St Catherine's Care Home Also known as St Catherine's Nursing Home

St Catherine’s Care Home provides nursing and personal care for a maximum of 47 older people on one floor in one purpose built building. At the time of our inspection visit there were 44 people using the service, the majority of whom were living with a dementia.

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

People felt safe, well looked after and loved. They felt the service was a place they could call ‘home’ and in which they were comfortable. Staff responded to people's individualities with a passionate and creative approach to enabling their independence. People were supported to play a full role in the running of the service, if they wanted, and an enjoyment of the things that made them unique. People’s religious beliefs were respected and celebrated.

Staff ensured there was a relaxed, affectionate and highly respectful atmosphere in which people’s individualities were respected and celebrated.

All staff demonstrated an understanding of the provider’s ethos of providing person-centred care and meeting the individual needs, wants and wishes of each person.

Systems and processes supported the open and accountable culture.

Staff were well trained, skilled and knowledgeable. They received the right support to do their jobs and ongoing encouragement to ensure they found time to chat with people on a one to one basis.

Activities and community involvement were varied and vibrant.

Medicines, the premises, utilities and safety equipment were all managed safely. The recent moved to electronic medicines and care documentation had been managed well. There was a proactive culture of analysing incidents and learning from them.

Feedback about the manager and staff was consistently positive from people, relatives and external professionals. Oversight of all aspects of the service was strong. There were clear plans and opportunities for continual service improvement through external engagement work and specialist-led dementia friendly reviews of the premises and end of life care.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

St Catherine's Care Home is a 45 bed care home that provides personal and nursing care to older people, including people with dementia. At the time of our inspection there were 42 people living at the home.

The service had 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 who used the service and relatives we spoke with consistently praised the skills of staff working in the home. One person living in the home told us, “I looked at a few homes before choosing this one and this was head and shoulders above the rest. Since moving in I have not been disappointed. The staff have been very supportive in helping me to settle.”

A relative summed up the views we consistently gained from all the relatives we spoke to by saying, “It was a huge comfort to us knowing (relative) was being cared for at this home and we will always be grateful for this and the way they were looked after in her final days, a rock of support every step of the way. This home makes a difference to people’s lives.”

People were supported with care and compassion and there was an ethos of care which was person-centred, valuing people as individuals. A relative told us, "I know my relative gets the very best care here. I'm 100% sure of that."

We found that this home was particularly effective in delivering quality care because of the emphasis it placed on building a really strong staff development programme. The provider valued their staff and saw them as an asset when delivering high quality care to people. Staff received extensive training and support to meet people's needs effectively.

Staff were well motivated and proud of the service. There was an emphasis on developing staff potential within a positive learning environment to create a high quality service. Staff had regular opportunities to reflect on their practice and to request any additional support or training. Staff were 'champions' in specialist areas and had received additional training and skills in their specific areas. Skills were then shared within the rest of the staff team to create more positive outcomes for people who used the service.

People were at the centre of care planning. People told us that they were made to feel in "control" from the time they first made the decision to move into the home. The staff knew the people they were supporting well and treated them in a respectful and friendly way. One person told us, “I get good support from all the staff, from the manager right through to the laundry staff and cooks.”

People were safe because risks had been identified and managed. All the staff in the home had completed training to give them the skills and knowledge to carry out their roles and to ensure people in the home were safe.

Systems were in place for the safe storage, administration and disposal of medicines. Records showed people received their medicines as prescribed and in their preferred manner.

People received on-going healthcare support from a range of both internal and external healthcare professionals and people’s health and nutrition were effectively monitored and responded to in line with nationally recognised practice. People were supported to eat a well-balanced diet and those who were at risk of malnutrition and/or dehydration had their food and fluid intake monitored. People told us of the high quality and range of the meals provided.

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.

The provider had a range of quality monitoring systems and had made improvements in response to people's feedback and audits. There was a strong commitment to deliver a high standard of personalised care and continued improvement based on the views of people who used the service and the enhancement of their lives. The staff team spoke positively about the support they received and were motivated and enthusiastic. Complaints were taken seriously, thoroughly investigated and lessons learnt from them.

St Catherine's Care Home is a 45 bed care home that provides personal and nursing care to older people, including people with dementia. At the time of our inspection there were 44 people living at the home.

The service had 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.

We found that clear processes were followed for reporting and responding to any safeguarding issues. The provider was open about their safeguarding procedures and trained staff in how to recognise and protect people from harm and abuse.

People and their relatives told us they felt the care provided at the home was safe. Risks had been assessed and measures were in place to ensure people’s personal safety. Steps were taken to provide care in a safe, comfortable and hygienic environment.

The risks associated with the safe use of medicines were not fully mitigated. Administration of medicines was not always accurately accounted for in records. Omissions in the application of topical medicines were evident and there had been an undue delay in one person receiving their medicines.

New staff were robustly recruited to check their suitability in working with vulnerable people. Enough staff of all grades were employed to ensure people received safe and consistent care. There was an appropriate skills mix and staff were given training and support which enabled them to care for people effectively.

People and their families were consulted about and asked to agree to their planned care. Where people were unable to give their consent, formal processes were followed to make decisions in their best interests.

People were given support to meet their health needs and access a range of health care services. A varied menu with choices of meals was offered and people told us they enjoyed the food. Nutritional risks were monitored and people were supported with eating and drinking where necessary.

Staff had a good understanding of people’s individual needs and preferences. They were caring in their approach and promoted people’s privacy and dignity. People were supported to express their views and make choices and decisions about their care and treatment.

Care needs were regularly assessed and recorded in personalised care plans. People’s care was kept under review, with their involvement, and adapted when their needs changed. People were able to engage in social activities and have their spiritual needs met.

The home had a defined management structure that provided staff with leadership and support. There was a continuous system for assessing and improving the quality of the service. Feedback about the service was actively sought and any complaints were properly responded to.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the management of medicines. You can see what action we told the provider to take at the back of the full version of the report.

We found people were cared for by staff who understood their needs and provided the care and treatment they required. However, action needed to be taken to bring personal records up to date and ensure they accurately reflected people’s planned care.

People were supported to meet their nutritional needs, including, where necessary, being given special diets and assisted with eating and drinking.

Care was provided by staff who were checked and vetted to make sure they were suitable to work with vulnerable people.

The expert by experience reported there, ‘appeared to be quite a number of staff on duty during our visit’ and that, ‘staff were kind and caring in their manner towards residents.’ They also reported one person, who was full of praise for the staff said, 'The lasses are lovely nothing’s a bother.’ Other people told the expert by experience that they too were happy with their care. The expert by experience told us that all the people they spoke to appeared clean and well cared for.

Care was planned to meet individual's assessed needs and was delivered by enough skilled staff to ensure people's safety and welfare. This included appropriate arrangements that made sure medication was given safely.

People and their relatives told us they received the care they needed and spoke highly of the commitment of staff. Their comments included, 'The day to day care is meticulous'; 'They are so very patient and tuned into people's needs'; and, 'All the staff are nice, very caring and friendly'.

There was a clear process for making complaints that people understood, and the service responded promptly to address any concerns.