Archived: St Michaels Mount

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found '

Is the service safe?

People had received the support they needed to meet their care and welfare needs. Equipment at the home had been maintained and serviced regularly. There were enough staff on duty to meet the needs of the people living at the home.

People had been cared for in an environment that was clean and hygienic. Parts of the environment were untidy, shabby and in need of repair.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had been agreed, proper policies and procedures were in place.

Is the service effective?

People had received the support they needed to monitor their health and obtain advice from health professionals when needed. Staff had a clear understanding of people's support needs and their role in meeting these.

People living at the home told us that they had received the support they needed with their health and personal care needs. They told us that they received pain relief as needed and staff responded quickly to requests for help.

Is the service caring?

People told us that staff had listened to them and acted on their choices. They told us that staff treated them with respect. We observed that staff interacted with people throughout the day and responded quickly when people needed help. People told us that they liked the staff who supported them. One person commented, 'We get on well.'

The opinions of people living at the home and their relatives had not always been listened to and acted upon.

Is the service responsive?

People's needs had been assessed before they moved into the home. Care plans were in place to guide staff on how to support people. These had been reviewed and updated as people's needs changed. Referrals for support from health professionals had been made and any advice given had been acted upon.

Is the service well-led?

Systems for checking the quality of the service were not always effective. Results of surveys to gain people's views of the service had not been acted upon. Audits of the environment had not identified areas for improvement noted during our inspection of the home.

Staff were knowledgeable about their responsibilities for ensuring people were protected from abuse or the risk of abuse and there was clear information in place for reporting such incidents.

Up to date medication policies and procedures were in place. Medication was appropriately stored and records relating to medication were completed correctly.

People were cared for by a sufficient amount of staff who had the right skills and experience.

Staff received appropriate support and learning and development opportunities.

The required checks had been carried out to ensure that people received a safe and effective standard of care.

'I couldn't say a bad thing about the staff, they are all very nice'.

'The food is nice and the people are nice'.

During our visit we found evidence that some of the people who used the service were not cared for safely and effectively and that staff did not always report incidents regarding the safety of the people who lived at St Michaels Mount to the appropriate authorities. We observed that there were times when there were insufficient staff on duty with knowledge and experience of the people they were caring for.

We found that appropriate arrangements were not in place for the management of the medicines. We also found that there were insufficient quality assurance systems in place to ensure people received safe and appropriate care, treatment and support.

We were able to speak with six people who used the service who told us the care they had received at St Michaels Mount was 'absolutely fine', and they had been "well looked after".

During our visit we observed that staff treated people in a kind and caring way and were respectful towards the people they cared for. There were enough skilled and experienced staff on duty to be able to meet the needs of the people who lived at St Michaels Mount.

We also saw evidence that accurate and appropriate records were maintained and the organisation was monitoring the quality of the service provided on a regular basis.

During our visit we observed that care was not always delivered in line with the guidance in the care plans and that some confidential records were not stored securely. We also found evidence that learning from audits of the service did not take place and appropriate action was not taken or changes implemented.