You are here

Archived: St Claire's Nursing Home Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 1 June 2017

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection on 1 and 3 November 2016. Breaches of two legal requirements were found. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breaches.

At the last inspection on 1 and 3 November 2016 we found that the provider was not meeting the standards of care we expect. This was in relation to the provider not taking into consideration the complex needs of people and there were insufficient staff to meet people’s needs. Also people had not been involved in the formation of their care plans, which had not been updated or adhered to by staff.

We undertook this focused inspection on 1 June 2017 to check that the provider had followed their plan and to confirm they now met the legal requirements. During this inspection on the 1 June 2017 we found the provider had made improvements in the areas we had identified.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for St Claire’s Nursing Home on our website at www.cqc.org.uk.

St Claire’s Nursing Home provides care for people who require personal care. It provides accommodation for up to 40 people. At the time of the inspection there were 36 people living at the home.

There was not 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. The current manager had commenced her application to become the registered manager with CQC.

On the day of our inspection we found that the registered provider had ensured that sufficient suitably trained staff were available to meet people’s needs. They had taken into consideration the complex needs of people and people’s needs were reviewed on a regular basis so staff were working with up to date information.

People and where necessary their family or other advocates were involved in the planning of their care. Care plans were updated on at least a monthly basis. A new system was being put in place so staff could access information more easily in the care plans and accurately record information.

Inspection carried out on 1 November 2016

During a routine inspection

We inspected St. Claire’s Nursing Home on 1 and 3 November 2016. This was an unannounced inspection. The service provides care and support for up to 40 people. When we undertook our inspection there were 35 people living at the home.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks, with some having loss of memory.

The provider is currently in administration and a management company is overseeing the running of the homes in the group. The management company keeps CQC informed of progress and their visits to the homes and ensures we have an up to date action plan for each location.

There was not 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. A new manager had just been appointed.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection there was one person subject to such an authorisation.

We found that there were insufficient staff to meet the needs of people using the service. The provider had not taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed and care planned, but not delivered in a consistent way. People and relatives were not involved in the planning of their care and had not agreed to the care provided. The information and guidance provided to staff in the care plans was clear but not always followed through in the records. Risks associated with people’s care needs were assessed, but the plans were not always followed by staff. This could put people at risk of harm.

You can see what action we asked the provider to take at the back of the full version of the report regarding insufficient staffing levels and the use of care plans to monitor people's needs.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives.

Activities were on offer for people to take part in, which some people declined, but others enjoyed. People had the opportunity to join a residents committee.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements. Some checks were not robust enough and senior staff did not highlight mistakes to staff to ensure people were safe.

Inspection carried out on 30 December 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection on 14 April 2015. A breach of a legal requirement was found. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

At the last inspection on 14 April 2015 we found that the provider was not meeting the standards of care we expect in relation to ensuring there were sufficient staff on duty to meet people’s needs.

Care could not be delivered to people as they wished and they told us their needs were not always met.

We undertook this focused inspection on 30 December 2015 to check that they had followed their plan and to confirm they now met the legal requirements. During this inspection on the 30 December 2015 we found the provider had made improvements in the area we had identified.

This report only covers our findings in relations to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for St Claire’s Nursing Home on our website at www.cqc.org.uk.

St Claire’s Nursing Home provides care for older people who require nursing and personal care. At the time of the inspection there were 35 people living at the home.

At the time of the inspection there was not a registered manager in post. However, the manager’s application was being processed by CQC. 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.

On the day of our inspection we found staff interacted well with people and people were cared for safely. People told us their needs were being met. Staff told us they had sufficient time to meet people’s needs and to help them take part in social activities. The provider had systems in place to ensure they knew the needs of people living at the home and could adjust the staffing levels when required.

Inspection carried out on 14 April 2015

During a routine inspection

We inspected St Claire’s Nursing Home on 14 April 2015. This was an unannounced inspection. Our last inspection took place on 20 August 2014 and the service was compliant. The service provides care and support for up to 40 people. When we undertook our inspection there were 36 people living at the service.

There was 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.

We found that there were insufficient staff to meet the needs of people using the service. The provider had not taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the number of staff available at times. You can see what action we told the provider to take at the back of the full report.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People had a choice of meals, snacks and drinks. And meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual. There were sufficient staff to meet people’s needs.

People had been consulted about the development of the home and quality checks had been completed. The manager was aware of the areas in the home that required refurbishment and was liaising with the provider about these.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. There was one person living at the home that were subject to such a restriction.

Inspection carried out on 20 August 2013

During an inspection looking at part of the service

People who used the service told us their current needs were being met. They told us staff were pleasant when attending to their needs. One person said, "Staff are lovely. They do what I ask them." Another person told us, "Staff attend to my needs well. If I choose to stay in bed I can."

Inspection carried out on 10 May 2013

During a routine inspection

Everyone we spoke with talked positively about the staff and felt they fully supported their care needs. People told us the staff spoke with them in a calm and polite manner. One person said, "Staff are so kind and ensure I do what I want to do." Records confirmed where permissions had been sought for the use of equipment and to share details of a person's care with other agencies.

The people we spoke with told us their care was personalised to their needs. They told us they knew staff kept records on them but most had not seen those records. They told us staff had however discussed their care plans with them. One person told us, "Staff are very attentive to me and I get what I need."

Records told us what equipment was is use, how it was checked to ensure it was safe to use and how repairs were completed. Each person had been assessed who needed equipment to aid their well being. One person said, "I was assessed for a new wheelchair and occupational therapists came to see me and staff here have helped me get used to it."

There were rotas in place showing which staff were on duty each day and night. People told us staff were not always available to meet their needs. One person said, "I sometimes have to wait for my meals." Another person told us, "I use my call bell and sometimes have to wait, staff don't always give an explanation of why they have taken so long."

The complaints process was on display and people knew how to use it.

Inspection carried out on 4 December 2012

During an inspection looking at part of the service

Everyone we spoke with spoke positively about the staff and felt they fully supported their care needs. People told us staff appeared to know a lot about them and felt relaxed and confident with the staff who looked after them. One person said, "I have no problems with staff, everyone is lovely." Another person told us,"I can see my care notes but choose not to." Another person told us, "Staff tell me they go to training sessions and I like to hear what they have achieved."

People told us they felt safe and secure. One person said, "I feel more secure than in my own home."

Everyone told us their assessed needs were always maintained and staff answered their call bells promptly. One person said, "They come quickly day and night when I press my call bell."

Records showed people had been involved in the planning of their care and were regularly asked about those needs and the running of the home. One person said, "I like to keep involved in the home."

Inspection carried out on 18 September 2012

During an inspection looking at part of the service

As part of our inspection we spoke with a number of people who use the service. They spoke positively about the care and support they received. They told us they liked living in the home and confirmed that they were supported to make choices and decisions about the care they received.

Comments included, "Everything is being done for me at the moment", "It's improved a lot lately" and "The call bell response is good."

During the visit we spoke with relatives who told us they were kept informed of events within the home. Comments included,"I cant praise them (the staff) enough" and "The dedication of the staff is second to none."

Inspection carried out on 24 July 2012

During a routine inspection

As part of our inspection we spoke with a number of people who use the service. They gave us both negative and positive views about the care and support they were receiving. They told us they liked most of the staff and confirmed they had been consulted about their care needs and how they could make decisions for themselves.

Positive comments included, "I do feel safe here", "Staff speak nicely to me" and "Staff are friendly".

Negative comments included," I have to ring my call bell three or four times before I can get staff to help me to the toilet", "I have to wait a long time to have my call bell answered, especially at meals times" and "Sometimes staff tell us they are short staffed".

During the visit we spoke with visitors who expressed mixed views about the care being delivered to their family members. One person told us their family member, "Felt loved and cared for" and another person told us they did not trust all staff to do a good job.

Inspection carried out on 24 January 2012

During an inspection looking at part of the service

We did not get peoples� views directly from them about these two outcome. However their experiences were captured through records, and other information we received from the manager.

Inspection carried out on 15 August 2011

During a routine inspection

People told us they were involved with their care. One person said �I attend the residents meetings regularly�.

People told us they were treated well with dignity and respect at all times; however they had to wait for attention because staff were busy. Another person told us they have difficulty getting out of bed and had to rely on the buzzer system. They had to wait for someone to come and attend their needs. Relatives also raised concerns regarding this.

People said that they trusted the people who care for them.

We were told the staff were very nice and relatives were very complimentary towards the staff. However some felt there were not enough staff for the high dependence of people in the home.