Background to this inspection
Updated
3 December 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was conducted by three inspectors
Service and service type
St Margarets is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced from the car park of the service. We did this to discuss the safety of people, staff and inspectors with reference to Covid-19.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with six people who used the service about their experience of the care provided. We spoke with nine members of staff including the registered and deputy managers, a registered nurse, two housekeepers, the cook, activity coordinator and care workers.
We reviewed a range of records. This included care records for six people and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We telephoned two care workers.
Updated
3 December 2020
About the service
St Margaret’s is a residential care home providing nursing and personal care to 43 people at the time of the inspection. The service can support up to 56 people, some of whom may be living with dementia. All facilities and accommodation are provided on the ground floor.
People’s experience of using this service and what we found
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. A more effective quality assurance system was in place and improvements had been made to the standard of care and consent records.
Systems were in place to investigate accidents and incidents, though records and staff practice did not always evidence what was learnt. We have made a recommendation about the safety of clinical equipment.
The environment was clean. Appropriate processes were mostly in place to prevent the spread of infections, though staff were not screening visitors and surplus decoration and soft furnishings could potentially compromise standards of hygiene. We have made a recommendation about following government guidance in relation to Covid-19.
There were systems in place to safeguard people from the risk of harm and abuse. People received their medicines as prescribed.
People told us they liked the food, and menus provided choices and alternatives. Any concerns regarding nutrition or other health needs were referred to health care professionals.
Staff had access to training, supervision and support. There were enough staff planned for each shift, but the management team struggled to cover some short notice absences. Staff were recruited safely and a recruitment programme was underway.
The home was friendly and welcoming. Works to provide a dedicated visiting room were in progress. The registered and deputy managers promoted a person-centred culture. Staff worked effectively as a team to meet people’s needs and preferences.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (report published 27 July 2019).
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 10 and 13 June 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the need to consent.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Margarets on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.