St Stephens Nursing Home

Updated 16 July 2019

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.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Stephens Nursing 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 service had a manager registered with the Care Quality Commission. This means that 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 unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection on 05 October 2016. This included details about incidents the provider must notify us about, such as abuse or when a person dies. We sought feedback from the local Healthwatch for information about 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. Healthwatch did not have any feedback on this service at the time we inspected. The provider completed a Provider Information Return (PIR). We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with 16 people using the service, two visiting support workers employed by outside agencies to provide one to one support, two health care assistants, one registered nurse, the cook, and registered manager.

We reviewed a range of records based on the history of the service. This included three people's care records and medicines records. We also looked at three staff files including their recruitment, supervision and training records. We reviewed records relating to the management of the service, quality assurance records and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and quality audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and survey questionnaires, these had been sent to us in a timely manner.

Updated 16 July 2019

About the service

St Stephens Nursing Home provides accommodation, personal and nursing care for up to 17 people who need support with their learning disability, physical disability and health needs.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 17 people. There were 16 people living at the service when we inspected. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were positive in their feedback. Everyone we spoke with felt safe living in the service, they were all very happy. People said, “If I need any help, they give it to me”; “I am able to get up when I like and go to bed when I like” and “Love it, can’t fault the place.”

People continued to be safe at St Stephens Nursing Home. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them. People felt a part of their local community and were supported to use local resources such as library, community park and pubs.

People were involved in the running of the service and were consulted on key issues that may affect them.

People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. One visiting support worker said, “Oral hygiene is excellent.”

We observed people’s rights, their dignity and privacy were respected.

Staff supported people to maintain a balanced diet and monitor their nutritional health.

Medicines were stored and managed safely by the registered nurses. The registered nurses were responsible for medicine administration. There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People received care from staff who were well supported with induction and training. Registered nurses’ competency was checked once a year with the Nursing and Midwifery Council [NMC].

People knew how to complain and that any concerns would be listened and responded to by the provider.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 (Report published on 04 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.