Background to this inspection
Updated
12 August 2020
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
Two inspectors carried out this inspection.
Service and service type
St Mark’s Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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. The registered manager was absent during our inspection and the service was being managed by the provider’s head of care and nursing and their quality assurance manager.
Notice of inspection
We gave the provider 24 hours' notice of the inspection. This allowed the provider time to let people know we would be contacting them for feedback and provide us with records for review as part of the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information shared with us as part of our attendance at serious concerns protocol meetings. We also contacted stakeholders within the Stockton-on-Tees serious concerns protocol forum to provide feedback. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with three relatives about their experience of the care provided over the telephone. We reviewed a range of records. This included four people’s care records and five medication records.
We spoke with two members of staff, including the provider’s head of care and nursing and their quality assurance manager.
Updated
12 August 2020
About the service
St Marks Care Home is a care home providing both nursing and personal care to people. The service accommodates up to 39 people with a range of needs including some living with a dementia. At the time of inspection 26 people were living at the service.
People’s experience of using this service and what we found
The service failed to maintain accurate and complete records in respect of people’s care and support. Individual risks associated with medical conditions were not identified. Some care plans contained inaccurate and missing information. Medicines were not managed safely.
The communication of important information about changes in people’s needs was not always effective. Governance systems were ineffective and failed to identify these shortfalls.
The provider had made some improvements since our last inspection. People had a safe environment. Health and safety checks were regularly conducted. Areas of the home had been repaired, resolving infection control issues. Safeguarding matters had been appropriately managed by the service.
People said they were happy with their choice of care home and they liked the homely feeling. People and relatives were complimentary about the care and support received. One relative told us, “My parent needs 24/7 365 days care because of their condition. I have no concerns whatsoever regarding their safety and can only praise everyone for the care.”
The provider had systems to learn from accidents and incidents, analysing the information for trends to enable them to reduce future incidents.
The service was open and transparent. An effective complaints process was in place and relatives and people we spoke with had no complaints.
The activity co-ordinator was enthusiastic about making people happy. Not everyone had the opportunity to access the community due to their care and support needs and there were limited activities available for people living with a dementia.
We recommended that the service research environments and suitable activities to support people living with a dementia.
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.
People were confident with staff members’ ability to support them safely. One person told us, “The staff seem to be trained to manage care safely and I feel confident when they are helping me.” The service supported staff with regular supervisions and appraisals.
The service had established partnerships with healthcare professionals to ensure people received joined up care. People, relatives and staff were regularly asked to provide feedback about the service.
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 inadequate (published 18 June 2019) and there were multiple breaches of regulation. This service has been in Special Measures since 18 June 2019. During this inspection the provider demonstrated some improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
At this inspection we found some improvements had been made but the provider had a continued breach of regulation 17.
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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.