Archived: St. Johns Wood Care Centre

St Johns Wood Care Centre is a care home that can accommodate up to 100 people, who require personal and nursing care. There were 69 people in residence at the time of this targeted inspection. Since our previous inspection the parent company owning the home has transferred its registration from Bondcare (London) Limited to another of their legal entities Bondcare (London2) Limited. Apart from a change in the structure of the provider which resulted in a change of registration, it continued to operate as previously with mostly the same staff and people using the service.

The service provided nursing and personal care on five floors, although the top floor was not in use at the time of this inspection visit. People had their own en-suite bedrooms and shared other bathrooms and shower rooms, as well as lounges and dining rooms on the floor where they live.

One floor specialised in caring for people with dementia, however, people living with dementia also lived on other floors of the home. Another floor specialised in caring for younger adults with acquired brain injury or other conditions limiting their ability to live independently.

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

At the time of our previous inspection the service was about to begin a process of improving care planning as care plans at that time were complex and lacked clarity. Updating the current assessment of need for each person using the service had begun prior to our previous inspection and had been completed.

Most relatives we spoke with felt able to raise things they wanted to although some did repeat concerns that they had separately raised over the previous few months directly with the Care Quality Commission. People usually felt that staff were caring, although there had been occasions over the last few months where a concern was raised about some specific areas of care for some people. Not everyone we spoke with thought there was enough consistency although others thought they had seen some improvement. The impact of lockdown during Covid 19 had understandably resulted in anxiety about the care of their loved ones at the home for some relatives.

There was a home manager, who had taken over from the previous manager three weeks prior to this inspection. This person was, however, able to demonstrate that they had a grasp of issues needing to be fully and properly addressed at the home.

Rating at last inspection:

The last rating for this service was requires improvement (published 7 March 2020).

We have not awarded a rating to the service on this occasion.

Why we inspected:

We undertook this targeted inspection to check whether the Warning Notice we served as a result of the previous inspection in relation to Regulation 9 (Person centred care) had been met. Work had been undertaken around care planning, and the previous issue had been largely addressed although fully utilising some aspects of the care planning system was still to be completed in a couple of instances that we saw. Enough improvement had been made at this inspection and the provider had complied with the warning notice and was no longer in breach of regulation 9.

We also looked at whether previously identified breaches in relation to risk assessments not being fully completed or followed through, Regulation 12 (Safe care and treatment), and monitoring people’s food and fluid intake, Regulation 14 (Meeting nutritional and hydration needs), had been met.

Risk assessments were completed although in two instances we saw that specific risk assessments had not been linked to a care plan need but the risk assessments had been compiled. Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.

Monitoring of people’s food and hydration, Regulation 14, had improved with one exception of this needing to be recorded more clearly. Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 14.

We also looked at the current management arrangements at the home and arrangements to keep people safe from harm.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not award a rating or change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Please see the safe and effective sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Johns Wood Care Centre on our website at www.cqc.org.uk.

Follow up:

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