Archived: St Augustine's Care Home

Updated 3 February 2023

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

The inspection weas carried out by two inspectors.

Service and service type

St Augustine’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 Augustine’s Care Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. There was a home manager in place who was in the process of registering with CQC.

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 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 9 people who used the service and one relative about their experience of the care provided. We observed the interactions between people and staff. We spoke with 11 members of staff including the home manager, the deputy manager and care staff.

We reviewed a range of records. This included multiple people's medicines records and elements of care documentation for 8 people. We looked at 2 staff files in relation to recruitment and staff supervision and agency staff check. A variety of records relating to the management of the service, including quality monitoring records, risk management records, staff training and meeting records as well as policies and procedures were also reviewed.

Updated 3 February 2023

About the service

St Augustine’s Care Home is a residential care home providing accommodation and personal care to up to 52 people. The service provides support to older people with physical and health related support needs, some of who also live with dementia. At the time of our inspection there were 39 people using the service.

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

Although people told us they liked living in the home, felt safe and staff were caring, the multiple changes in the management resulted in inconsistent leadership. Incidents, accidents and safeguarding concerns were not always used to learn lessons and to improve the service. Staff did not always receive the training they needed to ensure they were competent and skilled for their roles.

Staff told us they did not read care plans and relied mainly on verbal handover within the team and from management. Staff knew people’s individual risks and we observed they supported people in line with their individual needs but people’s care records were out of date and did not always accurately address all of their needs. This posed risk of people’s care not being effective and safe at all times, especially when the home experienced staffing challenges and was supported by agency staff.

There was a lack of structured approach to monitoring the quality of the service. The provider completed some audits of the safety and quality of the care people received and their home environment, but their management contingency action plans failed to effectively action shortfalls these audits identified. The provider and new management team took action to address these shortfalls following the inspection.

Staff ensured people could access healthcare services when they became unwell or their needs changed and they required specialist support. People received their medicines safely and were supported to eat and drink when they needed help.

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.

People told us they felt listened to and overall could access support from staff when they needed it. Staff considered things had been improving since the new management started to lead the team and felt the management were approachable and supportive. The provider worked in partnership with other agencies, including social and health services in the area.

For more details, please see the full report which is on the CQC website at St Augustine’s Care Home.

Rating at last inspection

The last rating for this service was good (published 5 April 2018). We also inspected this service on 28 February 2022 and looked at the infection prevention and control practices only.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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 good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements in Safe, Effective and Well-Led.

You can see what action we have asked the provider to take at the end of this full report.

The provider and the new management team took action to update their management contingency plans and improvement action plan and to provide staff with support to complete relevant training courses.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Augustine’s Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to staff training and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.