St Andrews Nursing Home

Updated 26 August 2022

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.

As part of this inspection we looked at the infection prevention and control measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

An inspector completed the inspection.

Service and service type

St Andrews Nursing Home 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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with seven people who used the service about their experience of the care provided. We spoke with the care director, regional manager, the registered manager, the deputy manager, two senior care workers, nine care workers, and an ancillary staff member. We observed how staff interacted with people using the service. We contacted four relatives following the visit.

We reviewed a range of records. This included seven people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 26 August 2022

About the service

St Andrews Nursing Home is a nursing home providing accommodation for up to 45 older people and people living with a dementia. Although registered to provide nursing care the provider decided to suspend offering this type of care in November 2021. There were 27 people using the service when we visited.

People’s experience of using this service and what we found

People told us staff were caring and they felt safe. We observed staff deliver care and support in a kind and compassionate manner. It was clear staff understood people's needs and how to manage any presenting risks. Risk assessments were clear and readily identified how to mitigate these, staff were familiar with these documents and the actions they needed to take.

There were enough staff on duty and staff were recruited safely. The dependency calculation led to one member of staff, at times, would be present in the units. The providers were closely monitoring the situation and confirmed flexibility was available to increase staffing as needed.

The level of internet connectivity was patchy and deteriorated the further away from the centre of the home people and staff went. The provider had taken steps to address this but found a range of measures had not worked. They were in the process of looking at alternatives.

People were protected from abuse by staff who understood how to identify and report any concerns. Incident monitoring records were appropriately used to understand themes and reasons for the events. These were used to learn lessons and discussed across the team. Medicine management was effective. Staff adhered to COVID regulations and procedures.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The systems the registered manager had in place allowed them to critically review the service and proactively looked at how improvements could be made. The registered manager and staff had worked diligently to ensure the new electronic record system was implemented effectively.

Staff told us that the registered manager was approachable and listened to their views. All felt the registered manager was running a good service. Staff were passionate about providing good care outcomes and took ownership for their practice. They had established good working relationships with all visiting professionals, and this had supported them to deliver effective care and support.

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 10 May 2018).

We completed a targeted inspection in March 2021 to look specifically at infection control and were assured.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This report only covers our findings in relation to the Key Questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Andrews Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.