About the service St Catherine’s Care Home is a two-storey purpose-built home that provides personal and nursing care to 60 people. The home is situated in the centre of Horwich, Bolton, and is close to local amenities, public transport and motorway networks. At the time of the inspection there were 54 people living at the home. One area within the home, Pike View specialised in providing nursing care for people living with dementia.
People’s experience of using this service and what we found
Medication was not always safely managed. However, actions were taken immediately following our inspection to address these concerns.
People were mostly protected from the associated risks of infection. However,, some areas of the home were tired and required attention. Pike View did not provide a fully dementia friendly environment, it was lacking appropriate signage, adaptations and reminiscence aids.
Staffing numbers tallied with staffing rotas, however, it was discussed with the registered manager to look at how staff were deployed throughout the home. Staff were safely recruited. Staff completed an induction on commencing work at the home and training was ongoing.
Health and safety checks were completed, and valid certificates were in place. Each person had a personal emergency evacuation plan (PEEPs). On checking the main file there were too many PEEPs for the number of people living at the home.
Activities were offered at the home. However, these were group activities and people cared for in bed did not have access to quality activities on a one to one basis. We recommended appropriate equipment was sought to provide a range of stimulation and enjoyment.
Care plans contained detailed information, including a pre-admission assessment and risk assessments were in place. People’s oral health care had been assessed. However, our checks found people were not always in receipt of oral care as documented.
Staff were trained in equality and diversity and people told us the staff were kind. We saw people were well-groomed and appropriately dressed. Staff interactions with people were friendly and respectful.
People and their relatives told us the food had improved. However, there were issues raised regarding the suitability of fork mashable diets. We recommended the registered manager ensured people were offered food to meet their dietary needs.
Staff supported people with access to other healthcare professionals when required. Staff worked with other agencies to meet people’s assessed needs.
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.
Systems were in place to receive and respond to complaints. The service had received several compliments from relatives.
Staff had an awareness of safeguarding and whistleblowing and knew how to raise concerns. Policies and procedures were in place for staff to refer to when required.
Staff felt supported by the registered manager. Residents’ and relatives’ meetings were held; however, these were not well attended.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 20 November 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made however, the provider was still breach of two regulations. The service remains rated requires improvement.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We identified two continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 namely safe care and treatment and good governance.
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.
We will arrange to meet with the provider and 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 and local authority to monitor progress.