The inspection visit at St Stephens Nursing Home was undertaken on 19 April 2017 and was unannounced. St Stephens provides nursing care and support for a maximum of 31 people, some of whom have dementia or physical disabilities. At the time of our inspection, the home was fully occupied. St Stephens Nursing Home is situated in a residential area of Blackpool close to the promenade. It offers 27 single room accommodation in addition to two double rooms with lift access to all floors.
There is a conservatory to the rear providing people with space for privacy and solitude.
At the last inspection on 14 October 2015, the service was rated as good in all five key areas and overall. The service met the requirements of the regulations.
During this inspection, a relative told us, “By a country mile this place is unbelievable.” Staff said they were exceptionally trained to undertake their duties. We found Investors in People (IIP) had recently awarded St Stephens with their Gold Standard for the provider’s excellent commitment to workforce development. This enabled staff to underpin their learning and practice to give people the best possible care. Another relative said, “The staff are very well trained.”
People and their relatives told us they found meals and their nutritional support were of a very high standard. The provider installed innovative systems to manage risks of malnutrition and swallowing difficulties to maintain their safety. For example, the management team recognised local issues meant people had to await access to specialist nutritional services. They overcame this with the latest information technology.
People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible. They demonstrated an excellent knowledge of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. Care records detailed people’s consent to their care and each area of their support contained decision specific, individual DoLS care plans.
We found the registered manager was exceptionally kind and understood the importance of high standards of care to give people meaningful lives. They inspired their workface to ensure quality of service provision was provided as a team. One staff member said, “To help someone eat, to do activities, to have a wash, to go out shopping, I love that. I also love that the residents love that.” Staff and the management team were acutely aware of the need to gain as much information about the person to provide highly personalised support. One relative said, “They know [my relative] very well because they checked with me and I know him very well.”
The registered manager’s main aim of care planning and support provision centred upon maintaining the person’s independence, whilst respecting their culture, diversity and human rights. We observed staff assisted people to be in as much control of their lives as possible. We found care records flowed extremely well, gave an in-depth picture of the person and were meaningful and comprehensive. The registered manager introduced highly innovative approaches to improve people’s self-confidence and independence.
We observed the registered manager enabled staff to have time to sit and chat with each person and provide activities for long periods throughout the day. People and families we spoke with said this was an exceptional part of care provision at the home.
The excellent leadership approach assessed, implemented and evaluated service provision and whether this maintained high standards in people’s welfare. The management team completed multiple, proactive and very in-depth quality assurance systems and we found evidence they acted upon any concerns. Satisfaction surveys were provided for staff, visitors and people who lived at the home. We saw responses were highly complementary of St Stephens.
We saw the management team had systems to manage accidents and incidents to reduce the potential risk to people’s safety. Care and environmental risk assessments were available to guide staff to reduce the risks of harm or injury. Staff were knowledgeable about reporting procedures if they suspected people were at risk from harm or poor practice.
Systems to aid people’s safety were underpinned by exceptional staffing levels and skill mixes deployed at St Stephens. One person who lived at the home told us, “How can you not feel safe here with the amount of staff on.” We saw evidence to confirm the management team checked staff backgrounds prior to their recruitment to ensure their suitability.
The registered manager and nurses had clear processes to manage people’s medicines safely. They explained to each person what their medication was for and continually reassured them. Staff received appropriate training and competency testing to ensure their medicines knowledge was up-to-date.