Archived: St Johns Nursing Home

Updated 9 October 2018

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.’

The inspection took place on 3 and 4 September 2018. The first day of the inspection visit was unannounced.

The inspection team consisted of two inspectors and a specialist advisor who is a registered nurse with extensive knowledge and experience in many fields including older person's care and dementia. The specialist advisor attended on the first day of our inspection.

We looked at the information we held about the service provided at the home. This included statutory notifications. Statutory notifications include important events and occurrences such as accidents and serious injury which the provider is required to send us by law.

We sought information about the service from the local authority and the clinical commissioning group (CCG). The local authority and the CCG have responsibility for funding people who used the service and monitoring its quality. In addition, we requested information from Healthwatch who is an independent consumer champion, which promotes the views and experiences of people who use health and social care.

During the inspection visit we spoke with four people who lived at the home and three relatives. Some people were not able to tell us about their experiences of living at the home due to their complex health conditions. We spent different periods of time in the communal areas and we saw how people were supported to eat and drink at lunchtime. This helped us judge whether people's needs were appropriately met and to identify if people experienced good standards of care.

We spoke with a range of staff which included, one team leader, four care staff, three nurses, one laundry staff member and the cook about their roles and the care they provided. We also talked with the registered manager, the operations manager and the deputy manager.

We looked at the records relating to five people who lived at the home, associated monitoring records and 21 medicine administration records. We spent time with a staff member during their medicine round and looked at how medicines were administered, stored and disposed of. We also looked at how incident and accidents were managed, six staff recruitment records, complaints and compliments and a range of quality audits the provider and management team made to assure themselves people received a safe, effective quality service.

Following this inspection, the registered manager sent us documentation to show staffing arrangements and actions plans they had developed to support continual improvements.

Updated 9 October 2018

This inspection was undertaken on 3 and 4 September 2018. The first day of our inspection visit was unannounced.

St Johns Nursing Home 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.

St Johns Nursing Home accommodates up to 46 people across two separate units, the Pines and the Limes, within one adapted building, and specialises in care for people living with dementia and rehabilitation for people with enduring mental health needs. In addition, there are three flats to promote more independent living. At the time of our inspection visit, there were 40 people living at the home.

There was a registered manager in post. 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.

We last inspected the service in October 2016 when we rated it as Good. In August 2018 we re-registered the service to reflect a change in the ownership structure of the registered provider. This change had no impact on the day-to-day operation of the service. Although, therefore, this was our first inspection of the re-registered service.

People were supported to stay as safe as possible by staff who understood what actions to take to reduce risks to their well-being. This included reducing risks to people’s physical health and mental well-being. The registered manager had recruited additional staff so they could reduce the need to use agency staff and to further promote consistency of care which met people’s wishes and choices. People could rely on trained and competent staff supporting them to have the medicines they needed to remain well and free from pain.

People benefited from living in a home where there were systems in place to reduce the risk of infections and staff knew what action to take to care for people if they experienced any infections. Checks on the environment were undertaken and systems for identifying if there was any learning after safety incidents were in place.

Staff considered people’s care needs and involved people who knew them well before people came to live at the home, so they could be sure they could meet people’s needs. Staff received the ongoing training they required so people would be supported by staff with the skills needed to help them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to choose what they wanted to eat and the registered manager was looking at ways to ensure the meals people were offered were to their liking and varied. Staff supported people to obtain care from other health and social care professionals so they would remain well.

People had developed caring relationships with the staff who supported them. Staff communicated with people in the ways they preferred and encouraged them to make their own day to day decisions about their care. People received care from staff who acted to promote their dignity and independence. Systems were in place to respond to any concerns or complaints and to act to resolve these.

People’s care had been planned by taking their individual wishes, histories and needs into account. People’s care plans incorporated advice provided by other healthcare professionals, so they would receive the care they needed. Procedures and processes were implemented to show people’s skin was regularly assessed and wounds were monitored regularly.

Staff had received compliments about the way care was provided. The registered manager and provider checked people received the care they wanted, so they would be assured people enjoyed a good quality of life and risks to their safety were reduced.

The registered manager listened to the views of people who lived at the home, their relatives and staff when developing people’s care and the home further. This helped to ensure people had the equipment they needed and opportunities to continue to do things they enjoyed as their needs changed. The registered manager planned further work to continually drive through improvements so people would benefit from living at a home where there was a cohesive staff team who were supported to further develop their caring skills and experience.

Further information is in the detailed findings below.