St John's Court

Updated 16 November 2022

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 Health and Social Care Act 2008.

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

On the first day of the inspection was carried out by 2 inspectors 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. On the second day of the inspection, 3 inspectors attended.

Service and service type

St Johns Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Johns Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was no registered manager in post. A provider representative told us they were actively seeking a permanent manager who they felt would be suitable for the position.

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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 2 relatives about their experience of the care provided. We spoke with 12 members of staff including the operations manager, the home manager, the deputy manager, nurses, senior care staff, care staff and the activities co-ordinator. 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 reviewed a range of records. This included 5 people's care records and medication records. We looked at 4 files in relation to recruitment and a range of files relating to training of staff. We looked at staffing rota's and staff allocation, along with incidents and accidents, complaints and safeguarding's. Along with a variety of records relating to the management of the service.

Updated 16 November 2022

About the service

St Johns Court is a nursing home providing personal and nursing care for up to 42 people. The service provides support to younger and older adults who have a physical and/or sensory impairment. The service also supports people living with dementia. At the time of our inspection there were 30 people using the service. St Johns Court accommodates 42 people across four separate wings, each of which has separate adapted facilities. One of the wings, Buttercup, specialises in providing care to people with dementia.

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

St John’s Court had been through a period of management changes over the past year, which people and staff told us had caused instability within the home. People gave mixed reviews about the food offered, the provider had listened to people’s concerns, but these had not been fully addressed. Some people and staff continued to say there were not enough staff on duty to meet people’s needs. The provider monitored staffing levels, however had not fully addressed the concerns that had been raised.

Some people and staff felt there were not always enough staff on duty to meet people’s needs in timely way. We did not find evidence that people were not safe with the staffing levels. The provider told us they were reviewing dependency tools to better understand if staffing levels were right.

People's end of life care needs were met in line with their preferences in a respectful and dignified way, however, record keeping around this required updating to reflect people’s most up to date wishes.

People told us they felt safe. Relatives felt their family member was safe and cared for in the right way. Staff recognised different types of abuse and how to report it. The provider understood their safeguarding responsibilities and how to protect people from abuse. Potential risks to people's health and wellbeing had been identified and were managed safely. People, and where appropriate, their relatives, had been involved with decisions in how to reduce risks associated with people’s care. People's medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.

People's care needs had been assessed and reviews took place with the person, and where appropriate, their relative. Staff had the training and support to be able to care for people in line with best practice. People were supported to have a healthy balanced diet and most people told us they were given food they enjoyed. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. 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 did support this practice.

People told us staff were kind and treated them well. Relatives felt the staff cared for their family member in a caring and supportive way. Staff treated people as individuals and respected the choices they made. Staff treated people with care and respect and maintained their dignity.

People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported to maintain contact with people who were important to them. People engaged in activities that were individualised to them. People had access to information about how to raise a complaint. Where complaints had been raised, these had been responded to in line with the provider’s policy.

The provider had systems and checks in place to identify and respond to shortfalls found within the service. The provider had changed aspects of their checks to ensure these were robust.

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 04 May 2022).

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

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St John’s Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.