This inspection took place on 2 and 3 March 2015. The first day of the inspection was unannounced and we informed the registered manager we were returning on the second day. At our previous inspection on 1 August 2014 we found the provider was not meeting the regulation relating to the provider having effective processes to seek the views of people living at the service and their representatives, in regard to the quality of the food service.
St Vincents’ House is a 92 bedded care home with nursing and provides care, accommodation and support for older people with general nursing care needs, people who are living with dementia and people with palliative care needs.
The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People and their relatives told us there were not always enough staff on duty to keep people safe and meet their needs.
People told us they liked the staff and felt safe with them. Staff had received safeguarding training, although some staff needed more support and guidance in order to fully understand the provider's whistleblowing policy.
The service conducted risk assessments to ensure people were safe, while taking into account their wishes and rights.
People were protected by rigorous staff recruitment practices. Staff received training, support and supervision to carry out their roles and responsibilities. However, improvements were needed to ensure that the supervision was meaningful and focused upon staff member’s individual circumstances.
There were robust systems in place to ensure people were safely supported with their medicine needs.
We were informed by staff that sometimes they did not have enough equipment such as hoists, gloves and incontinence pads; however, satisfactory supplies were available on both days of the inspection.
Improvements had been made to the quality of the food service, although some on-going work was needed to ensure that the food was consistently served at the correct temperature.
Most staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which care homes are required to meet. The service understood how to act within legal requirements when determining if people needed to be deprived of their liberty to keep them safe.
People’s healthcare needs were identified in their care plans and they were supported by the service to meet these needs.
People told us that staff were kind and talked with them. We observed that some staff appeared to be more task orientated when they provided care and did not offer a more personalised approach.
Although people and their relatives told us they took part in activities we saw limited evidence of this during the inspection.
People’s dignity and privacy was promoted. We saw that staff knocked on people’s doors before entering and closed doors if they were providing personal care.
There were systems in place to regularly review and update people’s care plans.
The service had systems in place to meet the needs of people who were at risk of developing pressure ulcers. However, there were gaps with the recording of the preventative care and how the staff treated pressure ulcers.
People told us they had received information about how to make a complaint and thought that the registered manager would respond well to any concerns.
People and their relatives told us they could speak with the registered manager and most people thought that the service was well managed.
Some staff expressed concerns to us that they did not feel consulted or valued by the management team.
The provider carried out surveys and audits in order to improve the quality of the service.
We found two breaches of regulation, relating to sufficient staff on duty to ensure people's safety and ensuring that people are always treated in a caring and compassionate way.
You can see what actions we told the provider to take at the back of the full version of this report.