, including a dementia café. Activities co-ordinators were attending additional training in relation to activities for people living with a dementia and people with sensory needs.

People’s needs were assessed before they moved into the service. This information was used to develop care plans and ‘snapshots’ of care which provided a summary of people’s needs. The manager was making improvements to care plans to ensure they were detailed and personalised.

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

Rating at last inspection

The last rating for this service was Good (published 14 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 1 December 2016

During a routine inspection

This inspection took place on 1 and 2 December 2016 and was unannounced. St Saviour’s provides accommodation and personal care for up to 58 people. On the day of our inspection 57 people were using the service who had a variety of needs associated with dementia and physical health conditions.

The service had a registered manager working at the service. However she had stepped down from the overall management of the service and was undertaking a supportive role for an associated manager who had recently been employed. We discussed with the provider and associate manager that the Care Quality Commission would require them to register with us as they were undertaking the role and responsibility of a registered manager. Both the provider and associate manager told us they would be making this change in the near future. 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 were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The manager shared information with the local authority when needed.

The risks to people’s safety were assessed when they were admitted to the service and measures identified to reduce the risks however there were occasions when measures in place to reduce the risk were not in place.

People received their medicines as prescribed and the management of medicines was safe.

Staffing levels were sufficient to support people’s needs and people received care and support when required. Medicines were managed safely and people received their medicines as prescribed at the times they needed them

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were protected from the risks of inadequate nutrition. Specialist diets were provided if needed. Referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care.

People were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously.

Inspection carried out on 30 July 2013

During a routine inspection

Prior to our inspection we reviewed all the information we had received from the provider. As part of our inspection we spoke with three people who used the service. We also spoke with a care worker, a cook, an activities coordinator, the deputy manager, the registered manager and the provider.

We spoke with three relatives about their views of the home. We observed the support staff gave to people who used the service. We also looked at records, including care files of four people and carried out a tour of the building.

We found people gave consent to their care and received care and support which met their needs. A person told us, �I am very independent and can choose what I want to do, the help is there if I need it.�

We asked people who used the service what they thought of the food that was provided for them. One person told us, �The cook is very good and the dinners are lovely. The food is always hot.�

We saw the building was clean, safe and well maintained and the provider assessed and monitored the quality of the service provided.

We found the service was well led.

Inspection carried out on 6 November 2012

During a routine inspection

We spoke with seven people who lived at the home, three relatives who were visiting the home, and a local doctor who was visiting the home, four staff members, the registered manager and the home owner. We also observed how people were supported with their care and looked at records. These included care plans and information about how the service operated.

People told us they had enough information to tell them about what the home provided when they moved in, that they could express themselves in the way they wished and were encouraged to make their own choices.

One person told us, "There is always something to do that we have chosen to do. Anyone with any common sense will tell you that this is a good home."

People also said they felt safe living at the home. They told us that they were confident that staff had the right skills and experience for the job and that they were honest and trustworthy. One person said, �They (staff) look after us well. My daughter always says she goes home contented knowing I am safe here.�

We found that people and staff felt confident taking any suggestions or concerns to the deputy manager and the manager. A relative of one person told us, "The manager and carers are always here to raise any questions or queries with."

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