Background to this inspection
Updated
14 March 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 was planned to check 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 comprehensive inspection took place on 18 and 19 February 2019 and was unannounced on the first day. The inspection was carried out by an adult social care inspector, assistant inspector, specialist advisor and an expert by experience on the first day and an adult social care inspector and assistant inspector on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The specialist advisor was a nurse.
Prior to the inspection we checked information we held about the service including whether we had received any statutory notifications. A statutory notification is information about significant events which the service is required to send us by law. The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We used all of this information to plan how the inspection should be conducted.
During the inspection we spoke with; the clinical lead assistant service manager, head of compliance, regional manager, a nurse, seven support workers, a kitchen assistant, activity coordinator and a member of the housekeeping staff. We spoke with 11 people who lived at St Stephen’s and five visitors which included the GP who supports the service.
We looked at care records belonging to ten people, four staff recruitment records, ten medication administration records (MARS) and other documents relating to the operation and safety of the service.
We used the Short Observational Framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us and made observations of the premises and care practice.
Updated
14 March 2019
This comprehensive inspection was carried out on 18 and 19 February 2019 and was unannounced. We last inspected St Stephen’s Care Home on 19 July 2016.
St Stephen’s Care Home (St Stephen’s) is a ‘care home’ providing care and accommodation for up to 40 older people. The premises are on one level and divided into two units, one of which provides support to people living with dementia. At the time of our inspection there were 37 people living at the home.
At the last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.
People continued to receive a safe service and were protected from harm and abuse. Medicines were managed and administered safely. Accidents and incidents were recorded and management had oversight to identify developing patterns to mitigate the risk of recurrence. Although we received contrasting feedback about staffing levels, during the inspection we observed that there were sufficient staff to meet people’s needs. Safety checks were carried out to ensure St Stephen’s was a safe place to live. Measures were in place to control and prevent the spread of infection.
People continued to receive an effective service. People’s needs were assessed before they came to live at St Stephen’s. Staff received a wide range of health and social care related training. Regular staff supervision and appraisal took place. Staff competency was checked. Food was served in line with people’s dietary needs. 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.
People continued to receive a caring service. People’s privacy, dignity and independence were promoted and they were treated fairly and without discrimination. People’s individual communication needs were considered. We observed kind, caring and patient staff practice.
People continued to receive a responsive service. The service was homely and person-centred. People’s preferences and needs were recorded in a personalised care plan. A new system of care planning had been introduced including a more robust process for review. There was a policy and procedure in place to manage and respond to complaints. People’s future wishes for end of life care were considered and the service followed the ‘Six Steps’ programme to ensure high quality care at this stage of life.
People continued to receive a service that was well-led. There was a well-developed performance framework to assess the safety and quality of the service. Measures were in place to continuously improve the service. There was a registered manager in post who was due to leave however a new manager had been recruited. The regional manager would be responsible for overseeing their induction to facilitate a smooth transition.
We have made a recommendation that the registered provider reviews access to records to ensure that they are available in the absence of the registered manager.
Further information is in the detailed findings below