Archived: St Catherine's View

People’s experience of using this service:

Leaders and management ensured a positive culture of person centred care, based on best practice and continuous learning. The management provided good leadership and were actively working to drive improvement. Feedback from people, staff and relatives confirmed the management were respected and led by example. Staff and people were supported and encouraged to share ideas about how the service could be improved and had been pro-active in supporting changes. Staff spoke enthusiastically about the positive teamwork and support they received. Fully embedded and effective systems were in place to promote lessons learned and to implement change, resulting in positive outcomes for people.

Staff were responsive to people’s needs and consistently went the extra mile to ensure people’s wishes and aspirations were known, understood and met. This had led to people being active and valued members of the community, continuing the ‘working’ life and having an important role in family life.

Staff felt their achievements were recognised and that they felt valued. Staff had a clear understanding of their roles and responsibilities. We observed staff were confident in performing their jobs and when speaking with people, other staff and the registered manager.

People and their families told us they felt the service was safe. Staff had received safeguarding training and had their competency in this subject checked. They were aware of the types of abuse that could happen to people, what signs to look out for and their responsibilities for reporting any concerns.

The registered manager had a good understanding of their responsibilities to notify the CQC of important events that happened within the service. People and their families had been given information so that they knew what to expect from the service.

People who required assistance with their medicines were supported by appropriately skilled and qualified staff. They had received training and competency checks and had a good understanding of the risks associated with the medicine people were taking.

Staff received appropriate induction into their role and learning opportunities were made available. They told us they received regular supervision and had a yearly appraisal. Staffing levels met the needs of the people using the service. Staff had been recruited safely.

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.

People, their families and other professionals had been involved in an assessment before the service provided any support. The assessment had been used to create care and support plans that addressed people’s individual identified needs. Staff demonstrated a good understanding of the actions they needed to take to support people. People had good access to healthcare services.

A complaints procedure was in place and people told us they were confident, and concerns would be dealt with appropriately by management.

Rating at last inspection: We previously inspected the service on 12 and 14 October 2016 and rated the service good.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

The service had a registered manager. 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.

People told us they felt safe at St Catherine’s View and people’s relatives confirmed staff provided safe care and kept them informed of any concerns. There were procedures in place to protect people from the risk of abuse. The registered manager acted on safeguarding concerns promptly and appropriately and staff had the knowledge and confidence to identify and report safeguarding concerns. Risks to people’s health and well-being had been assessed and plans were in place to minimise these risks. We found staff were aware of people’s risks and acted to support them safely.

We received mixed feedback about the staffing levels in the home. Staffing levels had been calculated using people’s individual needs as a guide. Some staff told us that changes in staffing levels and the way that staff were deployed in the home had resulted in them having less time to spend with people but people’s care needs were met. However, people and their relatives told us they thought there were sufficient staff to meet people’s needs. The provider’s operational managers were aware of the need to embed and monitor the changes to staffing arrangements and were keeping this under review. Overall it appeared there were sufficient staff to meet people’s needs safely.

Staff were recruited safely, the provider carried out all the required pre-employment checks to protect people from the employment of unsuitable staff.

People’s medicines were managed safely. Arrangements were in place to receive, store and dispose of medicines safely. Staff who administered people’s medicines were trained and had their competency assessed at regular intervals.

People and their relatives spoke positively about the staff in the home. Staff completed training to enable them to meet people’s needs effectively and to achieve professional development in their role. Systems were in place to provide support and supervision for staff. Staff had not always received the level of one to one supervision in line with the provider’s policy. The registered manager was taking action to address this at the time of our inspection.

Decisions about people’s care when they lacked mental capacity were guided by the principles of the Mental Capacity Act 2005 (MCA). People’s care plans evidenced specific decisions had been made in their best interests when they lacked the capacity to make these. When it was deemed to be in people’s best interest to restrict their freedom to keep them safe their rights were protected by an application for a Deprivation of Liberty (DoLS) safeguard. We observed people being offered choices and people and their relatives told us their decisions were respected.

People were supported with their dietary, nutritional and hydration needs. People and their relatives told us the food was good and drinks were encouraged and available. We saw people were supported to eat and drink when they required assistance and were offered choice. Particular attention had been given to supporting the needs of people living with dementia by creating appetising smells to stimulate their appetite, offering choice at the point of food being served and providing snacks to enable people to eat when they were hungry. This was important because people living with dementia may lose interest, ability and desire in eating and drinking sufficiently to maintain good nutrition and hydration.

People’s healthcare needs were met by on-site nurses and access to a range of healthcare professionals. People’s healthcare needs were monitored and detailed guidance was in place to enable staff to provide effective care and treatment.

People and their relatives spoke highly about the caring nature of staff and the positive relationships they enjoyed with staff. People told us their decisions about their day to day care needs were respected by staff and we found staff were aware of people’s individual preferences. Peoples’ relatives had given positive feedback about the care their loved ones had received at the end of their lives. Where people had expressed decisions about their care and treatment at the end of their life these were recorded and known by staff to ensure they received the care they wanted.

People’s needs were assessed prior to their admission, their care plans were personalised and contained information about the care and nursing actions required to meet their needs. Care plans included information about people’s personal histories and their preferred daily routines. We saw staff communicated effectively about people’s changed needs and care was planned and delivered to meet these.

Staff completed training in supporting people living with dementia and demonstrated they understood how to meet people’s communication and support needs. People’s relatives told us the dementia care was good and spoke highly about the design and facilities of the home that created a ‘dementia friendly’ environment. People had access to a range of activities to provide a stimulating and meaningful use of time. The provider had employed specialist dementia staff to lead on ensuring dementia care was based on and delivered in line with best practice guidance.

People’s concerns and complaints were investigated and responded to in line with the provider’s procedures. People and their relatives told us they felt confident to raise any concerns with staff.

An effective quality assurance system was in place which enabled the provider and registered manager to assess, monitor and improve the quality and safety of the service people received.

Information from accidents and incidents was collated and used to identify trends and monitor the preventative actions in place. People and their relatives were asked for their feedback about the quality of care they experienced and this was acted on.

The registered manager provided visible leadership in the home and kept the day to day running of the home under review. They conducted daily meetings that included clinical staff, senior care staff and department heads. Information from this meeting was disseminated to all staff in the home.

The provider’s values were to provide friendly, kind, individual, reassuring and honest care for people. Staff were aware of the values and we observed these were evident in the observations we made of staff practice in the home.

People we spoke with directly told us staff provided the care and support that they needed. Comments from people included: 'I can't fault the staff, they are excellent' and: 'Staff know what they are doing and are very kind and polite'. People said they felt safe in the home and were confident that staff would respond appropriately to any concerns they raised.