Background to this inspection
Updated
14 December 2018
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.
This comprehensive inspection took place on 5 November 2018. The inspection was carried out by two adult social care inspectors and an expert by experience. An expert by experience is a person who has experience of using, or of caring for a person who has used this type of service.
Before the inspection the provider completed a Provider Information Return (PIR). This asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the service. This included past reports and notifications. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with eight people who could express their views of living at the service. Not everyone we met who was living at St Martin’s was able to give us their verbal views of the care and support they received due to their health needs. We also spoke with four relatives, staff, the registered manager, Interim Operational Director and the Regional Manager. We used pathway tracking (reading people’s care plans, and other records kept about them), carried out a formal observation of care, and reviewed other records about how the service was managed. We looked around the premises and observed care practices on the day of our visit.
We used the Short Observational Framework Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We looked at care documentation for four people living at the service, medicines records, four staff files, training records and other records relating to the management of the service.
Updated
14 December 2018
St Martin’s is a ‘care home’ that provides accommodation for a maximum of 40 adults, of all ages with a range of health care needs and physical disabilities. At the time of the inspection there were 34 people living at the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
St Martin’s is situated in the town of Camborne. It is a purpose built one storey building with a range of aids and adaptations in place to meet the needs of people living there. There were people living at the service who were living with dementia and were independently mobile. There was pictorial signage at the service to support some people, who may require additional support with recognising their surroundings. There is a central hub of lounge and dining spaces, as well as three separate lounges. People’s bedrooms were personalised and were for single occupancy. There were a range of bathing facilities in each area designed to meet the needs of the people using the service. There was a courtyard which people could use.
This unannounced comprehensive inspection took place on 5 November 2018. At the last inspection, in May 2016 the service was rated Good. At this inspection we found the service remained Good.
The registered manager commenced at St Martins in April 2018. People and relatives were positive about recent management changes and said management were approachable, would listen to suggestions and felt supported. Staff told us with the change of manager and changes at senior management level there had been a number of positive improvements to the service.
The registered provider had improved quality assurance and governance arrangements. The management team were keen to implement changes that would improve the quality of people’s care and assist staff. For example, they had reviewed the deployment of staff to ensure that people’s needs were better met. One impact fof this was the number of incidents at the service had reduced significantly.
On the day of the inspection there was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with people in a caring and compassionate manner. People told us they were happy with the care they received and believed it was a safe environment. We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and understood their needs and preferences. The service was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes.
Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they needed and wanted. Risks in relation to people’s care and support were assessed and planned for to minimise the risk of harm.
Some people were at risk of becoming distressed or confused which could lead to behaviour which might challenge staff and cause anxiety to themselves and other people. Care records contained information for staff on how to avoid this and what to do when incidents occurred.
Accidents and incidents that took place in the service were recorded by staff in people’s records. Such events were audited by the manager. This meant that any patterns or trends would be recognised, addressed and the risk of re-occurrence was reduced.
Staff held a daily handover where information about people’s care would be shared, and consistency of care practice could then be maintained. This meant that there were clearly defined expectations for staff to complete during each shift.
There were systems in place for the management and administration of medicines. People had received their medicine as prescribed. Regular medicines audits were being carried out on specific areas of medicines administration and these were effective in identifying errors occurred such as not dating creams on opening.
People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards (DoLS) were understood and applied correctly.
People were protected from abuse and harm because staff understood their safeguarding responsibilities and were able to assess and mitigate any individual risk to a person’s safety.
The registered manager had implemented a nutrition project and invited people and relatives to contribute to this. This meant people preferences were being considered and were offered a choice in line with their dietary requirements.
People had access to activities both within the service and outside. Activities co-ordinators organised a planned programme of events. Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and could visit at any time.
Staff were supported by a system of induction training, supervision and appraisals. Staff said they felt supported by the manager and could approach them with any queries. Staff meetings were held regularly.
Staff were recruited in a safe way. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.
There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.
People were asked for their views on the service regularly. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The staff team were motivated and happy working at the service. The staff felt valued and morale was good.
There were effective quality assurance systems in place to monitor the standards of the care provided. Audits were carried out regularly by both the manager and members of the senior management team.