• Care Home
  • Care home

Archived: St Patricks Care Home

Overall: Good read more about inspection ratings

Crow Wood Lane, Widnes, Cheshire, WA8 3PN (0151) 495 3593

Provided and run by:
Community Integrated Care

Important: The provider of this service changed. See new profile

All Inspections

15 March 2018

During a routine inspection

St. Patricks is a purpose built establishment in a residential area in Widnes. It provides care and support for up to 40 people diagnosed with dementia. The home provides care over two separate units depending on their level of need; Ashley unit and Maguire unit. Each unit has its own lounge, dining room and utility kitchen. All bedrooms are single with en-suite toilet facilities. The home is operated by Community Integrated Care. At the time of our inspection, there were 36 people living in the home.

At the last inspection on the 5 March 2015, the service was rated Good. At this inspection we found the service remained Good.

The registered provider had taken action in accordance with recommendations we made at the last inspection regarding the development of the environment to make it more dementia friendly. An outdoor theme was created through the use of imitation ‘bus stops’ and benches alongside brick effect wallpaper. This provided a means of facilitating relief for people who have dementia and may want to leave the home. A mock shop and café with prices displayed in pounds and shillings provided a village feel. A new sensory room had been installed in the home to provide a relaxed environment where people could retreat to when they became agitated or wanted some quiet time.

There were a variety of activities in place provided by two activities co-ordinators employed by the service to promote social stimulation. This included baking, arts and crafts and bingo. People also had access to the on-site bar which was equipped with optics, bar stools and a dartboard. The registered provider worked with community partners such as the Widnes Vikings to enable people to access a dementia café at the grounds.

There was a registered manager in post at the service. The registered manager had worked at the home in a variety of different roles over 20 years, including as a staff nurse, before becoming registered manager in 2016. 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.

Our observations and review of staff rotas showed sufficient numbers of staff were deployed to meet people’s needs. Some staff and relatives thought that staff could be stretched at specific times throughout the day. We brought this to the attention of the registered manager during our inspection.

Staff were recruited safely and pre-employment checks were carried out before they started work at the organisation to ensure they were suitable to work with vulnerable people. Staff had received training in ‘safeguarding’ and understood the different types of abuse and the local reporting procedures.

Medicines were managed safely and effectively. Medication was administered by registered nurses and staff who had received the relevant training. Medication Administration Records were completed accurately and PRN guidance was in place for people who were prescribed ‘as required’ medication. People told us they were happy with how their medication was managed and received this when they needed it.

Risk assessments were detailed and contained sufficient information to guide staff on how to minimise the risk of harm for people who lived at the home. Fire procedures in the event of an evacuation were clearly marked out and regular mock fire drills were completed. Checks were completed to ensure the environment was free from hazards.

The training records showed staff had received relevant training to ensure they had the skills to support people effectively. Our discussions with staff showed that they had a good knowledge about the people they supported and understood people’s individual needs.

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. The service operated within the principles of the Mental Capacity Act 2005 (MCA). Our review of records showed that processes were in place to assess people’s capacity and make decisions in their best interests.

People were supported to maintain good health and well-being. The home had a good relationship with a local GP practice through the GP alignment initiative and had regular dialogue with the local community mental health team. Referrals were made promptly to health professionals such as SALT, the dietician and tissue viability nurses. Staff followed guidance that was implemented to achieve best outcomes.

People told us they enjoyed the food served at the home. Staff knew, and catered to, people’s individual dietary needs and preferences. Nutritional risk assessments were completed and diet and fluid charts were in place for those who required them.

We observed kind and compassionate interactions between staff and the people they supported. Staff offered tactile reassurance to people in distress. People told us they liked the staff that supported them.

Care plans were personalised and evaluated monthly. We noted that any changes in people’s needs were documented and actioned appropriately.

A complaints policy was on display in the home which contained details for the local authority and Local Government Ombudsman. People told us they would not hesitate to raise concerns with the registered manager if they felt they needed to. Complaints were documented and managed in accordance with the registered provider’s complaints policy.

Quality assurance systems were effective and measured service provision. Regular audits were completed for different aspects of the service such as medication, care plans and accident and incidents.

Opportunities were provided for people and their relatives to provide feedback on their experience of the care provided and contribute to improving the service delivery. This included quality assurance surveys, a suggestion box and family meetings.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with statutory requirements.

The ratings awarded at the last inspection were displayed at the entrance to the home.

5. 6. 24 March 2015

During a routine inspection

This inspection took place on 5, 6 and 24 March 2015 and was unannounced.

St. Patricks is a purpose built building and supports up to 40 people diagnosed with dementia and nursing care. St Patricks is run by Community Integrated Care (CIC). The service is provided within two separate units. Ashley unit and the Maguire unit are for people who are living with dementia and some people have behaviours that challenge. Each unit has its own lounge, dining room and utility kitchen. All bedrooms are single with en-suite toilet facilities. There is a large accessible car park provided for visitors.

The home has 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.

At our last inspection 17 October 2014 the service was not meeting two regulations, in regard to the management and maintenance of the building and in regard to the dignity and care to people living at St Patrick's. We have received updated action plans from the provider stating what actions have been taken to improve these issues.

People living at the home, relatives and staff were positive about some aspects of the home and had noticed various improvements to the cleanliness and the redecoration of the environment.

Staff supported people living with dementia, however there was limited evidence in the development of the environment for people with specific needs affected by their condition. We have made a recommendation about the development of the environment to meet the specialised needs of people with dementia.

Relatives and people living at the home were happy with the overall behaviours and standards of care provided by staff. We observed how staff spoke and interacted with people and found that they were supported with dignity and respect.

We found that senior staff had a good understanding of supporting people when they lacked capacity, including the requirements of the Deprivation of Liberty Safeguards. Staff took appropriate actions to fully support people who lacked capacity to make their own decisions.

We found care plans contained guidance to enable staff to know how to support each person’s needs. Both staff and relatives felt that the activities needed further development and they wanted to see a lot more access to social support. Further development of each person’s care plans incorporating their social support and aspirations would help to give better evidence of more individualised care that met people’s social needs and requests. We have made a recommendation about the planning and organising of individualised social support and care records that meets people’s personalised needs.

We noted the service had a complaints procedure. Relatives and people living at the home were confident that they could raise their opinions and discuss any issues with senior staff.

The service operated safe staff recruitment and ensured that staff employed were suitable to work with vulnerable people. Appropriate pre-employment checks were being carried out and application forms were robust to enable the management of the home to have adequate information before employing staff.

Staff had started to receive formal supervision to assist them in their job roles and in their personal development. Some training records needed updating to ensure that staff were up to date in all aspects of training needed for their role including new staff. We have made a recommendation that the training records for staff are updated.

Various audits at St Patricks were carried out on a regular basis by the registered manager and registered provider. This helped to ensure that appropriate standards were in place. These audits showed regular quality checks to show improvements to the standards of care and to the environment.

17 October 2014

During an inspection in response to concerns

We inspected St Patricks on 17 October 2014 in response to information of concern about the environment and the staffs ability to provide appropriate care.

This was an unannounced inspection. The inspection set out to answer four of the five questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service well-led?

This is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The overview and management of the building and assessment of environmental risks was poorly managed and lacked risk assessments to show effective actions to keep people safe. The environment was in poor condition in parts and not respectful to the people living at St Patrick's.

Is the service effective?

Four out of five relatives told us they were very happy with the care that had been provided to their relative and they felt their needs were being met. We observed the support being provided and it was clear that there were mixed standards of care practices. We discussed the care practices and culture within the service with the manager as the lack of individualised care and attention to respect and dignity needed appropriate actions taken to ensure each person was appropriately supported. Following our visit we referred two people to Halton Social services for an updated care management review to help ensure they were being provided with the most appropriate care for their needs.

Is the service caring?

We saw various examples of good communication and patience by some staff who interacted with each person in a friendly and positive manner. However, we noted one staff member standing up while supporting a person with their meal which meant they had no eye contact and no verbal communication when supporting the person. We heard staff openly shouting over to each other in the lounge discussing care and what needed to be done next and discussing general personal topics. Staff seemed oblivious and lacked respect in regard to being in the lounge of people living at the service.

Is the service well-led?

The organisation and provider oversight of quality checks at the service required development to help improve the monitoring of the service. This was specifically in relation to the management and maintenance of the building and in regard to the dignity, care and culture within the service to ensure individualised care to each person living at St Patrick's.

3 January 2014

During a routine inspection

We found that people living in the home were treated with respect and wherever possible asked for consent for treatment or care. Where people were unable to consent verbally their relatives were asked and in some cases an independent representative was involved. Relatives commented "Staff do not force themselves on her, they explain what they are going to do".

People in the home were well cared for. The four care records we observed were very detailed with clear plans of how their needs should be met. There was evidence to show that the individual support plans and the risk assessments were evaluated on a regular basis. One relative said "I know he is getting well looked after" and another "It really is excellent". This meant that the service could demonstrate they met people's needs and maintained their health and wellbeing.

The staff we spoke to were very aware of potential abuse and their role in protecting people. The relatives we spoke to were confident that this protection occurs and commented " We have no suspicions here".

The systems the provider had put in place to recruit staff were stringent and this meant that reasonable steps had been taken to protect people from harm.

The staff and relatives we spoke to understood the complaints procedure and were confident to use it. One relative said "We would go to Janet (the manager) with a complaint and if it was not resolved we would go higher up."

27 February 2013

During a routine inspection

We found that people were able to express their views and were involved in making decisions about their care and treatment. We spoke with three relatives of people who used the service who confirmed they had been involved in the implementation of their relatives support plans. Comments included “Mum is always clean and neat and tidy” and “The staff are always happy and pleasant towards us."

We looked at five care records and all had assessments of their health and social needs completed. There were individual support plans and risk assessments in place. There was evidence within them to show they were evaluated on a regular basis. This meant that the service could demonstrate they could meet people's needs and maintain their health and wellbeing.

We spoke to five members of staff. They told us they felt supported by the management team at St Patricks Care Home. Discussions with staff showed they had a good understanding of the people they supported. Comments from them included “I have confidence in the manager here” and “They(the provider) are very good at providing staff with training opportunities."

We observed staff interacting with people who used the service in a respectful and positive manner.

15 February 2012

During a routine inspection

Our observations indicated that staff were caring and attentive. The staff spoken with

were aware of the needs of the people who used the service. When we asked one person who used the service about the staff they told us that 'most of the people around here are very good.'

We spoke to two relatives who told us that the staff were respectful towards the people who used the service. They said that the staff were always seen to be warm and caring. They said that personal care and support was provided by the staff in a manner that promoted peoples dignity. They said that on their regular visits to the home they had always found sufficient numbers of staff to be available. Some comments

made were:

"The staff are very friendly and caring. We are very happy with the care our relative receives."

"The staff are very good, they are helpful and supportive."

Halton LINk* visited the home in October 2011. They concluded; 'St Patrick's appeared a friendly and welcoming purpose built care home. The home was well maintained and decorated and furnished to a good standard. The home showed good practice in the way it promotes the use of alternative therapies in the care of individuals diagnosed with dementia.

We were impressed with the attitudes of the staff we spoke to at the home, who all maintained a good professional attitude yet appeared friendly and considerate and upheld the dignity of residents.

Our only issue as a visiting team was with regard to the odour at the home which we were led to believe the home will attempt to deal with shortly.' At the visit by the Care Quality Commission the manager had addressed the issue of the malodour by replacing the carpet concerned.

Halton Borough Council carried out a monitoring visit of the service in January 2012. They found that the manager had taken action to address issues raised in a previous visit and they identified some further improvements to be made. Their report indicated the plans the manager has for making further improvements. Halton Borough Council were happy with the progress being made at the service.

*LINKs are networks of individuals and organisations that have an interest in improving health and social care services. They are independent of the council, NHS and other service providers. LINks aim to involve local people in the planning and delivery of services.