Archived: St Michael's Rest Home

Updated 19 December 2017

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. The inspection was unannounced and was the first inspection since the owner changed their legal entity.

The inspection team consisted of one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at and reviewed all the current information we held about the service. This included notifications that we received. Notifications are events that the provider is required by law to inform us of. On this occasion we did not ask the provider to complete 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 improvements they plan to make

We spoke with seven people who use the service, three relatives, six members of staff, the chef, the manager, two visiting registered nurses and the nominated individual who is also the owner of the home and a director of the provider’s limited company.

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 with us. We reviewed the care records and risk assessments for three people who use the service, recruitment records for three staff, and the training and supervision records for all staff currently employed at the service. We reviewed quality monitoring records, policies and other records relating to the management of the service.

Updated 19 December 2017

This inspection took place on 27 July and 3 August 2017was unannounced. St Michael’s Rest Home provides accommodation and personal care for up to 27 older people, some of who may have a diagnosis of dementia or a mental health condition. At the time of inspection there were 25 people using the service. This was the first inspection since the owner of the home changed their legal entity from a partnership to a limited company.

A manager had been appointed one month before this inspection and was in the process of applying to register with the CQC as the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Although everyone had an up to date care plan, not all of the relevant information about each person was included in their records. Some people had a mental health condition which was not recorded, and which staff did not understand. There was no information for staff, or risk assessments in place to keep people safe and to make sure their mental health needs were met.

Recruitment practices were not robust and there were some gaps in pre-employment checks, such as full employment history. Staff knew how to recognise the signs of abuse and that they should report any concerns they may have to the manager. There were enough suitable staff on duty to meet people’s needs and keep them safe. People’s medicines were managed safely.

The provider’s quality monitoring system was not always effective. Although the provider and manager were completing quality monitoring audits, they were not always identifying areas for improvement. The manager had been in post for one month at the time of the inspection, and had already noted areas for improvement at the service, and had a robust action plan in place, to make sure those improvements were made.

Although staff were caring most of the time, people’s privacy and dignity was not always protected. People had developed positive relationships with staff and there was a friendly and relaxed atmosphere in the home. People were supported to remain independent and do the things that were important to them, such as going to the shops.

The providers quality monitoring processes were not always effective. The manager had identified this and understood what action they needed to take to make sure this area of practiced improved. The provider asked for feedback about the service from people and staff. Any feedback received was acted on where possible. There was a complaints procedure in place and the registered manager and staff knew what they should do if anyone made a complaint.

The manager had a good understanding of the Mental Capacity Act (2015) and understood that some people living in the home did not have the capacity to make some decisions about their care. Some of the staff needed further support to make sure they understood their responsibilities under the Act. All of the relevant DoLs had been applied for, and where these had been authorised, the conditions of the DoLs were properly recorded and acted on.

People were well supported to eat and drink enough. Food was homemade and nutritious and people were supported with healthy eating and to maintain a healthy weight. Everyone was supported to maintain good health and appropriate referrals were made to health care professionals when required.