Background to this inspection
Updated
24 April 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an assistant inspector.
Service and service type
St Margaret’s Residential 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection, and we requested feedback from the local authority who work with the service.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We observed the care and support being provided to a number of people throughout the building at different points of the day, including lunch and an activity session.
We spoke with five people living at the service about their experience of the care provided. We also spoke with a visiting health professional, the assistant director, the registered manager, a senior care assistant and the cook.
We reviewed a range of records. This included various records for six people living at the service, as well as other records relating to the running of the service. These included staff records, medicine records, audits and meeting minutes, so we could corroborate our findings and ensure the care and support being provided to people were appropriate for them.
Updated
24 April 2020
About the service
St Margaret's Residential Home is a care home providing accommodation for up 21 people in one adapted building. At the time of this inspection 21 people were using the service who had a range of needs including dementia and physical disabilities.
People’s experience of using this service and what we found
Improvements were needed to ensure safe processes were consistently followed regarding the use of PRN (as required) medicines and monitoring people’s falls.
We also found a number of areas that would benefit from further work to promote people’s safety and well-being. These included making sure cleaning products are always locked away, consent processes being followed when people share a bedroom, staff training, supporting people’s communication needs and people’s access to activities.
These areas had not been identified through internal quality monitoring systems. This meant opportunities to learn lessons and improve things when they went wrong were sometimes missed.
Staff understood how to keep people safe from harm and abuse. There were enough staff to meet people’s needs, and checks were undertaken to make sure new staff were suitable to work at the service.
People were supported to stay healthy. Staff ensured they had enough to eat and drink and supported people to access healthcare services when they needed to. They understood how to protect people through the prevention and control of infection.
Staff were motivated and caring. They knew people well and treated them with kindness, respecting their privacy and dignity . People were supported to have maximum choice and control of their lives in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Leadership at the service was open and visible. They regularly sought feedback from people, relatives and staff; to see how well the service was performing.
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 21 September 2017).
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Margaret’s Residential Home on our website at www.cqc.org.uk.
During this inspection we found evidence that the provider needs to make improvements. We found no evidence that people had come to any harm from these concerns. Please see the safe and well-led sections of this full report.
The overall rating for the service has therefore changed from Good to Requires Improvement. This is based on the findings at this inspection. This is the first time the service has been rated Requires Improvement.
The provider confirmed soon after this inspection they had already acted, or had plans to address, all the issues identified for improvement.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.