St Michaels Nursing Home

St Michaels Nursing Home is a residential care home providing accommodation, personal and nursing care for up to 39 people in one adapted building, which includes a ground floor extension. At this inspection there were 29 people using the service, including 16 people receiving nursing care.

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

People's care and daily living arrangements were mostly individualised but not always ensured in a timely or responsive manner. Related management improvements were identified. This included, to ensure increased opportunities for people to participate in activities they enjoyed and were meaningful to them. However, this was not yet fully demonstrated as embedded or sustained ongoing.

Risks to people’s safety associated with their health condition, environment and any equipment used for their care were accounted for. Health and reportable incidents were routinely monitored and analysed, to help inform or improve peoples’ care and prevent any reoccurrence when needed.

The provider’s safeguarding, emergency contingency planning and staffing measures, helped to protect people from the risk of harm or abuse. People’s medicines were safely managed to ensure people received their prescribed medicines, as and when they should.

The environment was suitably adapted, clean, well maintained and designed to meet people’s needs. We were assured the provider was meeting with requirements and nationally recognised government guidance concerned with the prevention and control of infection, including COVID-19.

Overall, there were effective arrangements for the assessment, planning and delivery of peoples’ care, in line with nationally recognised standards and the law. Introduction of an electronic care plan record keeping system was in progress, to optimise accessibility and the timeliness of record keeping.

People were generally well supported to maintain or improve their health and nutrition through consultation with relevant external health professionals, when needed for people’s care. Standardised and lawful information sharing, helped to ensure people's care was consistently informed when they needed to move between services.

Staff were informed, trained and supervised for their role. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible. The provider’s related policies and systems supported this practice.

Overall, staff were caring to ensure people’s dignity and rights. Staff knew people well and overall understood how to communicate with people, in a way they understood.

The service was generally well managed and led. Regulatory requirements were being met. Staff we spoke with understood their role and responsibilities for people’s care.

The provider had established effective governance arrangements for routine service monitoring and oversight, to ensure the quality and safety of people’s care. A range of service improvements were demonstrated, either made or in progress from this, which also included remedial actions when things went wrong.

The provider strove to work in partnership with relevant authorities, care partners and others with an interest in people’s care at the service. Related consultation and feedback was used to help inform and improve the service.

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

Rating at last inspection This service was registered with us on 21 December 2021 and this is the first inspection.

The last rating for the service under the previous provider was requires improvement, published 27 June 2019.

Why we inspected

The inspection was prompted in part due to concerns we received about safety with regard to staffing and the management of risk; including from a provider notification following an incident where a person sustained a serious injury. This incident is subject to further investigation by CQC, as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. 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.

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 is good.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Following their registration and ownership of the service in December 2021.The provider had introduced revised comprehensive arrangements and related procedures, in line with nationally recognised guidance and the law, for the prevention and control of infection at the service. This included, to ensure safe admissions, visiting, testing and isolation arrangements for COVID19.

Relevant equipment, facilities and accessible information was provided, to support safe entry, social distancing, hand hygiene and use of personal protective equipment. Individual risk assessments were undertaken, to ensure appropriate guidance and support for people and staff who may be clinically vulnerable.

The provider had identified and commenced a comprehensive service improvement plan. A phased programme for the total upgrade, refurbishment, repair and renewal of the premises was in progress. This included total laundry refurbishment and dedicated environmental provision for effective cohorting and zoning, when needed. Timescales for monitoring and completion were identified.

Replacement bedding and revised cleaning schedules for the environment and care equipment were also introduced. Along with related staff instruction and ongoing management monitoring measures, to ensure environmental and equipment cleanliness and hygiene ongoing.

We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.