Archived: St Joseph's Nursing Home

Updated 17 September 2014

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This service was inspected as part of the first test phase of the new inspection process we are introducing for adult social care services. Before our inspection we looked at all the information we had available. This included information from notifications received by the Care Quality Commission, safeguarding information and the findings from our last inspection. We used this information to plan what areas we were going to focus on during the inspection.

We carried out a visit to the service on 9 April 2014. The inspection team consisted of two inspectors and an expert by experience who has experience of using or caring for someone who uses this type of care service. The inspection visit was unannounced which meant the provider and staff did not know we were coming.

At our last inspection, carried out over two days on14 and 18 November 2013, we identified problems with the safety and suitability of the premises and the arrangements for providing support and training for staff. We also found some shortfalls in records held relating to people's consent to care and treatment. Appropriate guidance was not followed for the correct completion of DNAR (Do not attempt resuscitation) records. Following the inspection the provider sent us an action plan describing the actions they were going to take to make improvements in the areas where problems were identified. At this inspection we looked at these areas again to see what changes had been made.

On the day we visited we spoke with four people who lived in the home, four relatives or visitors, a health professional and someone from the Clinical Commissioning Group, the body that commissions services funded by the NHS. We also spoke with the acting manager, the regional manager and four members of staff who were on duty during our inspection.

We looked at communal areas of the home including the kitchen and laundry areas, bathrooms, lounges and the activity room. When we spoke with some of the people living in the home we were invited to see their bedrooms. We also saw two shared areas, Blakewood and Lingwood, which were referred to as ‘wards’. These areas accommodated either four or five people in beds that were separated by curtains.

We spent time carrying out informal observations of care in lounge areas and dining rooms; we noted how people who lived at the service interacted with one another and with members of staff.

We examined records which included five people’s care plans as well as records that related to the management of the home. These records included quality audits, an overview of all staff training records and four staff files which contained recruitment records.

Updated 17 September 2014

St Joseph's Nursing Home provides nursing and personal care for up to 50 people. The home also provides end of life and palliative care. At the time of our inspection there were 46 people living in the home.

We found equipment used by staff when providing care and support was well maintained and safe. The environment in communal areas and individual bedrooms was also well maintained and clean. However, some areas throughout the home required improvement. These included one of the sluice rooms with areas of damaged tiling that could increase the risks of spreading infection and a bathroom that was not useable because the bath was boarded up. There was insufficient space to manoeuvre equipment safely to support people with mobilityneeds.

Further improvements were also needed to the two areas of multiple occupancy, which were referred to as wards. These areas lacked individuality and did not reflect people’s individual tastes. As the two wards contained beds separated by curtains there were also risks to people’s privacy and dignity when receiving care and support in areas that were open to people walking through. You can see what action we told the provider to take at the back of the full version of the report.

There were processes in place to provide staff with the training needed to give them the knowledge to care for people effectively. However, we found that some staff needed training updates for some core training.

People who lived in the home and their relatives told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm.

We saw positive interactions between staff and people living in the home and saw that staff were kind and respectful to people when providing care and support.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are a code of practice to supplement the main MCA 2005 code of practice. We looked at whether the service was applying DoLS appropriately and found they were meeting the requirements of the code.

Relatives told us that there was effective communication and staff kept them up to date with information about their family members.

Staff were knowledgeable about people’s needs and provided effective care. Care plans did not always contain enough information about people’s preferences and did not reflect the detailed knowledge demonstrated by staff.

People living in the home and their relatives told us that staff were kind, caring and cheerful. There were sufficient staff to support people with their care needs as well as social activities.

The acting manager had not been in the role of manager for long and we identified a number of areas for improvement which needed to be addressed.