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Inspection Summary


Overall summary & rating

Good

Updated 30 December 2017

This inspection took place on 30 October 2017 and was unannounced. We also returned on the 2 November 2017. The manager and regional manager was given notice of the second date, as we needed to spend specific time with them to discuss aspects of the inspection and to gather further information.

St Johns House was registered by the Care Quality Commission (CQC) on 21 November 2016. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led. This was the first comprehensive inspection since the provider registered with CQC, as such; they had not yet received a CQC rating.

St Johns House 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.

St Johns House accommodates 60 people over two floors with a passenger lift available to access both floors. Each floor has separate adapted facilities. The first floor specialises in providing care to people living with dementia. At the time of our inspection there were 20 people living at the home.

A recently appointed manager was in post and had submitted their application to register with 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. Both the manager and provider were available on the day of our inspection.

At this inspection we found systems for monitoring quality and auditing the service had not always been effective. This is an area requiring improvement.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People who were able to said they felt safe at the home.

Systems were in place to identify risks and protect people from harm. Care records contained guidance and information to staff on how to support people safely and mitigate risks. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required. Accidents and incidents were accurately recorded and were assessed to identify patterns and trends. Records were detailed and referred to actions taken following accidents and incidents.

There were sufficient numbers of staff to meet people's needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed. Newly appointed staff received an induction to prepare them for their work. Staff had access to a range of training courses and said they were supported to attend training courses.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely. However, medication audits indicated a high level of errors each month, in relation to administration. We found people’s safety had not been impacted.

People's capacity to consent to care was properly considered and the home worked in accordance with current legislation relating to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This included training for all staff on both subjects. Throughout our inspection, we saw that people who used the service were able to express their views and make decisions about their care and support. We observed staff seeking consent to help people with their needs.

There was a varied and nutritious menu where people could make choices. People had sufficient to eat and drink and were offered a choice throughout the day.

P

Inspection areas

Safe

Good

Updated 30 December 2017

The service was safe.

People had detailed care plans, which included an assessment of risk. These were subject to a regular review and contained sufficient detail to inform staff of risk factors and appropriate responses.

Staff had received safeguarding training and knew how to recognise and report abuse.

There were sufficient numbers of staff to make sure that people were safe and their needs were met.

Medicines were managed in accordance with best-practice guidelines.

Effective

Good

Updated 30 December 2017

The service was effective.

Staff had received Mental Capacity Act (MCA) training and our observations confirmed staff promoted choice and acted in accordance with people's wishes.

Staff were trained in a range of topics, which were relevant to the specific needs of the people living at the home.

People were supported to maintain good health and had regular contact with health care professionals.

People were provided with a balanced diet and had ready access to food and drinks.

Caring

Good

Updated 30 December 2017

The service was caring.

People were treated with kindness and dignity by staff who took time to speak and listen to people.

Staff acknowledged, maintained and promoted people's privacy.

People were consulted about their care and had opportunities to maintain and develop their independence.

Responsive

Good

Updated 30 December 2017

The service was responsive.

People received personalised care and support, which was responsive to their changing needs and met people’s social, and leisure needs in an individualised way.

People made choices about aspects of their day-to-day lives. People and/or their representatives were involved in planning and reviewing their care.

People knew how to raise any concerns and told us that they would feel confident to do so.

Well-led

Requires improvement

Updated 30 December 2017

The service was not always well led.

The monitoring of quality and safety of the service, were yet to be embedded and sustained.

There was an honest and open culture within the staff team. Staff told us they felt well supported.

People benefitted from a well organised home with clear lines of accountability and responsibility within the management team.

Staff told us that the manager was approachable and that they were encouraged to discuss any issues or concerns.