6 October 2022
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 Health and Social Care Act 2008.
This was a targeted inspection to check on concerns we had about how people’s nutritional and hydration needs were being met.
As part of this inspection we looked at the infection control and prevention 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.
The inspection was carried out by one inspector.
Service and service type
St Margaret’s Care home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Margaret’s Care Home is a care home with nursing care. 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 the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.
During the inspection
We spoke with 14 people who used the service and one relative about their experience of the care provided. We spoke with 16 members of staff including the senior regional director, regional director, registered manager, one nurse, three senior carers, eight carers and one activities person.
We reviewed three people's care records and medicines records. Some records relating to the management of the service, including staffing records, weekly weights overview, weight loss/gain data and people’s nutritional scores were also reviewed.
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.
6 October 2022
About the service
St Margaret’s is a residential care home providing accommodation, nursing and personal care to 55 older people at the time of the inspection. The service can support up to 60 people.
People’s experience of using this service and what we found
We received positive feedback from people, who told us they were happy living at St Margaret’s. They told us they felt safe with the level of staff available. People and their relatives were happy with the care, support and range of activities on offer.
People received person-centred support and staff knew people well. The care plans in place covered all aspects of people’s care and support preferences to ensure a personalised experience. People were supported to maintain important personal relationships with friends and relatives. There were systems in place for communicating with staff, people and their relatives to ensure they were well-informed about the service.
People were supported to have their say and to exercise their rights and access to advocacy was available if required. Information could be made available for people in the correct format. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Healthcare professionals the registered manager and staff team were all included in people’s care and support as and when needed. People who needed specialist diets were supported.
The environment was clean and maintained to a good standard with personalised bedrooms. Audits and monitoring systems were used effectively to manage the service and to make improvements as and when required. There were enough staff to support people and staff were always visible. Staff received support and a variety of appropriate training to meet people’s needs.
Medicines were managed well, safely administered and recorded accurately. Individualised risk assessments were in place. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 31 May 2019). There was also an inspection on 5 July 2019 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
The last rating for this service was requires improvement (9 January 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This is a planned re-inspection because of the issue highlighted above.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.