St Teresa's - Care Home with Nursing Physical Disabilities

Updated 21 October 2020

The inspection

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

This was a focused inspection to check on specific concerns that had been reported to the Commission. We looked at the service’s staffing levels, recruitment practices, staffing support, risk management systems, incident recording, complaints and review processes.

Inspection team

The inspection was carried out by two inspectors. An assistant inspector contacted relatives by telephone to gather their views on the service.

Service and service type

St Teresa’s - care home with nursing physical disabilities (St Teresa’s), is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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.

Notice of inspection

We announced the inspection two days before we visited to discuss the safety of people, staff and inspectors with reference to Covid 19.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and the information we had requested when the inspection was announced.

We had not requested the provider send us a provider information return as this inspection was completed in response to information of concern that the commission had received. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people the service supported.

We met with the registered manager and regional manager. Due to the concerns raised we invited all staff to have an opportunity to speak with us if they wished. We spoke with 11 staff during the inspection visit. We offered all staff the opportunity to contact the inspector following the inspection visit if they wished to share their experience of working at St Teresa’s. One staff member responded.

We reviewed the care records of three people and medication records for people who used the service. We reviewed the supplementary care records, recruitment process, staffing records and quality assurance records.

After the inspection:

We spoke with 8 relatives. We reviewed records provided to us by the registered manager. We continued to seek clarification from the provider to validate evidence found.

We sought feedback from health and social care professionals regularly involved in people’s care.

Updated 21 October 2020

St Teresa’s – Care Home with Nursing Physical Disabilities, provides accommodation with personal and nursing care for up to 27 people. There were 24 people using the service at the time of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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’s experience of using this service and what we found

People said they felt safe and well cared for. Relatives agreed with this view and commented “They have really kept all the residents very safe and they have thought about the residents as opposed to themselves – that is clear.”

There had been several changes in the management of the service since the last inspection. The recently appointed registered manager and regional manager had implemented the Leonard Cheshire organisation policies and procedures at the service. Staff found some of these changes challenging. For example, a review of staffing levels and deployment of staff around the service. Meetings with senior managers, human resources and staff were held to reach a compromise in how staff would be deployed around the service. Staff felt listened to and were satisfied with the allocation of core staff to particular units so that people could be supported by staff that knew them well.

People told us, as did relatives (with one exception) that there were sufficient staff on duty to meet people’s needs. Staff felt if the staff rota was adhered to there would be sufficient staff on duty to meet peoples care needs. The difficulties arose when staff went sick at short notice or did not turn up for shift. When this occurred staff completed additional shifts or agency staffing was arranged. The provider has reviewed and continues to monitor staffing levels across all departments.

Appropriate employment checks had been carried out to ensure staff were suitable to work with vulnerable people.

People told us ‘residents’ meetings were held so that they had the opportunity to share their ideas on how the service was run. They also felt able to speak with the staff at the service.

People said the quality of meals had ‘improved’ and their dietary needs had been catered for. This information was detailed in people's care plans. Staff followed guidance provided to manage people's nutrition.

Care plans contained information about people and their care needs. People were supported to make choices and had their support provided according to their wishes.

People were supported by staff who had received training to ensure their needs could be met. Staff received regular supervision to support their role.

People had good health care support from professionals. When people were unwell, staff had raised any concerns with health professionals to address their health care needs. Staff worked in partnership with health and care professionals.

Staff were patient and friendly, and people's privacy and dignity were respected. Staff knew how people preferred their care and support to be provided.

People were supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider had followed national and local Infection, protection and control guidance in line with the Covid-19 pandemic. The providers policy covered the use of PPE, handwashing, cleaning protocols, testing and the visiting policy: which had been recently reviewed to help visitors to see their families safely.

Systems were implemented to ensure the effective management of medicines. Staff who were administering medication were trained.

There were effective quality assurance processes in place to monitor the quality and safety of the service. There was clear provider oversight and they had ensured effective and competent management was in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 24 January 2018).

Why we inspected

We received concerns in relation to staffing levels and the impact this had on the quality of care and support that was being provided. We also received some concerns about the management of the service. As a result, we carried out a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained as Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Teresa’s- Care Home with Nursing Physical Disabilities on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.