This comprehensive inspection took place on 21 and 26 February 2018 and was unannounced. Crownwise St Andrews is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
St Andrews accommodates up to eight people with a mental health condition, in one large house over three floor house, in the London Borough of Lambeth.
The service had a registered manager in place. 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.
The service continued to develop and regularly review risk management plans to keep people safe. Risk management plans gave staff clear guidance on managing identified risks and minimising the risk of a breakdown in their mental health.
People continued to be protected against the risk of harm and avoidable abuse. Staff were aware of the providers safeguarding policy, how to escalate concerns and where appropriate whistleblow.
People received support from familiar staff that underwent rigorous checks to ensure their suitability for the role. Staffing levels were monitored to reflect people’s level of needs. Staff underwent training to effectively meet people’s needs, and received regular supervisions and annual appraisals to reflect and improve their working practices and the delivery of care.
Medicines were managed appropriately and regular audits carried out to quickly identify issues, so that the impact to people was minimal. Medicines were administered in line with the prescribing G.P.
The service had an embedded culture of ensuring 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 in the service supported this practice. Staff had sufficient knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
People continued to receive care and support from staff that respected and embraced their differences. People were encouraged to recognise and celebrate their culture and beliefs as and when they desired.
People were provided with foods that met their dietary needs and requirements, in line with guidance from a dietician and other healthcare professionals. People who required specific dietary requirements were provided with this and encouraged to make healthy choices.
The service had devised in collaboration with people, their relatives and healthcare professionals, care plans that identified their needs and gave staff guidance on how to meet their needs. Care plans were reviewed regularly to reflect people’s changing needs.
The service supported people to engage in activities of their choice and that met their social needs. People were encouraged to attend day centres and other community based activities as well as in-house activities organised by the activities coordinators.
The service had an embedded culture of undertaking audits to drive improvements within the service. Audits that identified issues were actioned swiftly. The provider continued to seek people's views through regular meetings, quality assurance questions and consultations