Archived: St Omer Residential Home

St Omer is a residential care home set within its own landscaped gardens. The home is set of two floors and provides accommodation and personal care for up to 28 older people some of whom may be living with a dementia or have a physical frailty. At the time of the inspection there were 21 people living at the home.

People’s experience of using this service:

People and their relatives consistently told us they were treated with exceptional kindness, compassion and respect and described their experience at St Omer as ‘outstanding.’ Comments included, “Fantastic,” “Exceptional,” “They know what I want before I do."

The provider's values and vision were embedded into the service, staff and culture. The provider and registered manager were passionate and committed to providing a service where people received personalised care and support.

People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

Risks had been appropriately assessed and staff had been provided with information on how to support people safely.

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

People and their relatives were involved in making decisions about their care. The service had established good links and worked in partnership with key organisations that provided social care services to improve people's opportunities and experiences.

People had access to a wide range of activities which met their personal preferences. Staff knew people well and described them as being kind, caring and compassionate. We were provided with many examples which demonstrated how the provider and staff had gone ‘above and beyond’ for people. For example, by going out of their way to buy personalised gift or just by taking the time to mend a treasured ornament or picture frame.

People, relatives and healthcare professionals told the home was exceptionally well led. Staff understood what was expected of them and were motivated to provide and maintain high standards of personalised care which treated people with dignity and respect.

The management team demonstrated a passion for providing a high-quality service, which was continually being developed to meet each person’s needs and there was a strong emphasis upon striving for continuous improvement and excellence. One relative said, “We have high expectations and I’m pleased to say so do they.”

The provider had a strong and effective governance system in place. The management team continued to carry out a regular programme of audits to assess the safety and quality of the service and identify issues.

The home was clean, well maintained and people were protected from the risk and/or spread of infection as staff had access to personal protective equipment (PPE).

Rating at last inspection: The home was previously rated as ‘Good.’ The report was published on the 7 September 2016.

Why we inspected: This was a planned inspection that was scheduled to take place in line with Care Quality Commission scheduling guidelines for adult social care services.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme.

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

The home had a registered manager. 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 said they felt safe and well cared for at St Omer their comments included “I do feel safe” “I’m very happy living here”. Relatives told us the staff were lovely, and people were well looked after. Health care professionals said the staff were very caring and compassionate, people were safe. We saw people were happy to be in the company of staff and were relaxed when staff were present.

People were protected from abuse and harm. Staff had received training in safeguarding vulnerable adults and demonstrated a good understanding of how to keep people safe. The policy and procedures to follow if staff suspected someone was at risk of abuse or harm were displayed along with telephone numbers for the local authority and the Care Quality Commission.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Most of the people who lived at St Omer were living with a dementia, which affected their ability to make some decisions. Staff had received training and demonstrated a clear understanding of the principles of the MCA in their practice. Staff sought people’s consent and made every effort to help people make choices and decisions. However, not all the records we saw demonstrated that decisions were specific, made in consultation with appropriate people, such as relatives or were being reviewed. We raised this with the registered manager who agreed the way the home was currently recording best interest decisions was not as clear as it could be. Following the inspection, the registered manager confirmed they had changed the way best interest decisions where recorded and reviewed.

People received their prescribed medicines on time, in a safe way, and given the time and encouragement to take their medicines at their own pace. We looked at how the home managed people's topical medicines or creams and found it was not possible to tell if topical medicines or creams had been applied. Staff responsible for the administration of medicines told us they routinely signed Medication Administration Records (MARs) for people’s topical medicines or creams in the belief these had been applied. Following the inspection the provider confirmed they had taken immediate action to address this.

Risks to people’s health and safety had been assessed and regularly reviewed. Each person had detailed risk assessments, which covered a range of issues in relation to their needs. The homes computerised care planning and monitoring system allowed for this information to be updated immediately and flagged up where action needed to be taken. Each person had a personal emergency evacuation plan (PEEP) and the provider had contingency plans to ensure people were kept safe in the event of a fire or other emergency. The registered manager and staff carried out a range of health and safety checks on a weekly, monthly, and quarterly basis to ensure that any risks were minimised. However, not all records we saw were up to date. For instance the provider told us the homes fire alarm system was tested weekly. Records showed that this was not consistently taking place. The registered manager and provider assured us they would take immediate action to address our concerns.

People told us they enjoyed the meals provided by the home. Their comments included, “the food is very nice,” and "there's plenty of choice.” Where people required soft or pureed diets, because of their health needs; each food item was processed individually to enable people to continue to enjoy the separate flavours of their meals.

People told us staff treated them with respect, maintained their dignity and were mindful of their need for space and privacy. When staff needed to speak with people about sensitive issues this was done in a way that protected their privacy and confidentiality. People and relatives told us they were involved in making decisions about their care and said staff continually asked how they would like to be supported. People felt their views were listened to and respected.

The home used a computerised care planning and monitoring system to enable the smooth and efficient running of the home. The system included all aspects of how the service was run, from staff reporting on duty, updates on any recent changes to people's needs, care planning and monitoring risks to people's welfare. Staff recorded every activity of care immediately it was provided. Each person had been provided with a paper copy of their care plan which was kept in their room and regularly updated. This meant people's care was closely monitored, day and night.

People spoke positively about activities provided by the home and said they had the opportunity to join in if they wanted. We saw a range of activities were available including music sessions, seasonal arts and crafts, animal therapy, board games and quizzes.

People, relatives, staff and healthcare professionals spoke highly of the registered and deputy managers and told us the home was well managed. Staff described a culture of openness and transparency where people, relatives and staff, were able to provide feedback, raise concerns, and were confident they would be taken seriously. One person said they knew who to speak to should they have a complaint and explained the registered manager was always available if they needed them.

The provider used a variety of quality management systems to monitor the quality of services provided at St Omer, which included a range of audits and checks. There were good systems in place for staff to communicate verbally any changes in people’s health or care needs through handover meetings. These meetings facilitated the sharing of information and gave staff the opportunity to discuss specific issues or raise concerns.

People’s opinions of the home had been sought through the homes annual residents’ survey. This information was analysed and written feedback was provided to people and their families.

Records were stored securely, well organised, clear, and up to date.

We spoke to the people who lived there, the manager and nine other members of staff who were on duty during our visit. We reviewed the care records of the people living there, the staff files, including training files, audit and administration records. We also spoke to four relatives and friends of people living there and a district nurse.

People told us that the care given was excellent, the management were approachable and any requests acted upon immediately. We were told 'this is our lovely home now' One relative told us they felt very lucky that a room had been available and in over two years had no occasion to complain.

People had formal meetings every six months, and annual questionnaires. We were told that the staff and management were always happy to discuss any problems and were satisfied that they would be consulted over any matters that might arise. Staff had regular meetings and formal supervision, with support available on a day to day basis.

We saw that all staff either had qualifications or were working towards them; we spoke to a training provider who told us the management were really good with all aspects of training, encouraging staff to progress to higher qualifications and keen to work with the provider.

We saw the home was open and inviting; people were coming and going throughout the day with activities in place during the afternoon. We saw that bells were answered quickly and that staff always had time to talk to people. One member of staff told us that the management 'encourage the staff to spend time simply talking to people, it is seen as very important' There were sufficient numbers of staff on duty and people told us they felt secure and knew that any needs they may have would be responded to very quickly.

People and relatives were very positive about the care delivered. Comments included, "We are well looked after." and "I have had great peace of mind since X has been here, X is well cared for.' We had previously received a report of concern that people's condition was not monitored and that staff did not respond to call bells. We did not see any evidence to substantiate this. People's needs were assessed and their care was planned and delivered in line with those assessments. Care plans had been regularly reviewed and updated.

People enjoyed each other's company and a range of activities were available. Staff had time to talk with people as well as to complete tasks. Care workers had received training which supported them to meet people's needs and there were sufficient staff on duty to respond in a timely way.

Effective systems were in place to safeguard people and to assure the quality of the service. The provider had responded to a previous complaint had revised a procedure as a result.