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St Martins Care Home Ltd Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 16 January 2020

During a routine inspection

About the service

St Martin’s Care Home is a residential care home providing personal care and accommodation to 15 people aged 65 and over at the time of the inspection. The service can support up to 15 people in one house and is situated in a residential area. Some people living at St Martin’s Care Home were living with dementia and others had high dependency needs due to reduced mobility.

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

People did not always feel there were enough staff working at St Martins Care Home Ltd. Staffing levels in the evening meant people were left unsupervised or supervised by visitors to the home whilst staff attended to other people’s needs. Daily checks of the premises and oversight of the building’s maintenance to ensure its safety were not routinely carried out, which exposed people to unnecessary risk. There were missed opportunities to interact and staffing levels meant care workers did not always have time to spend with people engaged in meaningful activity or conversation. Although staff could tell us how to respect people’s dignity and privacy, care practices did not always support this.

Referrals to healthcare agencies to improve people’s outcomes was inconsistent. People were referred to some health professionals including district nurses, their G.P, and speech and language therapists. However, the provider had not always referred people for assessments following declines in their mobility which meant them needing to be cared for in bed. There were not enough activities for people to help stimulate, engage and minimise isolation. Activities were not planned in partnership with people to make them responsive to people’s enjoyment.

Systems to monitor and improve the safety and quality of the service were not effective. Tools were used to calculate staffing numbers, but lack of oversight meant staffing levels did not always safely meet the needs of people. Maintenance of the building and its safety was not monitored effectively which meant people were exposed to unnecessary risks. There was no system to safely store people’s confidential information. Audits were carried out but not always recorded and failed to identify the issues discovered during the inspection.

People felt safe living at St Martins Care Home Ltd, and risks to people’s health were assessed with risk management plans for staff to follow. Accidents and incidents were recorded and monitored by management to learn from them. Staff were confident reporting safeguarding concerns and contact information for reporting concerns was located on people’s bedroom doors. Medicines were administered and stored safely.

Staff had access to online training relevant to their roles and some had completed vocational qualifications in health and social care. People were supported by regular care workers who knew them, because staff had worked at St Martins Care Home Ltd for a long time. People enjoyed the food and were given options and choices. Staff understood people’s needs relating to their eating and drinking and provided appropriate support and encouragement for those who needed it. Overall, 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. However, staff did not always respond to the needs of one person living with dementia in a positive way. This person liked to explore their environment but was sometimes told to sit down rather than being encouraged to interact or engage. However, people said staff were kind and caring and the atmosphere at St Martins Care Home Ltd was homely and friendly. There were friendly and warm interactions between staff and people.

Staff were fully engaged in a game of ‘bingo’ and supported people to take part. Internet access was installed throughout the home so people could maintain contact with others throu

Inspection carried out on 28 November 2018

During a routine inspection

We inspected this service on 28 and 30 November2018, the inspection was unannounced. The inspection was carried out by one inspector.

St Martins provides accommodation with personal care and support for up to 15 older people who may needs due to physical disabilities. Some people were living with dementia and other associated illnesses.

A requirement of the services’ registration with us is that they have 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. There was a registered manager in place.

This was the first inspection under a new provider of the service. It was previously registered with us under a different provider and was registered as St Martins Care Home for the Elderly.

At this inspection, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service requires improvement in safe, effective, caring, responsive and well led. The overall rating for the service is Requires Improvement.

The provider had systems in place to monitor the quality and safety of the service people received, but these were not always effective. Actions to mitigate risks to people had not always been taken by the provider. There were areas of the home that posed potential risks to people's safety and welfare. There were insufficient numbers of staff to ensure that people were given the appropriate support to keep safe. Medicines were not always administered in line with the person's prescriptions. Some medicine recording errors had occurred and it was not clear when rescue medicines had been given.

Some people felt that staff understood and responded to their health needs. Some aspects of diabetes care were not monitored appropriately and information for health professionals was not always accurate.

Staff felt supported by the manager and received training in their roles. Staff on shift met some people’s individual needs. People could take part in some activities, however some people were at risk of becoming isolated.

People told us they felt safe with staff. Staff understood their responsibilities in keeping people safe from abuse. There were systems and processes in place to support this. People felt staff were kind and caring and enjoyed the food that they were offered.

Further information is in the detailed findings below.