Archived: St Marthas Care Centre

Updated 5 October 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector, an assistant inspector, specialist professional advisor. The specialist professional advisor on this inspection was someone who had nursing expertise; and one expert by experience, an expert by experience is someone who has had experience of working with this type of service.

Service and service type

St Marthas Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The registered manager had resigned from their position and temporary management arrangements were in place whilst the provider was recruiting to the vacant post.

Notice of inspection

This inspection was unannounced and took place on 05 September 2019. We agreed with the manager to return and complete the inspection on 09 September 2019, when the inspection team consisted of one inspector.

What we did before the inspection:

We looked at information we held about the service, including notifications they had been made to us about important events. We also reviewed all other information sent to us from other stakeholders, for example, the local authority and members of the public.

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.

During the inspection, we spoke with 12 people using the service and four relatives to ask about their experience of care. 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 to us.

We spoke with the regional manager, the acting manager. We also spoke to one nurse, two senior care staff, five care staff, the chef a domestic and two healthcare professionals.

The acting manager was a quality and compliance manager for the provider. They were managing the home at the time of the inspection and we were informed by the provider they will continue to do so until a registered manager is appointed. We refer to this person as ‘manager’ in this report.

We looked at the care records for four people, three staff employment related records and records relating to the quality and management of the service. Details are in the Key Questions below.

Updated 5 October 2019

About the service: St Marthas Care centre is a residential care home providing personal care for up to 50 people. The home is split into two separate units called Beech which provides nursing care and Ash provides residential care. At the time of the inspection 40 people lived at the home.

People’s experience of using this service:

At our previous inspection we found a breach of regulation12,14, and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to risks to people not being managed effectively, nutritional and hydration needs not been met and ineffective quality monitoring of the service. At this inspection we found that improvements had been made and most breaches had been met.

Further improvements were needed to ensure the quality systems in place were fully effective and imbedded into day to day practice.

Improvements had been made to how risks to people were assessed and managed. Although some further improvements were needed to ensure people received consistent care. People's care records were not always detailed and kept up to date and some documentation was incomplete. Work was underway to improve these, so they were person centred and guided staff on the way people preferred their care and support to be provided.

There had been management changes and a number of care and nursing staff changes. Staff were caring and kind however, a number of staff were still settling into their role and familiarizing themselves with people’s care needs and working through their training requirements.

Recruitment practice was not always robust the provider had not followed their own policy regarding requests for second references. Recruitment to vacant posts was taking place and the provider had brought in additional management and clinical support during this unsettled time to provide leadership and stability to the staff team.

People and their relatives were positive about the support they received.

People were supported to receive their medication as prescribed and staff demonstrated a good knowledge of types and signs of abuse and how to report concerns of abuse.

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.

Rating at last inspection: The last rating for this service was requires improvement (published July 2019).

Why we inspected: We carried out an unannounced comprehensive inspection of this service on 29 May 2019. Breaches of legal requirements were found. We undertook this focused inspection to check they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-Led.

The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains as requires improvement.

Enforcement

We have identified a breach in relation to the quality monitoring systems.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk