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Little Sisters of the Poor - St Peters Residence Requires improvement

Reports


Inspection carried out on 3 August 2020

During an inspection looking at part of the service

Little Sisters of the Poor - St Peter's Residence is a 'care home' with nursing, registered to accommodate up to 56 people. There were 46 people living there when we inspected, many of whom were living with dementia. We found the following examples of good practice:

The provider had appropriate arrangements in place to reduce the risk of infection. Visitors to the home were required to wear appropriate personal protective equipment (PPE) to keep people safe, and this was made freely available throughout the home. Signs were placed around the home to remind people, staff and visitors of the PPE required. The home was spotlessly clean when we inspected. The cleaning schedule had been adapted throughout the pandemic to reflect current guidance and changes to visitors being allowed into the home.

The provider ensured that all staff received appropriate training to manage coronavirus. Staff received training in infection prevention and control and the use of PPE. We observed that staff followed appropriate guidance when using PPE. Staff and the management team had worked hard to assist people with dementia to understand the virus and how to keep themselves safe.

When necessary to reduce the risk of cross-contamination, people were supported within an isolated unit with their own staff team. Staff supported people to quarantine and provided physical and emotional support to assist them to understand the requirements. People were not admitted to the home during the height of the pandemic, to reduce risks.

The home's large gardens and abundant space meant that furniture and equipment were easily rearranged to facilitate social distancing. Communal areas such as the chapel, dining room and activities rooms had signs indicating their reduced capacity, and changes had been made to the way these rooms were used. For several weeks during the height of the pandemic, these rooms were closed and religious services were streamed to people's bedrooms so they could still participate in aspects of religious life that were important to them. Staff supported people on a one-to-one basis with activities in their rooms during this period.

The provider ensured that people were able to keep in touch with their loved ones, and were able to be seen by relevant health professionals, through the use of video calling when visiting was restricted.

The management team ensured staff wellbeing was considered, and managed the staffing rota to maintain consistency for people using the service. Two volunteers lived at the home during the lockdown period to provide additional support to people who needed it.

Further information is in the detailed findings below.

Inspection carried out on 2 March 2020

During a routine inspection

About the service

Little Sister of the Poor – St Peters Residence accommodates up to 59 older people across four separate units, in one purpose built building. At the time of our inspection 56 people were living at the home.

People’s experience of using this service

Medicines were not always managed safely, with registered nurses not demonstrating full knowledge in medicines administration. Fire drill procedures were not always as robust as they could be to ensure safety was routinely checked.

Management quality assurance systems were not always effective in identifying issues in a timely manner. Improvements required in medicines and fire safety had not been previously identified by the provider.

The environment was not as dementia friendly as it could be, to support with orientation. We have made a recommendation in relation to reviewing appropriate dementia friendly environments.

Staff were safely recruited, with some improvements needed to ensure that full employment history was up to date. Incidents and accidents were appropriately responded to. The home was very clean and well maintained.

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

People were well supported with their nutritional needs and were able to access healthcare professionals when they needed to. Staff were well supported through induction, supervision and training.

People and relatives felt that people were well cared for, in a friendly and accommodating environment. Staff ensure they respected people’s privacy and dignity, whilst supporting them to be independent.

Complaints were responded to as necessary. People had their communication needs supported and received personalised care. There were a range of activities available for people to participate in if they chose to.

People, relatives and staff were positive about management support, and spoke highly of the teamwork approach to ensure people received good care.

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

Rating at last inspection:

The last rating for this service was good (published 16 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to good governance at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 23 May 2017

During a routine inspection

Little Sisters of the Poor – St Peters Residence is a residential care home that provides accommodation and personal care to up to 56 older people, including people living with dementia. There were 52 people using the service at the time of this unannounced inspection. The facilities available within the service included private bedrooms with en-suite, communal living areas including sitting rooms, dining rooms, chapel, library, an activities room, art and craft room, reminiscence room, hair dressing saloon, shop, physiotherapy room, clinic rooms and well maintained gardens.

At the last inspection on 7 February 2015 the service was meeting all the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, inspected at that time. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Little Sisters of the Poor – St Peter Residence’ on our website at www.cqc.org.uk.

The service had a registered manager supported by unit team leaders. 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 and associated Regulations about how the service is run.

People, relatives, staff and professionals told us the service was managed well. The service operated in a way that demonstrated there was an open and transparent culture at the service. Staff told us they were happy working at the service and they felt valued and appreciated as a member of the team at Little Sisters of the Poor – St Peters Residence. The registered manager was visible and approachable, enabled and empowered staff to seek advice from her. The registered manager had worked at the service for a number of years so knew staff and people well. There were regular meetings and team building events where staff shared significant information and experiences together. Staff told us they received the leadership and direction they needed. Regular checks and audits of the quality of care were carried out to improve on service delivery.

The registered provider had systems and processes in place to protect people from harm People knew and were empowered to report any concern or abuse. Staff also had knowledge and understanding of the various types of abuse. They knew how to report an allegation of abuse and felt confident that any concerns they raised will be thoroughly investigated and addressed. Staff knew how to whistle blow if need be. Staff demonstrated that the protected people from harm and abuse while promoting their Human Rights.

Risks to people were managed in a way that promoted their health, well-being, individuality and independence. Staff knew the risks associated with people’s health and well-being and actions to take to manage them. The registered provider had innovative systems in place and guidance for staff to manage those risks safely. Positive risk taking was encouraged so people could live an independently as able.

People received their medicines according to instructions. Only trained and competent staff administered medicines to people. Medicines administrations records were correctly completed. Staff undertook regular checks to ensure people received their medicines as prescribed. Medicines were stored safely.

People received support from a sufficient number of staff with suitable skills and experience to meet their needs. Staff told us they had sufficient time to enable them to meet people’s needs safely. Appropriate recruitment procedures were followed to recruit staff to ensure only suitable applicants worked with people.

People had access to a range of healthcare services and to maintain their well-being and good health. Staff acted on recommendations of professionals to meet people health needs. This helped to improve of maintain people’s health.

Inspection carried out on 06 February 2015

During a routine inspection

This unannounced inspection took place on 6 February 2015. The last inspection of St Peter’s Residence took place on 13 December 2013 and it met all the regulations inspected then.

The service provides accommodation and personal care to 56 older people, including people living with dementia. There were 53 people using the service at the time of this inspection.

The service had a registered manager in post. 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.

Staff had received safeguarding training. They understood how to recognise the signs of abuse and knew how to report their concerns if they had any. There was a safeguarding policy in place and there were leaflets displayed about the home on how to report any concerns, so people and visitors knew how to report abuse.

People consented to the care and support they received. The service met the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People received care and support in a safe way. The service identified risks to people and had appropriate management plans in place to ensure people were as safe as possible. People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

There were sufficient staff available to meet people’s needs. People told us staff were kind and caring. We observed that people were treated with dignity and respect by the staff. People were supported to communicate their views about how they wanted to be cared for. People told us they enjoyed the choice of food that was available to them at the service and it met their nutritional needs.

Staff were trained to provide good care to the people they cared for. Staff received the support and supervision to carry out their duties effectively. Staff demonstrated their knowledge and awareness of how to meet the needs of older people. People had advanced care plans in place and they received the care and support they wanted.

Staff told us that they worked well as a team and there was an open and transparent culture in the home which enabled them communicated freely and improved their morale. Regular staff meetings and team building exercises took place to ensure staff were supported to do their jobs.

The service worked with various organisations to develop and improve services for people. People participated in community events and projects. People received appropriate support from health professionals to ensure they received appropriate care and treatment. Medicines were handled and managed safely; and people received medicines as prescribed.

People were asked for their views and their feedback that was used to develop the service. The registered manager responded appropriately to complaints about the service. Regular checks and monitoring of the service were undertaken to ensure the service was of good quality and met people’s needs.

Inspection carried out on 10 December 2013

During a routine inspection

We spoke with more than thirty of the people using the service, and with ten people who were visiting their relatives on the day of the inspection. We also spoke with two volunteers present.

People living in the home were complimentary of the service and expressed their satisfaction with the quality of care, they told us they were happy and felt privileged to be at this home.

A person said, "Caring and compassionate staff, we are well looked after and people feel safe, everyone knows you cannot find a more caring home."

People told of a lifestyle that offered solace and fulfilment to people in their advancing years. One person told of the wide range of activities provided in the home, from daily worship and family entertainment to visiting the Christmas Lights in London�s Oxford Street.

Another person said �there is never a dull moment here we have plenty of worthwhile things to do, some of us may be old but we still enjoy sewing and crafts, and helping to prepare the vestments for the chapel.�

A relative visiting told us �Mum settled in and adapted to her new home very quickly, staff reassured her and made her feel at home, she loves the spiritual side of the home, and this is most important to her.�

Staff told of their satisfaction from working in this home, they spoke of the caring culture that was fostered, and felt that there was clear guidance and support on providing "a good quality of care."

Inspection carried out on 3 January 2013

During a routine inspection

People using the service told us about the caring ethos they experienced and described the many ways that this was reflected in areas of practice.

A person living in the home for many years said, "People feel valued and safe here, the home is well run and run in the best interest of people that use the service, we can relax in the pleasant surroundings or join in the events that take place, people from all walks of life are provided for".

A person told us that staff were compassionate and supportive, they found their kind words and deeds provided emotional support that helped them get through a difficult period after losing their spouse.

A person using the service told us that at 98 years of age they were no longer able to remain independent and safe in their own home and moved to live at St Peter's. They said "I made the right decision and choose to spend the rest of my time here; I like this service and was familiar with it from my involvement with a friend who lived here happily for many years".

A relative visiting their mother told us of significant improvements to their health since they came to live at St Peter�s Residence, they contributed this to the good meals and the consistently high standard of care delivered.

Inspection carried out on 29 December 2011

During a routine inspection

People living at St Peter's and their visitors shared with us their experiences. The comments received during our visit reflected the confidence and the high regard people have for the home and for the staff that care for them.

People using the service find that their spiritual, physical and social care needs are met, they are not restricted by disabilities, but are given opportunities to exercise and maintain daily life skills.

People find that their healthcare is promoted, conditions are monitored and appropriate action is taken to respond to issues and concerns that arise.

A good wholesome and varied diet is enjoyed by all, people are involved in planning the menus according to preferences and cultural and dietary needs.

A number of couples have lived at the home. They said how much they appreciated the fact that they were able to be suitably accommodated, cared for appropriately and remain together as they become increasingly frail.

We heard about the dedication and commitment of the sisters and carers at the home, " "The sisters know the importance of promoting dignity, individuals matter here, this is reflected in how they lead and guide the care staff by example and good practice" were the comments received from two family members.

Those that wish to can take take treasured items of furniture for their rooms to make them personal. The environment overall is maintained to a high standard with a variety of pleasantly furnished lounges and quiet rooms for people to use and entertain their visitors.

One of the people living at the home for some years said, "We realize that we are fortunate to live in such a beautiful home where the caring ethos is palpable, we feel valued and priveleged".

People said that the lifestyles experienced was meeting their expectations and contributing to a fulfilling lifestyle. One of the people spoken to said, "You can join in as many activities as you like, there is so much to choose from, but I like to go out in the mini bus to the local shops every week".

Another person told us of the tranquil environment that he enjoyed, he was able to pursue his passion for reading and said "you need never be lonely here with so much going on every week".

Two of the visitors spoken to said, "We would love to see all frail older people experience the same quality of care that people receive at this home".