St Michaels Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last inspection we rated this question as requires improvement, this rating has improved and is now rated as good. Leaders and staff made sure that people were at the centre of the care and treatment. This was evidenced in individual peoples care plans which included end of life care and peoples wishes regarding cardiopulmonary resuscitation. We saw examples of staff working with services outside of the home to ensure that people had access to specialist services to support continuity of care, support and treatment. For example, ophthalmology, audiology and chiropractic services. Leaders had put systems in place for people and their families to share ideas, raise complaints and feedback about the care they received.

This service scored 68 (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 relatives told us they received care that’s centred around their needs and is well coordinated. Comments included, “They’re a good team. They have to deal with quite a lot of high maintenance people”.

Staff told us that people had care plans in place that were person centered. Staff knew how to access them and made the time to read them. Leaders told us that they ensured that care plans fully reflected people’s physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act.

We observed staff during the assessment following care plans for individual people. They used the correct hoists and sat people in the lounge in areas they liked to sit. For people, that liked to stay in the room, this was accommodated ensuring the had access to reading material or the TV remote. Staff supported people to make choices on what food they wanted at mealtimes.

People and relatives told us they received care that was well coordinated internally and externally. One relative gave us an example of how the provider supported with resolving and issue with medication delay that occurred as a result of gaps in communication between different services. People told us they were supported to access other health and social care services and professionals when needed, for example GP, district nurses and social services.

Care staff and management told have us multiple examples of working with other agencies to support people. They showed us evidence of how they frequently liaise with other professionals to achieve the bets outcomes for people. Examples included, arranging eye and hearing tests on a yearly basis. Dentist appointments when required or annually and a chiropody was available for appointments with people that required foot care.

Leaders worked with the partners to ensure that the care needs of the people using the service was joined up, supported and funded.

The provider had systems and process in place to ensure continuity in people’s care and treatment and worked well with other services to support people’s outcomes. There was a referral pathway in place and referral to external services in order to meet peoples needs. Managers and staff understood their duty and responsibility to collaborate with other services to improve care provision. We saw evidence that due to an issue with accessing a person medication in a timely way, a safeguarding referral had been made and a meeting set to discuss how this situation should be managed between the home, the GP and the pharmacy moving forward so the same situation did not reoccur.

People and relatives confirmed they can access information and advice from the provider. Comments included, “Yes, we can (access information) on his (relative) behalf, we usually just speak to the manager”. “[When we need information and advice] I feel comfortable asking [manager’s name] any questions”. People told us there was an opportunity to access information in residents and relatives’ meetings.

Leaders told us they shared information with people and relatives in relatives and residents’ meetings. They told us that information can be provided for people in any format depending on their needs and communication preferences. They told us that a lot of pictorials, dementia friendly information/ signs were available around the home.

Processes were in place to ensure that people can get information in required format. We saw multiple examples of pictorial, dementia friendly prompts around the home. For example, pictorial menus. People’s individual communication needs were clearly recorded in their care plans. Leaders were aware of their responsibilities under the Accessible Information Standard.

People and the relatives felt involved and listened to. One relative gave us an example of how the provider accommodated a bigger room for a person as this was the person’s preference. Another relative gave following example, “She is always involved in activities, and they ask her what she wants to have regarding food”.

Leaders told us they had systems and process to listen and involve people. They told us there was a complaint policy and poster available for all to see in a communal area. They told us they organised meetings for relatives and residents to give them the platform to share their views. They gave us examples of how people are involved, for example in the design of communal areas that are suitable for people’s preferences (garden room, pub room) and people’s own bedrooms (choosing own wallpaper and a colour theme).

Managers and staff made it easy for people to share feedback and ideas about the service and how to raise complaints. Monthly residents and relatives meetings were held for people to raise concerns and ideas. Prior to starting the redecoration work at the home everyone was sent a questionnaire about what wallpaper, paint colour, furniture they would like. The manager told us that relatives had not attended the meetings as they spoke to her when they visited their loved ones rather than waiting for the meeting. A complaints poster was displayed in reception for all visitors and people using the service to see and provide details of how to complain. In the last 6 months there had been one complaint. We reviewed this complaint and found that it had been fully investigated and resolved as per the providers policy.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People’s relatives told us that people had care plans that were shared with others who needed to be informed, for example in person needed to go to a hospital. People or their relatives when appropriate were asked about their wishes regarding cardiopulmonary resuscitation. The relatives said they could discuss their loved ones’ care plans, including end of life care and wishes with staff.

Leaders told us end of life care and wishes regarding cardiopulmonary resuscitation were discussed with people as part of care planning. Staff told us that when possible, their discussed what matters to people with them, or with their relatives when appropriate.

Staff followed a process and recorded people’s wishes regarding cardiopulmonary resuscitation and end of life care as part of initial assessment and reviewed it as part of care planning. People had end of life care plans in place, however they could be more personal. Leaders told us people don’t always wish to discuss their end of life with staff and they found it difficult.