Archived: St Augustines Court Care Home

We last inspected this service on 15 February 2014. At that time we found the provider did not have effective systems in place for obtaining people's consent. Assessments of people's mental capacity to make decisions had not been completed. Some people were administered medicines covertly without obtaining their consent. At this inspection we found the service had assessed people's capacity to make decisions. However, people's care plans did not always fully document the decisions which were being made in the person's best interests. We used the evidence we collected during our inspection to answer five questions. A summary of what we found is set out below.

Is the service safe?

Some people required one to one support from care staff. We saw care staff spend time with the person they caring for. Some people were receiving one to one support which meant they had a member of staff supporting them during the day time. We observed care staff checking people were safe, if for example, they had gone out into the garden for a walk.

We observed one person in the lounge sitting in a chair designed to meet their needs. The person required support to transfer into and out of the chair. Care staff re-positioned the person every two hours to prevent them from developing pressure sores. We saw care staff kept records of everyone who was at risk of pressure sores and needed frequent re-positioning.

Is the service effective?

We looked at four people's care plans and found their needs had been assessed. This included identifying the risk of not receiving sufficient quantities of food and drink and developing pressures sores.

We found care plans and risk assessments were reviewed. Professionally registered staff updated people's care plans based on their observations which were documented in the daily records.

Is the service responsive?

We visited one person who was in bed. We saw the person's food intake was monitored. There were records of how much they ate and drank and how often care staff re-positioned the person because of the risk of developing pressure sores. The person's interests and hobbies were recorded. We saw they liked classical music.

We spoke with the activities co-ordinator who showed us some of the activities they organised for people. They told us about a training course they had attended about the importance of people's memories. The course had taught them how to engage with people's through memories. We saw one person liked to feed the hens which lived in the garden at the home.

Is the service caring?

A relative told us they had been given a list of homes in the area to visit. They said this one was the first one they had visited and that, 'It ticked all the boxes as far as I am concerned. I found everyone was receptive and understanding.'

We observed care staff support people and them engage and interact with them. We saw care staff support people who needed assistance to eat their lunch.

Care staff we spoke with understood people and were familiar with their care plans and the support they needed.

Is the service well led?

The provider had a system for quality assurance in place which consisted of audits and checks designed to identify and manage the risks to people's health and welfare.

The provider had obtained the views of relatives about the service in June 2014. The results had been analysed and an action plan developed.

The manager met with care staff to discuss the quality of the service and how to improve the support people received.

Care staff were supported with training to carry out their roles effectively. However, care staff were not being appropriately supervised and appraised.

We used our Short Observational Framework for Inspection (SOFI) to record our observations about the experiences people had at the home and how the staff interacted with them. The SOFI is used when inspecting services for people whose communication has been affected by disability or disease.

All of the visitors we spoke with were happy with the standards of care their relatives' received. One visitor said, 'The staff are all very helpful. This is a specialist job and we're happy with everything that's happened.'

We found mixed evidence about how the provider was obtaining and acting in accordance with the legal requirements for people who did not have the capacity to consent and those who required assistance to communicate.

We found that people were cared for and their individual needs were being met by the service. We saw staff interactions with people who use the service were caring and polite. We found there were enough staff with the right skills available to meet peoples' individual needs.

There was a system to handle complaints and support for people who wanted to make their views known.

During our inspection we observed that the staff were attentive to people's needs. Staff interacted with people using the service in a friendly, respectful and professional manner. We saw that staff sought their agreement before providing any support or assistance. Most of the people we saw were relaxed, engaged with their surroundings and interacted well with each other.

We saw that staff received training essential for caring for older people, and when talking with them we found that they were knowledgeable about the people they supported.