St James House

Updated 20 October 2020

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.

Inspection team

The inspection team consisted of one inspector 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.

Service and service type

St James House 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

We gave the service 24 hours' notice of the inspection. Due to the COVID-19 pandemic we wanted to review documentation remotely and make arrangements to speak with people and staff. This helped minimise the time we spent in face to face contact with the management team.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent to us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager, a senior care worker and three care workers. We spoke with three people who lived at the service and three relatives. We viewed five care plans and associated risk assessments. We looked at multiple medication records and medication audits. We viewed two recruitment records of new staff members. We viewed documents relating to the management and the safety of the service and audits to monitor and improve the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received feedback from one professional who regularly visits the service.

Updated 20 October 2020

About the service

St James House is a residential care home. The service provides support with personal care and

accommodation to people with a range of support needs, including younger and older adults with a learning disability, autism or mental health support needs.

Services for people with learning disabilities and or autism

The service was registered to provide support to up to 15 people and there were 13 people using the service at the time of our inspection. The service is larger than recommended by best practice guidance. However, we have rated this service good because the size of the service was not having a negative impact on people. The building design blended into a local residential area and there were no identifying signs outside to indicate it was a care home. People were encouraged to access the community and undertake person centred activities.

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

People and their relatives told us the service was safe. We observed a calm and relaxed atmosphere during our site visit. Medicines, recruitment and infection prevention and control were managed safely. Individual and environmental risk assessments were detailed and up to date.

People, relatives and staff told us there was a positive culture within the service that promoted people’s choices and independence. Care records were person centred and the service had effective quality assurance processes in place to ensure the service was always improving.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 February 2019) with breaches in Regulations 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 23 and 24 October 2018. Breaches of legal requirements were found in Regulations 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

We also looked at infection prevention and control measures under the safe key question during an inspection in August 2020. This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes. 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 coronavirus and other infection outbreaks effectively.

You can read all our previous reports, by selecting the ‘all reports’ link for St James House 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.