20 June 2019
During a routine inspection
St Faith’s Nursing Home is a residential care home which can provide personal and nursing care to 69 people aged 65 and over. At the time of the inspection 59 people lived in the home.
People are accommodated in one adapted building. Each person is provided with their own private bedroom with toilet and washing facilities. Additional toilets and bathrooms are available and are adapted to accommodate people’s needs. A choice of communal areas provides additional places to sit, eat and take part in social activities. There is easy access to a garden with adaptions to the home’s entrances to accommodate wheelchairs. Car parking is on site.
People’s experience of using this service and what we found
The process for monitoring the administration of people’s medicines had not been effective enough to identify that two people, had not been receiving some of their medicines as prescribed. A delay in senior managers being aware of this meant action was not taken in a timely way to review this and ensure, these people, were protected against the potential risks associated with not receiving medicines as prescribed. A process for identifying gaps in staff signatures, on people’s medicine administration records (MARs), was in place. However, this was not leading to effective action being taken, in a timely manner, to follow these recording errors up and to ascertain if people had received their medicines or not. No harm had come to people, but these processes were not robust enough to protect people from, potential risks, associated with not receiving their medicines as prescribed.
During the inspection and after, immediate action was taken to ensure these two people’s medicines management was reviewed. Action was also taken to improve the monitoring of people’s medicines administration and the action taken when recording errors were identified. It was too early for us to make a judgement about whether the action taken would be effective in reducing risks to people.
The provider’s quality monitoring processes, for monitoring other areas of the service and making improvements where needed was working well. In all other ways the service was being well managed. People told us they would recommend the service to others. A senior management structure was in place providing consistent leadership for staff who were being supported to work in such a way which resulted in good outcomes for people. There were effective communication processes in place to ensure people, their relatives and staff felt well informed of any changes to the service.
An open and transparent culture had been developed where staff were confident to challenge poor practice and people and their relatives felt able to report any concerns they may have. Staff felt well supported and valued by both the registered manager and provider. They told us they felt proud to work at St Faith’s Nursing Home. People considered the home to be well-led and they confirmed senior managers were visible and approachable. Managers engaged with people and their relatives to seek their views on the services provided to them. They were keen to learn from areas of dissatisfaction or when things did not go to plan.
Other medicines had been administered to people as prescribed. Medicines were received into the home in time for administration and they were stored according to pharmaceutical guidelines. Risks to people’s health and potential environmental risks were identified, assessed and managed to reduce or mitigate risks altogether. People lived in a clean home where arrangements were in place to prevent and control infection. There were processes in place to learn from errors and near misses, so staff practice, and the service people received could continually improve.
People told us they were well looked after, and they had confidence in the staff to meet their needs. Staff received training and support to be able to meet people’s needs safely and lawfully. People told us they received plenty of food and drink and had a choice in what they ate and drank. People’s nutritional health was supported, and any associated risks to this assessed and managed.
People confirmed they had access to healthcare professionals who helped them maintain their health. Staff worked with commissioners of adult social care and acute health care to ensure people could access support when they needed it. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive was possible and in their best interests. The policies and systems in the service supported this practice.
People told us staff were kind, caring and supportive. Care was delivered in a way which maintained people’s dignity and privacy. People told us staff explained things to them in a way they could understand. Staff supported people to maintain their independence and, where possible, to retain skills they already had. Those who mattered to people, family, representatives and friends were made welcome and could speak on behalf of people where needed. There were no restrictions on visiting.
People’s care was planned and designed around their needs and personal preferences. People or their representatives were included in this planning and in the review of their care. Care was reviewed and altered to accommodate changes in health, abilities and risks. People told us they were treated as individuals and their care was personalised.
People had access to social activities and supported to take part in activities which suited their abilities and preferences. There were arrangements in place for people, their representatives and others to raise a complaint and for this to be investigated and addressed. People’s end of life wishes were explored with them, or their representatives, and they were supported to have a dignified and comfortable death.
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 17 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the ‘Is the service well-led?’ section of this full report. Effective action was taken during the inspection to reduce and mitigate potential risks to people.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Faith’s Nursing Home on our website at www.cqc.org.uk.
Follow up
We will discuss with the provider their progress on the improvements they made during and after the inspection, about the monitoring of people’s medicines administration, to ensure this action leads to the service improving their rating in well-led to at least Good. We will continue to monitor information we receive about the service. We will return to visit the service as per our re-inspection programme. If we receive any concerning information we may inspect sooner.