St Michaels Nursing Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At our last inspection we rated this question good, this rating remains unchanged.Staff treated people with kindness, empathy and compassion. People and relatives told us that staff listened to them and understood their individual needs, including cultural social and religious needs. We observed staff responding to peoples immediate needs to minimise individual concerns or distress throughout the assessment. We saw that staff used specialist adaptive equipment, such as sensor mats and hoists to promote peoples independence.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they were treated with kindness empathy and compassion and staff respected their privacy and dignity. They felt staff listen to them and communicate well with them. They felt that staff knew their preferences, wishes, personal histories. People and relatives told us that staff mostly respond to their needs quickly especially if they are in pain, discomfort, or distress. We asked if people were treated with respect and dignity and the comments we heard included, “Yes, definitely. They strip wash [relative] several times a day and he has never complained about the staff”. “Yes, absolutely”.

Staff told us they treated people with kindness, respect, and dignity in their day-to-day care and support. Staff comments included, “I always ensure they are treated respectfully; I treat them as if they’re my parents, my family”; “I treat them as I would like to be treated and I respect their individuality”; “I ensure that I am always kind and polite and I listen”. When we asked staff about how they ensure that people’s privacy is maintained while carrying out personal care tasks, they told us, “Ensure door and curtains are shut and always ask permission before doing something”; “We always explain what we are going to be doing before we do it”.

Leaders told us they monitored staff interactions with people to ensure that they are treated with dignity and respect. They also told us about the action they had taken previously when a staff member did not treat people with dignity and respect. This action evidenced that leaders ensured that they advocated the rights of people who use the service to be treated with kindness and respect.

During our site visit we observed that staff treated people with kindness and respect. We saw staff communicating with people appropriately. We saw staff maintaining people’s dignity, for example knocking on their door before entering their rooms.

Overall, people and their relatives told us their needs and preferences were understood. One relative gave us a following example of accommodating preferences, “When [name] first went in, he had a small room and [name] said that he needed a bigger one and they moved him to one that was twice as big”.

Staff told us they treated people as individuals, considering any relevant protected equality characteristics. Staff told us about the relevant information regarding people’s needs, preferences, personal, cultural, social and religious needs were recorded in the care plans.

We observed that people were treated as individuals by staff who appeared to know them well. We noted that staff knew people’s likes and dislikes and followed people’s care plans, for example in regard to their food preferences.

The provider had systems and processes in place to ensure that people were treated as individuals. People had comprehensive needs assessment and care plans in place that recorded and reflected their needs and preferences as well as personal, cultural, social and religious needs. These were regularly reviewed and contained mostly up to date information. The gaps we identified and feedback to the manager were promptly addressed.

People and their relatives told us they had choice and control over their care whenever possible. Relatives told us they felt welcomed to visit their loved ones whenever they wanted. People and relatives told us they were offered choices. Comments regarding independence, choice and control, included, “[Name] is always involved in activities, and they ask her what she wants to have re food”; “They asked us what colours he wanted in his new room, and it is lovely”.

Staff told us they supported people with maintaining independence, choice and control. Leaders gave us examples of how they supported people with that. For example, the decoration within the home and individual bedrooms. Staff assured us that people choices were respected and accommodated whenever possible.

We observed that staff supported people with making choices. For example, during lunch time, options of food and drinks were offered. We heard staff asking questions such as, “Where would you like to go?”; “What would you like to do?”.

The provider had systems and process in place to support people’s independence, choice and control. For example, people’s preferences were recorded; when people lacked mental capacity to make decisions best interest decision was completed; welcoming approach to visitors to support people with maintaining relationships and networks that are important to them.

People and their relatives told us they felt listened to. People and relatives felt the staff responded promptly when people were distressed.

Care staff and leaders told us about how they were alerted to people’s changing needs and take time to observe their needs. Staff told us about the tools they use to help them with monitoring people’s changing needs. Staff told us they look out for changes in behaviour, presentation. Staff said “Physical observations are taken once a month at least. A qualified nurse carried out physical health observations if someone is not themselves. Staff use a national early warning score (NEWS 2) to help triage and decide on further actions if a person becomes unwell; a urinary tract infection identification tool; “I stumble” app- to help decide what actions to take following a fall”.

We observed staff speaking to people about what they would like, how they can help them and asking if they were ok. We saw staff reassuring a person who was in distress. We saw that additional support was in place for people who required it, for example 1:1 care for people who experienced distress or at high risk of falls. However, on one occasion we saw a long delay in responding to a call bell used a person in a bedroom. We discussed it with the manager and they told us about their plans on how to improve staff’s responses to call bells.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.