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St Catherine's Care Home Requires improvement

We are carrying out checks at St Catherine's Care Home. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 November 2018

This unannounced inspection took place on 29 August 2018.

St Catherine's Care Home Horwich, Bolton is a purpose built two storey care home. The home is close to Horwich town centre and close to a bus route and the motorway network. The home provides nursing care or personal care for 30 people and cares for 30 people living with dementia in a separate area of the home called Pike View. On the day of the inspection there were 58 people living at the home.

St Catherine's 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.

This last inspection took place 7 December 2017 and the overall rating was Requires Improvement. We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in relation to Person centred care, dignity and respect, safe care and treatment, medication, governance and staffing.

At the inspection on the 29 August 2018 we found that some of the breaches had been met. However, we found continued breaches in medication, person centred care and governance. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

There was an appropriate safeguarding policy and procedure in place, staff had undertaken safeguarding training and had a good understanding of how to report any concerns.

Staff recruitment was robust and staffing levels were good on the day of the inspection. There was a good induction programme for new staff and training was on-going.

There had been improvements to the overall cleanliness of the building. There was a rolling programme of refurbishment following the installation of a new heating system. The hot water in some of the bathrooms was extremely hot and could be potentially dangerous to people. Medicines were not safely managed.

Health and safety certificates were in place and general risk assessments and individual risk assessments had been completed.

People told us the food was ‘awful’ and we found choices were limited. This was due to the catering contractors that the home was instructed they had to use. The mealtime experience could have been improved. People were waiting for long periods of time to receive assistance with their meals.

People had mixed views about the care provided at the home, some people thought that care was task orientated and staff had not enough time to spend with people who used the service. We saw visitors were welcome at any time.

There were up to date policies on privacy, whistleblowing, medication and confidentiality. Residents’ and relatives’ meetings were held; however, these were poorly attended. The registered manager held a ‘drop in’ meeting so people could speak with her if they wished.

Some of the care files we looked at did not always show evidence that collaborative needs had been assessed and there was limited evidence to suggest people’s preferences had been addressed.

There was an up to date complaints procedure in the reception area and this was also in the information provided to people living at the home and their relatives.

The service was working within the legal requires of the Mental Capacity Act 2005 (MCA) and the deprivation of Liberty Safeguards (DoLS).

People we spoke with said the registered manager was approachable. We saw evidence of staff supervisions and appraisals. Staff meetings took place; however, these were poorly attended.

The service worked in partnership with other agencies and were involved with the Bolton Care Homes Excellence programme.

Inspection areas

Safe

Requires improvement

Updated 22 November 2018

The service was not consistently safe.

There was an appropriate safeguarding policy in place, staff had undertaken safeguarding training and had a good understanding of the issues and how to report any concerns.

Medicines were not safely managed. The hot water temperatures were unsafe in some areas of the home.

Staff recruitment was robust and staffing levels were satisfactory on the day of the inspection.

The cleanliness of the home had improved.

Effective

Requires improvement

Updated 22 November 2018

The service was not consistently effective.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs).

There were concerns raised about the quality of the food. People were not receiving a healthy and nutritious diet.

Caring

Good

Updated 22 November 2018

The service was caring.

People told us that staff were kind and caring. We saw good staff interactions with people.

We saw that visitors were made welcome at any time.

There were up to date polices on privacy and dignity and confidentiality

Responsive

Requires improvement

Updated 22 November 2018

The home was not consistently responsive to people’s needs.

Consideration needed to be given to providing meaningful activities and stimulation.

Some of the care files we looked at did not always show evidence that collaborative needs had been assessed.

Well-led

Requires improvement

Updated 22 November 2018

The service was not consistently well led.

People we spoke with said the registered manager was approachable. We saw evidence of staff supervisions.

Residents’ and relatives’ meetings were held periodically. Staff meetings were held; however, these were poorly attended.

There was a system in place for monitoring the quality of the service provided. However, some of the audits had failed to identify some important issues.