St Patricks Care Home

Updated 21 December 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Patricks Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. St Patricks Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 6 June 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 9 members of staff including the registered manager, nurses, care staff, domestic staff and the person responsible for maintenance. We spoke with 4 people and 4 relatives about the experiences of care they or their loved ones received. 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 with us.

We reviewed a range of records including 5 people's care records and multiple medication administration records. We also reviewed a variety of records relating to the management and governance of the service.

We reviewed evidence that was sent to us remotely as well as seeking clarification from the provider and registered manager to validate evidence found. We looked at audit and governance data, as well as policies and procedures. We also reviewed 2 staff personnel files in relation to recruitment remotely.

Updated 21 December 2022

About the service

St Patricks Care Home is a care home providing personal and nursing care for up to 40 people. The service provides support to older people and people who are living with Dementia in one adapted building. At the time of our inspection there were 38 people using the service.

People’s experience of using this service and what we found

Infection prevention and control procedures were not effectively managed. Unclean areas of the home were observed across both days of the inspection and we found PPE was not stored in a way that prevented cross contamination.

Not all risks were assessed and monitored which placed people at potential risk of harm. Risk assessments were not always completed in a timely manner and records did not always show that risk was effectively monitored. Medication administration records did not always evidence that people received their medicines as prescribed.

Governance processes were not always effective at improving the quality and safety of the service. Auditing tools were in place. However, they did not identify all concerns found during the inspection in relation to risk assessments and care plans. When concerns were identified, there was not always a clear timescale of when these would be actioned.

There was a system in place to record and analyse incidents. However, we found that not all individual incidents were effectively analysed. We have made a recommendation about the analysis of incidents.

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. However, we identified that mental capacity assessments were not always completed in a timely manner. We have made a recommendation about the completion of mental capacity assessments.

Staff were safely recruited following the completion of appropriate pre-employment checks. There were enough staff to support people safely. The registered manager had ensured safe staffing levels by using agency staff when needed.

A safeguarding policy was in place and concerns were shared with the local authority when required. People told us they felt safe in the care of staff and relatives were also assured that their loved ones were safe living at the home.

People and relatives told us that staff were experienced and knowledgeable about their roles. When people’s needs changed, the provider was extremely responsive and appropriate referrals to other agencies were made in a timely manner. People achieved positive health outcomes because the engagement with health professionals was effective.

People were positive about the food. Independence with food and drink was promoted through the use of adapted cutlery and plates.

People made everyday choices in relation to their care and treatment. People provided positive feedback in relation to staff respecting their views. A person told us, “Staff listen to what we say.” People were treated with dignity and respect. Our observations found that staff were caring in their approach.

An effective system was in place to ensure complaints were managed in an open and transparent way.

Staff told us that managers were approachable and there was a positive staff culture.

Relatives told us they were happy with the care their family members received and they were kept up to date about important changes in people's physical health.

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

Rating at last inspection

This service was registered with us on 18 November 2019 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 17 April 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

The registered manager and provider have been responsive to the feedback provided during the inspection and has implemented changes to improve the quality and safety of the service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.