St Martins

Updated 14 July 2023

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 1 inspector, a specialist nurse advisor, and an 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 Martins 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 Martins is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 7 June 2023 and ended on 8 June 2023. We visited the location again on 3 July 2023 to ensure they were meeting the action plan they had submitted to the CQC.

What we did before the inspection

We reviewed information we had received about the service since the it had come under new ownership. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 11 people and 1 relative of people who used the service about their experience of the care provided. We spoke with 5 members of staff including the registered manager, director senior care assistant, domestic staff, and kitchen staff. We also spoke with 1 professional who worked with the provider.

We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 July 2023

About the service

St Martins is a residential care home providing accommodation and personal care to up to 21 people. At the time of our inspection there were 15 people living the service. The property is a 2-storey building with a large rear communal garden.

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

People were at risk of infection due to poor infection control practices. Premises and equipment were not clean or hygienic and staff were not clear on their responsibilities. People were at risk from health and safety concerns which had not been identified or acted upon in a timely manner.

Whilst people told us they felt safe, risks had not always been assessed or monitored. Whilst attempts were made to reduce risks, the actions had not been clear or co-ordinated. Identifying and reporting of risks, issues and concerns were unreliable and inconsistent. Where issues had been highlighted action was slow to be taken. The provider did not have the appropriate policies and procedures in place to guide staff on how to deliver person centred care in line with latest legislation and best practice guidance.

Medicines were administered safely and in line with people’s wishes. People were supported to eat and drink enough to maintain a well-balanced diet. People were supported by trained and experienced staff who were recruited safely. Safeguarding systems and processes were in place and people were protected from the risk of abuse, harm and neglect.

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

The last rating for this service was good (published 23 February 2023).

Why we inspected

The inspection was prompted in part due to concerns received about health and safety concerns related to the premises and fire safety. A decision was made for us to inspect and examine those risks.

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.

We received concerns in relation to the health and safety of the premises. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to safe care and treatment and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.