St James Care

Updated 4 January 2019

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 took place between 26 November 2018 and 29 November 2018. We visited the care home on 26 and 27 November and the provider’s head office on 29 November. The visit to the care home was unannounced. We gave 24 hours’ notice of our visit to the head office to make sure the person we needed to speak with would be available.

The inspection team comprised an inspector, an inspection manager 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. The Expert by Experience on this inspection had experience of using services for people with needs arising from their mental health and substance use.

Before the inspection we reviewed information we had about the service, including previous inspection reports and notifications the provider sent to us. A notification is information about important events which the provider is required to tell us about by law.

Before the inspection, the provider completed 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 contacted health and social care professionals who worked with the service.

We spoke with eight people who lived at St James Care. We observed care and support people received in the shared area of the home.

We spoke with the registered manager, the provider’s operations director and three members of staff. We looked at the care plans and associated records of five people. We reviewed other records, including the provider’s policies and procedures, internal checks and audits, quality assurance survey returns, training and supervision records, medicines records, Deprivation of Liberty Safeguards application and authorisations, and recruitment records for two staff members. We received input from health and social care professionals before and during the inspection.

Updated 4 January 2019

Care service description

St James Care is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St James Care is registered to accommodate up to 16 people who have mental health needs arising from their alcohol dependency and who want to continue to drink. It is owned and managed by the Society of St James, a major charity in south Hampshire supporting homeless people and people with needs arising from alcohol and substance dependency.

Rating at last inspection

At our previous inspection in May 2016, we found the service met the requirements of the regulations and was good overall, but there were improvements to be made with respect to measures in place to make sure people were safe. At this inspection the provider had made improvements in this area, the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Rating at this inspection

At this inspection we found the service remained good overall and had improved to outstanding in responsive.

Why the service is rated good

People’s care and support achieved outstandingly positive outcomes. People with complex needs received support to achieve goals which in some cases were genuinely life changing and life saving. The service was valued by other professionals as a unique residential care service for people with long-standing alcohol dependency.

People were protected against risks to their safety and wellbeing, including the risk of abuse and inappropriate care, risks associated with medicines, and the risk of the spread of infection. There were sufficient suitable staff deployed to support people safely. There was a positive attitude to learning from incidents and near misses.

People were supported by staff with the relevant skills and knowledge. Care and support were delivered according to detailed and up-to-date assessments and care plans. People were happy with the food and choices offered. The provider worked with other services for people to access the healthcare services they needed. The provider complied with legal protections in place for people who lacked mental capacity. 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.

There were positive, caring relationships between people and the staff who supported them. The provider supported people to be actively involved in decisions about their care and support. The service people received had a very positive impact on their dignity, independence, self-esteem and confidence.

There were appropriate management systems in place, and staff were motivated in a supportive, empowering atmosphere. The provider engaged people who used the service and staff to identify improvements. There were excellent relationships and partnerships with other health and social care services.

Further information is in the detailed findings below.