St James's Lodge

People’s experience of using this service and what we found

Staff were observed wearing and disposing of personal protection equipment (PPE) properly. However, the staff walked some distance into the home before they picked up their personal mask at the start of their shift. The provider has assured us this matter has been addressed.

We found the following examples of good practice:

Good social distancing was observed by staff. People were supported to social distance and had dedicated support from staff to ensure they were not then lonely. People had the facility to contact family virtually.

People admitted to the service had a confirmed negative Covid test 24 hours before admission. They were Isolated for 14 days and re-tested soon after admittance. Clothes and personal items, if they could not be cleaned, were quarantined for 72 hours. Families were made aware that any items, such as presents and gifts needed to be isolated for 72 hours, this helped families in their planning of special occasions. For example, at Christmas, presents were delivered early so they could be isolated and given on the day.

People at their end of life were able to have visits from their family There were systems in place to ensure that families were tested and checked for signs and symptoms of COVID-19. Full personal PPE was worn, and families advised of areas they could/not go into while in the building.

The provider and registered manager were undertaking regular checks to ensure good standards of infection control were maintained.

This inspection was a scheduled comprehensive inspection based on previous rating.

St James’s Lodge (St James’s) was inspected on the 25 & 26 October 2018. This was an unannounced inspection.

What life is like for people using this service:

People were assured of continuing to receive care that was safe, effective, caring responsive to their needs and well-led.

Everyone we spoke with told us St James’s was a lovely place to live and visit, that staff were kind and caring and people were treated with respect.

People were involved in their day to day lives through being empowered to make their own choices about where they spent their time, who with and how. Their independence was promoted and staff actively ensured people maintained links with their friends and family.

People's health was well managed and staff had positive links with professionals which promoted wellbeing for them.

Staff showed a genuine motivation to deliver care in a person-centred way based on people's preferences and likes. People were observed to have good relationships with the staff team.

The environment was safe and people had access to appropriate equipment where needed. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.

Staff were recruited safely in good numbers to ensure people’s needs were met. There was time for social interaction and activity with staff. Staff knew how to keep people safe from harm.

People were given a good, healthy diet and kept hydrated. The service was following a new, internationally agreed way of monitoring people’s food needs. They were also ensuring Dignity in Food guidelines were integral to this.

The registered manager, provider and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us they were approachable and that they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service.

Rating at last inspection: The service was previously rated as Good. The report was published on the 5 May 2016.

About the service: St James’s Lodge is a nursing home that is registered to provide personal and nursing care to 38 older people. There were 28 people living there at the time of the inspection.

Recommendations:

• In respect of equality, diversity and human rights, we recommend the provider review their Statement of Purpose and training to ensure everyone knows they are welcome to their home, including people who may have difference, and staff are better able to understand the diversity of people.

• We have recommended that the provider reviews the Accessible information standards and the ensure the requirement implemented in their work

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. If any concerning information is received we may inspect sooner.

The full details can be found on our website at www.cqc.org.uk

St James’s Lodge provides residential care to up to 38 younger and older adults. Nursing care is provided. People may be living with dementia, a learning disability, physical or sensory disability or be on the autistic spectrum.

A registered manager was employed to manage the service. 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.

People told us they were safe and happy living at St James’s Lodge and were looked after by staff who were kind and treated them with respect, compassion and understanding. All staff expressed a commitment to values of providing only good care and to continue to improve the service. People, relatives and staff all stated that the registered manager led by example.

People felt in control of their care. People’s medicines were administered safely and they had their nutritional and health needs met. People could see other health professionals as required. People had risk assessments in place so they could live safely at the service. These were clearly linked to people’s care plans and staff training to ensure care met people’s individual needs. People’s care plans were written with them, were person centred and reflected how people wanted their care delivered. People’s end of life needs were planned with them. People were supported to end their life with dignity and free of pain.

Staff knew how to keep people safe from harm and abuse. Staff were recruited safely and underwent training to ensure they were able to carry out their role effectively. Staff were trained to meet people’s specific needs. Staff promoted people’s rights to be involved in planning and consenting to their care. Where people were not able to consent to their care, staff followed the Mental Capacity Act 2005. This meant people’s human rights were upheld. Staff maintained safe infection control practices.

Activities were provided to keep people physically and cognitively stimulated. People’s faith and cultural needs were met.

There were clear systems of governance and leadership in place. The registered manager ensured there were systems in place to measure the quality of the service. People, relatives and staff were involved in giving feedback on the service. Everyone felt they were listened to and any contribution they made was taken seriously. Regular audits made sure aspects of the service were running well. Where issues were noted, action was taken to put this right.

We saw that staff followed safe cleanliness and infection control procedures and people told us that their relatives were well looked after, saying "It is very very nice, very clean. (My relative) gets a wash every day. (My relative) says they are happy with the care, and I am too." There were enough staff on duty, and the staff told us that they did not feel over worked or rushed. The home kept good records that ensured the physical welfare and safety of people living at the home.

We heard how staff involved people, and their families, in their care. However the records for this did not always reflect the home's practice. Nevertheless people, and their relatives, felt involved and told us "The staff are approachable, I can talk to them if I am worried."

We spoke with relatives during the visit. They told us that they were happy with the progress and treatment their relative was receiving. They told us that staff kept them informed at all times of the care being delivered and progress. They told us that their relative was very happy being in the home as they were in for short period of time. They felt that they would be happy for their relative to live in the home long term. Relatives were told us that people were treated as individuals and with respect which was positive.

We spoke with staff who were happy with their job. They told us that they had attended induction prior to commencement of employment. Staff told us that they were supported to ensure that they were aware of the provider's policies and procedures by being giving time to read. They were also allocated shadow shifts to familiarise themselves with people and their care being delivered. Staff told us that they were aware of ensuring people's privacy and rights. Training was available for staff to attend which was relevant to people's needs.