St Augustine's Care Home

Updated 4 July 2023

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 Augustine's Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Augustine's Care Home is a care home without 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. We visited the home unannounced on 12, 30 May and 7 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 7 relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, deputy manager, head of care, senior care staff, care and ancillary staff. We reviewed a range of records. This included 9 people's care plans and multiple medicines records for people. We looked at recruitment checks for 3 staff members. A variety of records relating to the management of the service, including training, staff rosters, audits, meeting records and an action plan were also reviewed.

Updated 4 July 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and/or who are autistic.

About the service

St Augustine's Care Home is a residential care home providing accommodation and personal care to up to 52 people. The service provides support to people living with physical and mental health related care needs, older people and people living with dementia. At the time of our inspection there were 42 people using the service. The home is divided into four units, A, B, C and D. Unit B specialises in providing care to people living with dementia. The service places a strong emphasis on the teachings of the Catholic Church with support also being provided by the religious sisters who live in the adjoining convent. People have access to the on-site chapel.

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

People’s records were not always consistent, up to date and detailed enough to ensure staff had clear guidance on all of the individual needs and risks. People received safe care as staff knew them well and the management ensured there were robust handovers and summary records available. The provider did not always effectively manage infection outbreaks and infection prevention and control in the home.

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, appropriate applications for deprivation of liberty when people required constant supervision and could not leave the home on their own were not always in place. People’s consent for care was not always appropriately recorded.

The provider did not always have fully embedded and effective governance systems in place. Some improvements had been achieved in recent months, for example, around staff training, recruitment and management of medicines. However, other identified shortfalls had not been successfully addressed yet and there was limited assurance around how the management team maintained an effective oversight of the quality and safety of people’s care.

There were enough staff to support people safely and new staff had to undergo a range of checks to ensure their suitability. People and their relatives told us they felt the home was safe. Staff knew how to raise concerns and felt able to speak up when needed. People received safe support with medicines and eating and drinking.

Staff supported people in person-centred way. People were encouraged to do what they liked. Staff knew their individual preferences, wishes and lifestyle choices and provided care in a respectful and caring way.

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 02 February 2023 and this is the first inspection.

The last rating for the service under the previous provider was requires improvement, published on 03 February 2023.

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about infection prevention and control. A decision was made for us to inspect and examine those risks.

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.

We inspected and found there was a concern with the provider’s response to an outbreak of an infection in the home, so we widened the scope of the inspection to become a comprehensive inspection which included all 5 key questions.

Enforcement and Recommendations

We have identified breaches in relation to infection prevention and control 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 and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.