St Marks Court

Updated 7 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and one 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 Mark’s Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Mark’s Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post. A peripatetic manager was managing the service whilst the provider recruited another manager.

Notice of inspection

This inspection was unannounced.

Inspection activity started remotely off-site on 5 September 2022 and ended on 26 September 2022. We visited the service on 26 September 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we communicated with eight people who used the service and 10 relatives about their experience of the care provided. Not everyone who used the service communicated verbally or wished to speak on the telephone, therefore they gave us permission to speak with their relative. We spoke with 20 members of staff including the manager, regional manager, 12 care workers including one senior and agency care worker, one nurse, one cook, two domestic members of staff and two activities staff. We received feedback from two health and social care professionals.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medicines records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training information and policies and procedures were reviewed.

Updated 7 October 2022

About the service

St Mark’s Court is a care home providing personal and nursing care to up to a maximum of 60 people. The service provides support to older people including people who live with a dementia. At the time of our inspection there were 43 people using the service.

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

At our last inspection the provider had failed to robustly manage the risks relating to the health safety and welfare of people, including managing risks to people’s nutrition and pressure area care.

At this inspection improvements had been made and the service was no longer in breach of the regulation good governance as systems had improved to monitor the quality of service provision.

We have made a recommendation that the provider continues to make improvements to governance including menus, and as a result of people’s feedback to ensure person-centred care is provided.

Records now provided detailed guidance to assist staff to deliver care and support to meet people’s needs safely. Risks were assessed and mitigated to keep people safe. Staff recruitment was carried out safely and effectively.

An infection control system was in place. However, not all areas of the home were well-maintained or clean and there were signs of wear and tear.

We have made a recommendation about continuing with the programme of refurbishment in a timely manner, ensuring the environment is appropriately designed to meet all people’s needs and an appropriate standard of hygiene is maintained.

The provider was monitoring the use of PPE for effectiveness and people’s safely.

All people and relatives were complimentary about the care provided by staff. They trusted the staff who supported them. They said staff, although, “very busy”, were kind and caring and supportive of people and their families. Their comments included, “All the staff are lovely” and “The staff are very friendly and extremely welcoming."

Staffing capacity was sufficient to ensure people's needs were met in a safe way. People's feedback was staff were "very busy."

We have made a recommendation the provider continues to keep staffing levels and staff deployment under review to ensure people receive timely and person-centred care.

Systems were in place for people to receive their medicines in a safe way.

There was evidence of collaborative working and communication with other professionals to help meet people's needs.

The staff team provided support discreetly and with compassion. People’s privacy was respected, and people were supported to maintain contact with relatives.

There was a cheerful atmosphere at the service. One relative commented, “The home has a very homely feeling.”

Staff spoke positively about working at the home and the people they cared for. Staff said the manager was very approachable and they were supported in their role.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 January 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 3 November 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Mark’s Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.