Archived: St Johns House Residential Care Home

St Johns House Residential Care Home 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.

The home provides care and support for up to 23 older people, some of whom have dementia and physical disabilities. On the day of our visit there were 18 people using the service.

At the last inspection, the service was rated overall Good, with Requires Improvement in safe. At this inspection we found the service was overall Good, with Requires Improvement in responsive.

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.

Staff had knowledge and followed service policies and procedures to protect people from potential harm and abuse. Staffing numbers were appropriate to meet people’s needs in good time. Staff undertook appropriate recruitment checks which meant they were suitable to work with vulnerable people. Medicine management records were accurately maintained to ensure people had their medicines as prescribed. Staff followed safe infection control procedures. Incidents that occurred were regularly reviewed by the registered manager to ensure that causes were identified and dealt with as necessary.

People’s care records lacked information on the support people required and the guidance for staff on how to meet people’s individual needs. We made a recommendation about this.

Staff were trained appropriately for their role. Systems were in place to monitor the attended training courses which ensured that the registered manager was notified when staff were due for a refresher course. Some people told us the food provided was not always meeting their preferences. Staff supported people to meet their dietary and nutritional needs as necessary. The service provided important information about people to other agencies quickly when required. People had access to healthcare services as necessary. The provider was working to improve the premises for people living with dementia. People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible.

People told us that staff were kind and respectful towards their care needs. People’s religious needs were known and supported by the staff team. People had a say in how they wanted to be cared for and staff encouraged people to make decisions regarding their care and support needs. Staff maintained people’s dignity and respected their right to see their family when they wished to. The service encouraged people’s independence which meant they carried out activities by themselves where possible.

Staff followed guidance on how to use moving and handling techniques. This meant that people were provided with appropriate support to move around when they wished to. People and their relatives were aware of the complaints procedure and felt confident to raise their concerns if necessary.

Activities provided at the service had not always suited people’s care and support needs. We made a recommendation about this.

Staff felt well supported by the management team and approached the registered manager for advice when they needed it. People said the registered manager was responsive and attentive to their care needs. Staff were aware of and followed their responsibilities in relation to safe information sharing. Regular audits were carried out to monitor the quality provision at the service. The registered manager had shared information and updates with external agencies to improve the care delivered for people.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff and from looking at records. We requested information from the provider. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were protected from the risk of abuse. All staff had been trained in how to recognise abuse and how to raise concerns. They were aware of the whistleblowing procedure and we saw posters and leaflets on display informing people how to report abuse.

People told us they felt safe at the service. Comments received included "I feel safe and I feel well." and "we don't have any bullies here." One person said one of the good features of the service was "the way that we are treated".

At a meeting for people who lived at the service they were reminded to "tell someone" if anyone was unkind to them.

Is the service effective?

Care plans described people's individual needs and care was provided in accordance with them. Records, our observations and discussions with people confirmed that this support was provided by trained and knowledgeable staff,

Is the service caring?

People were supported by kind and attentive staff. People living at the service said they felt the care was good especially as they never felt "rushed" by staff. One person said the care "makes me feel that I am getting better." Another person described the staff as "angels." and said that the staff attitude was good, explaining that "we are not talked down to."

Is the service responsive to people's needs?

People said they were helped when they needed to be. One person said whenever they used the bell in their room to call for help "no matter what time, they are there straight away." We noted during our visit that call bells were responded to promptly.

Is the service well-led?

The service was well-led. The manager was registered and had been in post for several years. The provider visited the service to check the quality of the service provided. Service development was discussed to identify areas of improvement. Staff were well supported and trained to provide a good service.

People told us they were satisfied with the care they received. We were told that the staff were caring and helpful. Comments we received about St Johns House included "I like it here because it is comfortable and clean". A visitor said they liked the service because it was "small and personal".

We saw people enjoying activities during our visit and several people told us they had enjoyed a recent visit to Littlehampton. People said they felt safe at the service and although they had none, they felt able to raise concerns and complaints with staff.

Staff were recruited safely and appropriate checks were made to ensure they were suitable and experienced for their roles.

People we saw said they were "happy living here" and "liked the staff and food". People also told us that they "liked the activities provided for them". We found that the service had systems in place which assessed people's needs and care plans were written clearly. Well written risk assessments were in place for people and relatives were given the opportunity to plan for people's needs..

Staff listened to the people who used the service and provided for them according to their wishes on a daily basis. Staff observed people's dignity and respected their wishes. There were sufficient trained and experienced staff working at the home. We spoke with staff who said that "they liked the people they worked with".

We noted that some procedures regarding mandatory safeguarding required reviewing.