St Johns House

Updated 2 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: One inspector carried out the inspection on both days and was assisted by a second inspector and an Expert by Experience on day one of inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service. The Expert by Experience on this inspection had expertise in caring for older people.

Service and service type: The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. 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.

Notice of inspection: The inspection was unannounced on the first day and we informed the provider we would be returning on the second day.

What we did: Before the inspection we reviewed information available to us about this service. This included incidents the provider must notify us about, such as abuse; we sought feedback from the local authority and professionals who worked with the service. We assessed the information we require providers to send us at least once annually 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 the provider, registered manager, deputy manager and four members of staff. We also spoke with 24 people and nine relatives/visitors and spent time observing the environment and the dining experience.

We looked at three people’s care records, a selection of medication administration records (MARs) and documentation about the management and running of the service. This included recruitment information for three members of staff, staff training records, policies and procedures, complaints and staff rotas.

Updated 2 February 2019

About the service: The service is a residential care home that was providing personal care and accommodation to 32 people aged 65 and over at the time of the inspection.

People’s experience of using this service: People using this service benefited from a service, which had maintained and built on the outstanding work that they did with people. People told us the service was, “Fabulous”, “The best there is” and “Like living in paradise.”

The provider demonstrated how they had achieved outstanding practice, development and improvement at the service. The leadership team sought creative ways to provide a personalised service and had achieved excellent results through exploring best practice and professional support and implementing it to enhance people's lives.

The staff team were highly motivated and were actively involved in and contributed to the continuous improvements in care and support. The provider and registered manager were dedicated to providing individualised care that met the highest of standards and promoted people's independence and quality of life.

The registered manager demonstrated a strong and supportive leadership style, seeking feedback in order to further improve the care and support provided. The registered manager and staff team used innovative, but safe practices to develop people's independence and create a vibrant, happy and thriving community.

Communication within the service was excellent at all levels and encouraged mutual respect between staff and people who used the service. People received exceptionally effective care. Staff collaborated with people and relatives to find out people’s interests and needs so they could provide person-centred, tailored packages of care that had a positive impact on outcomes for people who used the service.

The provider had attained regional and national recognition through accredited schemes, which acknowledge quality practice such as The Living Wage Foundation and Customer First. The management team encouraged and consulted with staff at all levels to improve the quality of service and all staff were encouraged to develop positive relationships with people living at the service and with each other. Staff took key roles to research best practice and promote better outcomes for people. For example, the activity co-ordinators had worked with a national company to develop and deliver person-centred activities which people found stimulating and enjoyable.

There was a truly holistic approach to assessing, planning and delivering care and support. Each person who used the service had a personal plan linked to their preferences and needs. Their wishes and choices were recognised and valued and people received excellent support to achieve a full and satisfying way of life. People were at the heart of the service, which was organised to suit their individual needs and aspirations.

Staff were caring, kind and compassionate with people, recognising them as individuals and treating them with respect and dignity. There was a strong emphasis on eating and drinking well. Meals were an enjoyable occasion, tables were attractively set and people could either sit in social groups they felt comfortable with or take their meals privately in their own rooms according to preference. Themed days, including special meals and celebration meals, featured regularly on the menu.

The atmosphere within the service was exceedingly friendly and open. A positive and innovative way of managing risk was discussed and developed with people who used the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

More information is in the full report.

Rating at last inspection: Outstanding (report published 9 June 2016).

Why we inspected: This inspection was a scheduled inspection based on the previous rating. The service has improved its rating of outstanding in two key questions, and now has achieved outstanding in four.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.