St Matthews Unit

Updated 2 September 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 3 inspectors, a Specialist 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 Matthews Unit 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 Matthews Unit is a care home with 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 not a registered manager in post at the service. An interim manager had been in post for 7 months whilst the provider recruited a registered manager. A new manager had been recruited and was soon to join the service. They will then submit their application to register.

Notice of inspection

This inspection was unannounced. Inspection activity started on 15 June 2023 and ended on 30 June 2023. We visited the location’s service on 15 June and 16 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service about their experience of the care provided and 10 relatives. We spoke with 8 members of staff including the manager, deputy manager, nurse and care workers. We reviewed a range of records. This included 11 people's care records and multiple medicine records. We looked at 5 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 2 September 2023

About the service

St Matthews Unit is a care home providing personal and nursing care to 46 people with a diagnosis of dementia and/or mental health at the time of the inspection. The service can support up to 52 people.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support: Overall the management of risks associated with people's care and support had improved. People had strategies which provided guidance in the event they became distressed. However, wound and pain management needed to improve at the service. We found concerns in relation to the management of medicine. For example, the provider did not always have written instructions for staff about the reasons for giving people when required medicine.

People were mainly supported to have maximum choice and control of their lives and staff mainly 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 supported by enough staff to meet their individual needs and to pursue hobbies and interests in their local community.

Right Care: Staff knew people well and used people's preferred communication methods, however, care plans were still being updated and improved to support staff to provide person-centred care. Staff had received additional training around people's health conditions and responses and interventions for people who experienced distress. The range of activities had not increased since our last inspection, but people were going out when they wanted to.

Right Culture: Improvements had been made in provider oversight and governance systems. Our evidence identified that improvements needed more time to fully embed into working practices. The provider had learnt lessons from our previous inspection findings and been open about where things had gone wrong. A new manager had been appointed. Relatives and staff were positive about changes, including improved communication and consultation.

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 inadequate (published 29 July 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The last rating for this service was inadequate (published 29 July 2022). The service has been rated requires improvement. This service has been rated requires improvement or inadequate for the last four consecutive inspections.

This service has been in Special Measures since 29 July 2022. During this inspection the provider demonstrated that improvements have been made.

Why we inspected

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.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see safe, effective, responsive 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.

The provider has taken a number of actions during and following this inspection to mitigate the risks identified at this inspection.

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

Enforcement

This service has been in Special Measures since 29 July 2022. During this inspection the provider demonstrated that 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.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.