St Anne's Nursing Home provides nursing and residential care to a maximum of 50 men and women who are elderly or have physical care needs. The service is provided by Blackberry Hill Limited and there were 47 people in residence at the time of our inspection. This inspection took place on 10 and 11 May 2017 and was unannounced. At our previous comprehensive inspection in March 2015 we found that, although risks were identified and reviewed, there was a lack of consistency among the staff team about how to respond to all potential risks. We also made two recommendations regarding activities and recommended a wider variety and inclusion of activities aimed to promote people’s mobility. At our focused inspection on 23 February 2016, we found that the breach of regulation 9, regarding risk assessments, and the recommendations regarding activities had both been resolved and all the areas of the service were rated as good.
At the time of our inspection, a manager was employed at the service. This person had applied to register with CQC. 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.
There were a mixture of views from people about the choice and diversity of food provided and menu options. The provider acknowledged that improvements to people’s dining experience could be achieved and was taking action to do so. The policy of protected mealtimes lacked clarity, which was acknowledged by the provider and changes were made to explain this more clearly to visitors and staff.
The provider had a policy and guidance available for staff about keeping people safe from abuse and staff had training about this. The members of staff we spoke with had a good understanding of how to keep people safe and what they should do if they had any concerns.
Risks to people using the service were considered and common risks such as the risk of falls and those associated with people’s healthcare needs were included. Any risks associated with people’s individual circumstances were also given attention and responded to.
There were policies, procedures and information available in relation to the Mental Capacity Act 2005 [MCA] and the Deprivation of Liberty Safeguards [DoLS] to ensure that people who could not make decisions for themselves were protected. 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 were supported to maintain good health. Nurses were on duty at the service 24 hours and a local GP visited the home each week, but would also attend if needed outside of these times. A GP was visiting and spoke with us during this inspection and told us of how well the home co-operated in response to people’s known and emerging healthcare needs.
Eight people we spoke with that either used the service, or were relatives, specifically commented about caring attitudes of staff and gave examples. The care plans we looked at showed that attention was given to how staff could ascertain each person’s wishes. There had been significant improvement to the efforts that were made to engage people in varied and interesting activities. This received praise from people living at the home and activities were offered to people whether they were able to participate in a group or to do so individually.
Communication between people using the service, relatives and staff were respectful. Although some people said they felt some staff could be more communicative. Staff we spoke with talked about the people they cared for with dignity and respect and we observed compassionate interactions between people using the service and the staff caring for them.
The provider listened to and responded to complaints and acknowledged that further changes could be made to ensure the continued effectiveness of complaint responses. People’s views were sought, as too were the views of relatives, visitors, health and social care professionals and staff. The feedback that people gave was taken seriously and the provider took action to monitor and improve the quality of the service.
There was regular and effective communication between staff and management of the home and the service provider. There were ample opportunities to raise anything of concern and to discuss care practices and improvements to the service. The views of staff were respected as was evident from feedback we received from staff.
At this inspection we found that the service met all of the regulations we looked at.