St Davids Residential Care Home

Updated 14 January 2022

The inspection

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Consisted of one CQC inspector.

Service and service type

St Davids Residential Care Home 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; however they had been absent from the service since May 2021. The service had appointed an interim manager, who was not registered with the commission at the time of the inspection. This means that in the absence of the registered manager, the provider is legally responsible for how the service is run and for the quality and safety of the care provided. We liaised with the registered provider and interim manager during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we held on our system about this service, and sourced feedback from the local authority.

During the inspection

We spoke with the provider and interim manager and two senior members of care staff. We observed the provision of care and support in communal areas and spoke with two people living at the service. We reviewed a range of records. This included two people's care records and information relating the governance and oversight of the service. Formal feedback was given to the provider at the end of the site visit.

After the inspection

We liaised with the provider to source additional information and clarification around points identified during the inspection visit.

Updated 14 January 2022

About the service

St David’s Residential Care Home is a residential care home providing personal care to 14 people aged 65 and over at the time of the inspection. The service can support up to 18 people. The home is an adapted period building in a seaside resort.

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

Whilst the people who used the service had benefited from some improvements to the service since our last inspection, the provider had failed to ensure the environment was safe and free from harm. Their governance monitoring system had been ineffective at identifying and rectifying these concerns. However, prompt action was taken by the service to make these areas safe.

The outcomes for most people were good. However, for some, this was not the case and a lack of staff meant we observed that they were left unstimulated and without meaningful interaction for a long period of time. This also put people at risk.

Communication was generally good however, some relatives we spoke with reported that this could be improved as they did not always feel fully involved in their family member’s care. Staff reported good internal communication, a positive atmosphere and a supportive management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We also saw that people’s needs were met in relation to their nutritional, healthcare and medicines needs.

Most relatives and all the staff we spoke with talked positively about the service and management of the home. Relatives told us they would recommend it with one commenting, “I cannot fault it” while another said, “[Family member] is really happy and I would recommend it. Staff know how to treat people and they are very caring, and they listen.”

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 (report published on 22 October 2019) and there were four breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, although we found some improvements, the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about multiple aspects of the service including staffing, risk management and quality of care. A decision was made for us to inspect and examine those risks.

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.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to environmental safety issues, infection control management and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.