Archived: St Johns Wood Care Centre

Updated 21 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was unannounced which meant the provider and staff did not know we were coming. The inspection took place on Monday 15, Tuesday 16 and Friday 19 August 2016. The inspection team comprised of four inspectors.

Before the inspection, we looked at notifications that we had received and communications with other professionals, such as the local authority safeguarding and commissioning teams. We received written feedback from two visiting social workers, spoke with a visiting GP and two social workers.

During our inspection we also spoke with thirteen people using the service, a GP and two social workers who were visiting, fourteen members of staff (nine care staff and five nurses), an activity coordinator, the assistant chef, the registered manager, the deputy manager and the area manager for the provider.

As part of this inspection we reviewed 24 people’s care plans. We looked at the training, appraisal and supervision records for the staff team. We reviewed other records such as complaints information, audit information, maintenance, safety and fire safety records.

We used the Short Observational Framework for Inspection (SOFI), which is a specific way of observing care to help to understand the experience of people who could not talk with us. We wanted to check that the way staff spoke and interacted with people was having a positive effect on their wellbeing.

Updated 21 October 2016

St Johns Wood Care Centre is a 100 bed nursing home which provides nursing and/or personal care for up to 100 predominantly older people and young people with physical disabilities. Each person has their own bedroom and there are communal lounges and dining areas on each of the four floors of the home.

This inspection took place on 15.16 and 19 August 2016 and was unannounced. At our previous inspection of this service on 21, 23 and 29 December 2015, we found five breaches of regulations, namely Regulation’s 9 (Person centred care), Regulation 12) (Safe care and treatment), Regulation 14 (Meeting nutritional and hydration needs) and Regulation 18 (Staffing). The provider sent us an action plan after the inspection detailing how they would address these breaches. At this inspection we found that significant progress had been made although some improvement was still required.

At the time of our inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The staff of the service had access to the organisational policy and procedure for protection of adults from abuse. They also had the contact details of the London Borough of Camden which is the authority in which the service is located and other authorities who also placed people at the service. Staff said that they had training about protecting people from abuse and this training had been updated, which we verified on training records. We found there were the designated numbers of staff on each floor during our visits. Staff were regularly present in communal areas to identify and respond to immediate assistance that people required.

We saw that risks assessments concerning falls and those associated with people’s day to day risks were much improved. Measures to minimise emerging risks, and in particular those associated with falls, were now being speedily identified. This improved the response to safety concerns that arose for people living at the home.

We saw there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make some decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required.

People were supported to maintain good health. Nurses were on duty at the service 24 hours and a local GP visited the home twice each week, but would also attend if needed outside of these times. Healthcare needs were responded to well and we saw that staff supported people to address their medical needs.

The care plans we looked at were based on people’s personal needs and wishes in some cases, were now much more clear in areas such as nutrition and hydration and contained better information about people’s care needs, but could still be improved upon in terms of the consistency with which information was recorded. People’s personal, cultural, religious and lifestyle pretences were not given sufficient attention in care planning.

People’s views were respected and we found much improved communication and interaction between staff and people using the service. Feedback from people using the service showed that the view was of a caring staff group and we saw that staff were respecting people’s dignity and right to make free choices.

The service had undergone a long period of uncertainty last year about its ownership and operation. We found that the provider who had taken over the service had implemented detailed oversight systems for monitoring of the performance of the service.

As a result of this inspection we found one breach of regulation in respect of staff adhering to completing mandatory training updates. You can see what action we told the provider to take at the back of the full version of the report.