St Anne's Court

We found the following examples of good practice.

People told us the managers and staff at St Anne’s Court worked every day to keep them safe. We spoke with seven people who were all complimentary about the care they received, in particular during the COVID-19 pandemic. People told us they were supported to maintain vital contact with their loved ones. People told us they were treated with affection, we observed many caring interactions between the manager, staff and people which contributed to the atmosphere of the home.

There were safe practices in place for welcoming visitors to the home. These included rapid COVID-19 testing, temperature checks, hand sanitising, symptom and health checks. Vaccination status was checked for all visiting professionals. Records of mandatory staff vaccinations were maintained. Staff testing for COVID-19 was at the frequency in line with government guidance.

Supplies of personal protective equipment (PPE) were in good supply and we observed staff wearing this correctly. When it was necessary for people to isolate from others we noted individual PPE stations outside their room to maintain good hygiene practices.

The home was a good standard of cleanliness. At the start of the pandemic St Anne’s Court worked to provide ‘care’ training to other disciplines of staff such as the domestic and housekeeping team. This formed part of their emergency contingency plan and meant that if they were experiencing staff shortages during the pandemic they could be supported to deliver care by other members of the team. The home manager told us general cleaning took place daily and bedrooms were deep cleaned once a month on a rota basis or as needed. High use points such as bannisters and door handles were cleaned often throughout the day. Staff had training in infection prevention and control and were shown how to put on and take off PPE correctly. St Anne’s Court had an infection prevention control policy in place and undertook regular audits of the cleanliness within the home.

St Anne’s Court is a care home that provides personal care for up to 26 older people. At the time of the inspection, there were 22 people living at the service.

People’s experience of using this service:

People told us they felt safe, they were relaxed and familiar with the staff and each other. People were cared for by a consistent staff team who had received appropriate training to carry out their roles.

People’s dietary needs and preferences were assessed and where needed, people received support to eat and drink. Meal times were an important social event in the day.

People were supported to access health care services. People received assistance to take their medicines as prescribed.

People received care that was compassionate, respectful and responsive to their individual needs. Care plans were comprehensive and reviewed each month.

People and their relatives knew how to complain, one concern had been raised and this had been addressed robustly.

No people were receiving end of life care at the time of our inspection visit. The staff were proud of the care they provided at the end of people’s lives.

The registered manager who owned the home, the manager and staff shared a clear vision about the quality of care and service they aimed to provide. They worked in partnership with other organisations and the local community to make continuous improvements and develop best practice.

More information is in detailed findings below.

Rating at last inspection:

The last inspection was focused. The overall rating was Good (report published in May 2017).

Why we inspected:

This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up:

We will monitor information received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

The service has 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. At the time of the inspection two managers had been appointed by the registered manager to run the service.

At the last inspection, the service was rated as overall good with one breach of the regulations relating to the safe management of medicines. At this inspection staff had taken action to ensure people received their medicines as prescribed, and people told us they were supported to take their medicines as prescribed.

People told us they felt safely cared for and made additional comments about the overall quality of the care they received. One person said, “It’s very nice. It’s sort of small and homely. The staff are very good and very kind” and another person told us, “It’s what I call homely”.

Robust systems were in place to make sure accidents and incidents were reported, investigated and plans put in place to mitigate the risk of reoccurrence.

Recruitment was managed safely.

There were systems in place to ensure the environment was safe for the people who lived at the home.

St Anne’s Court is registered to provide residential accommodation without nursing. The service is registered to provide accommodation and residential or nursing care for up to 26 people. The service does not providing nursing care. At the time of our inspection the service was providing residential care to 19 older people. Rooms are on the ground and first floor and all have en-suite facilities. There are also adapted wet rooms on each floor. Rooms on the first floor can be accessed by a lift or stair lift.

The service has 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.

People were not always receiving their medicines in a proper and safe way.

People had not consistently had their medicines administered safely. Some people took medicines that were covered by the Misuse of Drugs Act. We found they were not always administered in line with the act. One person had eye drops that once opened needed to be discarded 28 days later. We checked the date on the bottle and they were being used 12 days after they should have been discarded. Staff told us that prescribed creams were being administered but records did not confirm this. One person had been administered medicine covertly. There are national guidelines for the administration of medicine being administered covertly and they were not being followed. Staff medicine administration practices were not identifying errors and taking the appropriate actions. Medicine was stored safely. Medicines were checked when they arrived in the home and records showed us that any discrepancies with the orders were identified and the appropriate actions taken. Medicine audits being carried out were not robust enough to identify issues we found. We discussed this with the managers who recognised this was an area that required immediate action.

People and their families told us they felt the care was safe. Staff had received safeguarding training and understood how to identify any possible abuse and how to report it. Risks to people had been identified and actions put into place to minimise the risk whilst respecting people’s freedoms and choices. People were involved in decisions about how risks they lived with were managed.

There were enough staff to meet people’s needs and they had been recruited safely. Processes were in place to manage unsafe practice.

Staff received an induction and on-going training that enabled them to carry out their roles effectively. Some training had been specific to people living at the home and included dementia awareness and diabetes. Formal supervision was not consistently taking place regularly but staff felt supported and had opportunities for personal development.

People received care that was designed to meet their needs and staff supported people’s ability and choices about their day to day care. One person had been assessed as not having the capacity to make some decisions for themselves. A best interest’s decision had been made in line with the principles of the mental capacity act. The manager was aware of which people had a power of attorney in place and the decisions they could be involved in on behalf of their relative.

People were supported by staff who understood their eating and drinking requirements. Fresh water was available in people’s rooms. People had their weight monitored monthly and actions were in place to minimise any identified risk

People had access to healthcare which included GP’s, chiropodists, occupational therapists and dentists.

People and their families described the staff as caring and felt their dignity and privacy were respected. We observed staff talking and having fun with people. Support was provided at a persons’ pace and not hurried or rushed. Staff were knowledgeable about people’s interests and events that were important to them which meant they were able to have meaningful conversations. People had been involved in decisions about their care and these had been respected. Advocacy information was available to people.

Care and support plans contained clear information about people’s assessed needs and the actions staff needed to take to support people. We observed practice that reflected what we had read in people’s care plans. People’s changing needs were identified and acted upon promptly. Information was shared at handover that kept staff up to date with people’s care needs. Daily notes however were sparse at times and not easily linked to care plans but reflected general observations.

People had opportunities to be involved in their local community. People also were supported to enjoy opportunities for individual activities.

A complaints procedure was in place and people and their families were aware of it and felt able to use it if needed. Complaints that had been received had been investigated and actions taken that ensured positive outcomes for people.

The registered manager had submitted a provider information return (PIR) six months prior to our inspection that showed evidence that they had a clear idea of where they were achieving well and where they could improve people’s experience of care. This had identified that improvements in medicine administration and auditing were required. . Other audits had been carried out which had successfully led to better outcomes for people. They included pressure care, accidents and incidents, complaints and checks on the environment and kitchen.

People, their families and staff all told us the service was well led. Staff had a good understanding of their roles and responsibilities and felt appreciated by the managers. They described the culture as friendly and that there was good teamwork. The managers had a good understanding of their responsibilities for sharing information with CQC and other statutory agencies. An annual quality assurance survey was carried out and included obtaining feedback from people, their families, staff and visiting professionals. Feedback had been used to improve service quality.

You can see what action we told the provider to take at the back of the full version of the report.