We carried out a review of the data available to us about St John's House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about St John's House, you can give feedback on this service.
St John’s House is a residential care home providing accommodation and personal care for up to a maximum of 60 people. The service provides support to older people, some of whom live with dementia. At the time of our inspection there were 51 people using the service.
The home is purpose-built with accommodation over 2 floors and 3 separate suites, 1 of which is for people living with dementia. It has multiple communal areas and extensive accessible gardens.
People’s experience of using this service and what we found
The nurturing, supportive and warm culture created within the home meant people received an exceptionally compassionate and individualised level of care that improved their quality of life. The service recognised that understanding people’s life histories, values and beliefs aided them in creating support plans that met people’s often complex needs, including those associated with living with dementia. People told us the service consistently delivered care that exceeded their expectations and achieved positive outcomes that relatives did not feel was possible. This included end of life care which was especially thoughtful and compassionate not only to the people who used the service but their families and loved ones.
Staff worked patiently, diligently, and innovatively with people, their relatives, and professionals to maximise people’s potential, quality of life and wellbeing. People were placed at the heart of the service and were supported to have maximum choice and control of their lives. 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 worked in an open and transparent way which encouraged accountability and improvement. It recognised the benefits of working collaboratively with others and had participated in a number of research projects and pilots, all with the view to enhancing people’s health and wellbeing. Staff had built strong links with the local community and mutually supportive and respectful relationships had been fostered.
The provider had a robust quality assurance system in place that ensured people received a consistently high-quality service. The system was used meaningfully and encouraged staff participation and ownership. Actions were taken in response to findings and the provider had a clear accountability structure in place. Incidents were shared with staff and reflective practice was used at all levels to drive improvement. Where we identified minor shortfalls as part of the inspection these were acknowledged and promptly actioned by the registered manager.
All the people we spoke with told us they had no concerns about the service and would highly recommend it. They told us staff were skilled at providing excellent and attentive care that made people feel valued and cared for. People told us the management team were responsive, supportive, and welcoming. People’s lives had been enhanced by living at St John’s House.
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 30 December 2017).
Why we inspected
We inspected this service due to the length of time since it was last inspected.
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 COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
People's health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular health checks. People’s rooms were decorated in line with their personal preferences.
We found people looked happy and were relaxed and comfortable with staff. People were supported by staff who understood their needs and abilities and knew them well. Staff were kind and caring towards people and upheld their privacy and dignity at all times.
People's privacy was respected. Staff ensured people kept in touch with family and friends. People were able to see their visitors in communal areas or in private. The service placed a strong emphasis on meeting people's emotional well-being through the provision of meaningful social activities and opportunities. People were offered a wide range of individual activities, which met their needs and preferences.
People were involved in planning and reviewing their care as much as they could, for example in deciding smaller choices such as what drink they would like or what clothes to choose. Where people had short term memory loss staff were patient in repeating choices each time and explaining what was going on and listening to people's stories. Staff had good knowledge of people, including their needs and preferences. Care plans were individualised and comprehensive ensuring staff had up to date information in order to meet people's individual needs effectively.
The manager told us complaints would be listened to and managed in line with the provider's policy. People had access to information on how to make a complaint, which was provided in an accessible format to meet their needs. Complaints had been investigated. Records were kept of the complaints and actions taken.
People and their relatives were involved in developing the service through meetings. People and their relatives were asked for their feedback in annual surveys. Staff felt the management team were very supportive and said there was an open door policy.