St Heliers Hotel

Updated 23 July 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 Health and Social Care Act 2008.

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.

Inspection team

This inspection was completed by one inspector.

Service and service type

St Heliers Hotel is a care home providing care and support to older adults, some of who were living with dementia. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. St Heliers Hotel is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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 not a registered manager in post. A manager was in post and was in the process of registering as manager with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse, serious injuries and deaths. We reviewed the last inspection report and the action plan.

We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service about their experience of the care provided. We spoke with five members of staff including the deputy manager, care workers, administrator and kitchen staff. We also spoke with a visiting relative. The manager was unavailable on the day of the inspection and we spoke with them briefly on the telephone.

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

Updated 23 July 2022

About the service

St Heliers Hotel is a residential care home providing personal care to up to 30 older people most of who were living with dementia. At the time of our inspection 23 people were living at the service.

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

The quality of service people received had improved since our last inspection. People told us that they felt safe and they received the care and support that they needed. Management of the service had improved. Since the last inspection a new manager had been appointed. They were in the process of registering with the Care Quality Commission.

The manager had a clear vision of how the service needed to develop and was striving to develop an open and transparent culture. A governance framework was in place which covered all aspects of the service and the care delivered. Numerous quality assurance audits had been completed. When shortfalls had been identified, plans were in place to continue with the improvements. However, some shortfalls concerning records that were not up to date and inaccurate had not been identified in the audits. The manager took immediate action to address this. We will check that improvements have continued and sustained at the next inspection.

Risks to people's health and safety were identified. The manager had ensured all risks associated with people and the service had been assessed. People were supported with their health needs. The manager had oversight of incidents and accidents and lessons had been learnt when things went wrong.

Improvements had been made in the staff recruitment processes. Staff were recruited safely, and safety checks had been completed before they started working at the service.

Peoples medicines were managed safely, and people received their medicines when they needed them and as prescribed by their doctor. The service worked in partnership with other professionals, and the community when able to do so.

The manager and staff promoted and encouraged person centred care to ensure people were treated as individuals. Staff knew how people preferred to receive their care and support. There were enough staff available to make sure people received the personal care and support that they needed although they did say they were rushed at times. The manager was in the process of increasing the number of staff working on each shift to meet the increasing needs of people. This would also allow more resources for staff to take people out in the local area.

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 support this practice. Staff had received training in a range of subjects, including medicines administration. Audits had identified that some training and supervisions had fallen behind. There were plans in place to address this shortfall. Staff received support, guidance and advice from the manager. The manager had the skills and knowledge required to meet people's needs. People's health needs were monitored and met. Maintenance of the service had improved and there were on-going improvements. People received a healthy and nutritious diet. When people were unwell or needed extra support, they were referred to health care professionals and other external agencies.

People were protected from the risk of avoidable harm. When concerns were identified about people's safety, information was shared with appropriate stakeholders so investigations could be conducted.

People, relatives and staff were engaged in the service. Their views were listened to and acted on. 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. Staff helped to maintain people's independence by encouraging them to do as much as possible for themselves

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 7 October 2021). There were three breaches of the regulations. Following the last inspection, we required the registered provider to send us a monthly update and action plan to inform the Care Quality Commission (CQC) about the improvements they were making following previous inspections when continued breaches of the regulations had been identified. The provider had done this.

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

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Heliers Hotel 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.