Archived: St Margarets Rest Home

Below is a summary of what we found. The summary describes the number of different methods we used to help us understand the experiences of people who used the service.

During our inspection we looked at three out of 15 people's care records. We saw the provider's policies and procedures; we undertook observations, we spoke with two out of 15 people who used the service, a relative of a person who used the service and two members of staff. We also spoke with the registered manager.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

In the care records we looked at we saw that risk assessments regarding people's individual health, care and support were completed. We saw that measures were in place to minimise risks whilst supporting a person's right to live as independent a life as possible.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care services. The provider advised us that, at the time of our inspection, no DoLS applications had been made for people who used the service. Our inspection found that this was not in line with recent legislation around how a care service may be depriving someone of their liberty.

Staff we spoke with told us that they understood their role in safeguarding the people they supported. They demonstrated to us their understanding of safeguarding and what they would do and who they would contact if they had a concern.

We looked at three staff recruitment records and these showed us that pre-employment safety checks to ensure that staff were of a good character and deemed suitable to work with vulnerable adults had taken place.

Is the service effective?

People's support and care needs had been assessed and plans were in place within the care records we looked at. The two staff members we spoke with were able to demonstrate their knowledge of people who used the service including their individual support and care needs.

Is the service caring?

We saw positive, respectful and caring relationships between people who used the service and the staff who supported them. One person who used the service told us that they were, 'Well cared for.' Another person we spoke with said that staff were, 'Polite.'

Care records we looked at demonstrated to us that people were supported to live as independent a life as possible with assistance from staff. We found that people's individual needs were recorded to protect and promote a person's human rights.

Is the service responsive?

In the care records we saw, we noted that healthcare professionals were involved in people's care. We saw documented evidence that people were supported to attend external healthcare appointments.

Is the service well-led?

People who used the service, their relatives and healthcare professionals were given the opportunity to feedback on the quality of service provided. Results of this feedback were positive about the quality of service provided.

The provider had systems in place to monitor the quality of the service provided on an ongoing basis.

People's plans of care were well written and provided staff with sufficient information to care for each person in a way the person liked to be cared for. We saw that regular reviews of people's plans of care had been completed and where changes had been made to reflect the person's most up-to-date care information.

People were provided with a sufficient quantity of nutritious food and refreshments throughout the day. People could have a different meal if they did not like what was on the menu.

We found that each person who required mobility aids had these provided in a clean condition and maintained condition. A person we spoke with said, "I always use this (my walking aid) especially after a recent fall." Equipment that had been provided helped to promote people's independence.

The majority of people or their representatives were satisfied with the quality of care provided. People using the service were supported to complete the quality assurance survey including an easy read format where this was the most appropriate method. Relatives we spoke with said, "We have never had cause to complain. If we ever had a problem or concern we would speak with the manager."

We reviewed the staffing rosters for January 2013 and found that the staffing levels were based upon people's assessed health risks. Staff who we spoke with confirmed to us that they were able to request additional staff assistance if people's care needs changed. Staff who we spoke with were also aware of the process for requesting on-call staff. Staff rosters we reviewed demonstrated to us that senior carers and staff with appropriate health care qualifications were rostered for each shift.

We found that since our last review of compliance the provider had taken remedial action to review people's care plans which were now easy to read with up to date and relevant information.

We looked at three people's care plans and found that monthly reviews had been introduced with meaningful information that monitored people's changing needs. We saw that an activities schedule had been produced and from the documented evidence we noted that regular planned activities took place.

We reviewed the control of medicines and found that all medicines were accurately accounted for with a monthly check by the manager. This ensured that people could be confident that they would receive their medication as prescribed by staff whose competency to administer it safely had been assessed.

We looked at three staff files and found records that accurately documented training attended and completed by staff.