St Stephens Nursing Home

Updated 22 February 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

This inspection was carried out by an inspector, a specialist advisor, with a mental health nursing background, 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 Stephens 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 the 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. We used the information the provider sent 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 about St Stephens with one person, eight relatives, six staff, the registered manager and the provider. We further discussed the home with two visiting healthcare professionals. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We walked around the building to carry out a visual check and ensure St Stephens was clean, hygienic and a safe place to live.

We looked at records related to the management of the service. We did this to ensure the provider had oversight of the home, responded to any concerns and led St Stephens in ongoing improvements. We checked care records of four people and looked at staffing levels, recruitment procedures and training provision.

Updated 22 February 2020

About the service

St Stephens Nursing Home is a nursing home providing personal care to 31 people with complex needs at the time of our inspection. The service can support up to 31 adults who live with dementia, enduring mental health conditions and/or a physical disability. Accommodation consists of single, spacious bedrooms and multiple communal areas for people’s comfort and relaxation. St Stephens Nursing Home will be referred to as St Stephens within this report.

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

The provider continued to deploy high staffing levels and excellent skill mixes to retain people’s welfare. They had good oversight of everyone’s safety and checked their processes reduced risks. A relative said, “I go home happy.” The registered manager had good systems to protect people from poor practice and to manage their medication safely.

The provider continued to heavily invest in staff to maintain their outstanding expertise. A relative told us, “The staff are well trained and know exactly how to get the best from my [relative].” The management team retained strong assessment procedures to minimise disruption from failed placements. A relative stated “It was a big step for us to move my [relative] into a home. The staff were superb.” The provider maintained an excellent nutritional care model. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff excelled in the application of the MCA and people stressed they felt at the heart of their decision-making.

The registered manager continued to maintain high standards of dignity and respect. A relative commented, “If I ever needed care such as this, I would come here myself.” Another relative added, “This home is fantastic.” They instilled a highly inclusive environment and genuine desire to celebrate difference and each person’s individuality. The registered manager continued to plan and agree care highly focused on involving people and their representatives.

The management team continued to build highly advanced care plans and assessments that fully involved people to help staff meet their needs. A relative said, “I can’t ask for more. My [relative] is content and much calmer since he came to the home.” The registered manager maintained an excellent programme of activities for people’s stimulation and wellbeing. They continued to provide exceptional care for people at the end of their lives.

Staff and people told us leadership was exceptional. A staff member stated, “Working at St Stephens is great. I feel really valued.” The management team continued to engage extremely well with other agencies to provide an outstanding service. They endeavoured to review lessons learned and involved everyone in service development. The provider continued to excel at acquiring people’s feedback about quality assurance.

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 outstanding (published 20 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.