St. Michaels

Updated 2 July 2021

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 Care Act 2014.

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 was carried out by two inspectors.

Service and service type

St. Michaels 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before 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. 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service. We spoke with four members of staff including the registered manager, operations director and two care workers.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one person who uses the service.

Updated 2 July 2021

About the service

St. Michaels is a residential care home providing personal and nursing care to five people who have autism or and learning disabilities at the time of the inspection. The service can support up to five people. The service is made up of four flats located in one building and a purpose-built bungalow with its own enclosed garden area within the grounds.

St Michaels is a specialist service for people that have anxious or emotional behaviour that has previously limited their quality of life and experiences. Each person lives in their own flat or a bungalow. The staff team and service provided is organised around people’s individual needs.

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

People we spoke with told us they were happy and felt safe living at St. Michaels. There were sufficient staff to meet people’s needs and keep them safe. Staffing was regularly reviewed by the registered manager and amended to meet people’s needs. People were supported by consistent staff teams. Staff understood and were passionate about safeguarding people from the risk of abuse.

Staff knew people well, and understood the risks aligned to each individual. For example, some people lived with epilepsy. Staff were clear on how best to support them safely, and aware of any recent seizures, and any medication they may need. People’s homes were clean and well maintained.

The registered manager and staff demonstrated they cared and respected the people living at St. Michaels. Staff had positive relationships with people and were passionate about ensuring each person lived their life to the fullest. People were clearly engaged in the service, people were involved in decoration, and people’s unique skills had been used to create logos for a group they were a part of.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and Independence. People were empowered to make day to day decisions and were not restricted. People were encouraged and enabled to be as independent as possible.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. Staff were passionate about supporting people to achieve the best outcomes for them. People were discussed and promoted as individuals.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. There was a positive culture within the service, demonstrated by all staff and the registered manager. People were observed to look happy, smiling and making jokes with staff.

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 11 February 2020).

Why we inspected

We received concerns in relation to incidents between people, the management of behaviours which people could find challenging and the culture of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating 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.

The overall rating for the service has not changed. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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

Follow up

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.