Archived: St Martin's Care Home

At the last inspection of this service on 2 November 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because equipment was not always used safely and requirements of the Mental Capacity Act 2005 were not always followed. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to meet the requirements of the law. At this inspection we found the provider had followed their action plan and they were now meeting the requirements of the law.

This service 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. This service is registered to accommodate up to 42 people. At the time of the inspection 42 people were living at the service; some of whom were living with dementia and other chronic conditions. Of the people living at the service; 31 required nursing care and 11 required support with personal care.

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.

People received effective, personalised care that was thoroughly planned and had been adapted to meet their needs. They directed and agreed to their care and the principles of Mental Capacity Act were being applied. People’s end of life care was discussed and planned and their wishes respected.

People were supported to express their views, make choices about their care, and have maximum choice and control of their lives. People chose when to get up, what to wear, when to go to bed and how to spend their day. People had the opportunity to take part in group activities such as; painting, karaoke, bingo, visits from external entertainers, playing darts and using the in house ‘bar’. Staff spent time with people on a one to one basis and encouraged people to stay in touch with their families and receive visitors.

People were encouraged and supported to eat and drink well and there was a varied daily choice of meals on offer. Health care was accessible for people and appointments were made for regular check-ups as needed.

People felt well looked after and supported. We observed friendly relationships had developed between people and staff. Care plans described people’s preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible.

Staff were supportive, caring and provided dignified care. They understood individual’s preferences and supported people’s lifestyle and social interests.

People's individual needs were met by the adaptation of the premises. Risks associated with the environment and equipment had been identified and managed. Technology, such as sensor mats, were used to alert staff if people at risk of falls got out of bed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

We found that a safe service was provided by a staff team who were appropriately recruited, trained and supported. Established systems were in place for preventing harm and abuse. Robust arrangements had been made to protect against risks, maintain health and wellbeing, and give medicines safely.

The service had an open, inclusive culture and was well managed. Feedback was sought and responded to. Complaints had been recorded and responded to appropriately. The governance of the service ensured regular monitoring of standards and the quality of care provided. Where shortfalls were identified action had been taken to make improvements.

St Martins is registered to provide support for up to 42 people. At the time of our inspection 16 people were receiving support with nursing care and 26 people were receiving support without nursing care. This meant the home was fully occupied.

The home had a registered manager. 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

During the inspection we spoke individually with twelve of the people living at the home and with four of their relatives. We spoke individually with six members of staff who held different roles within the home. We examined a variety of records relating to people living at the home and the staff team. We also looked at systems for checking the quality and safety of the service.

We found breaches of regulations relating to the premises and equipment being safe to use and relating to obtain consent from people for their care and treatment. You can see what action we told the provider to take at the back of the full version of the report.

The building was adapted and contained equipment to support people with their personal care and mobility needs. However some parts of the environment were unsafe and some of the equipment in use did not work correctly or was not suitable for the people using it.

Information about whether people consented to their care and treatment was not always up to date. This included a lack of recording that risks had been explained to people and regular reviewing of people’s decisions with them. Where people had the ability to consent for themselves other people had signed their care records without an explanation of why this had occurred.

Sufficient staff worked at the home on a daily basis to meet people’s support needs. However a high turnover of senior staff including managers and nurses meant that the service lacked consistency for people living there. This had also impacted on staff morale.

People living at the home and their relatives liked and trusted the staff team who took time to talk with people and ensure they were comfortable. Staff had a good understanding of their role and were provided with training to enable them to increase and maintain their skills.

People were offered a choice of meals which they enjoyed. Where needed they received support with their nutrition.

People received the support they needed with their personal care and health care. Prior to moving into the home people’s needs had been assessed so that staff were aware of the support the person needed. Care plans were in place for everybody living at the home. It was not always easy to locate information within the care plans which could impact on staff finding information in a timely manner.

A variety of activities took place in the home which people could participate in if they wished.

People were given information about the home and how it operated and systems were in place for obtaining people views. However these systems were not always effective. Results of surveys carried out were not readily available at the home so new managers could check that they had been actioned.

People felt confident to raise concerns or complaints with staff and a system was in place for dealing with these. Records of complaint investigations were not always readily available or easy to follow.

Systems for auditing the quality of the service were in place and an action plan was in place to check improvements were being implemented. These were not fully effective at picking up on improvements required to the service.

Staff members at St Martin`s Care Home received appropriate training which ensured people using services were provided with care delivered by experienced and knowledgeable staff. We also observed evidence of regular supervisions which provided staff with the opportunity to raise any concerns or issues related to their work roles. People using services and family members we spoke to said they felt able to raise any issues or complaints with any member of staff and have them dealt with in an efficient manner and within a stated time-scale.

“It’s a very nice place and I’m quite happy”.

“All the staff are good and the night staff are exceptionally good".

“She’s much better since she came here because she is getting proper care and good food”.

The people who accessed the service provided by St Martin’s were cared for by staff that were appropriated recruited, well trained and experienced at supporting them. The organisation monitored the quality of the service provided on a regular basis.