St Antony's Care Home

We found the following examples of good practice.

The home was clean and hygienic. Systems were in place to ensure good levels of hygiene.

Risks in relation to visitors had been assessed and action taken to ensure visits were still in place at the service. Regular Infection Prevention Control (IPC) audits were undertaken. Managers kept up with with current guidance and knew who to contact if they needed advice around IPC.

Staff had access to supplies of Personal Protective Equipment (PPE) and had received training to ensure they used this correctly. All staff had regular testing for COVID-19, and all had received their vaccinations. Staff were trained on how to keep people safe from the risk of infection.

At the last inspection in March 2016, the service was rated Good.

At this inspection we found the service remained Good.

The service demonstrated they continued to meet the regulations and fundamental standards.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service at St Antony’s Care Home were positive about the care and support provided. They said staff treated them in a kind and caring manner.

Staff had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern. They were confident that any concerns raised would be taken seriously by the registered manager and acted upon.

Staff were positive about the service provided and felt confident in the quality of care given to people using the service. Staff felt able to speak to the registered manager to raise any issues or concerns.

People were supported effectively to have their health needs met. People’s prescribed medicines were being stored securely and managed safely.

People using the service were satisfied with the food provided to them.

The staff attended regular training which gave them the knowledge and skills to support people effectively. The service understood and complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff understood the importance of gaining people’s consent before assisting people.

A registered manager was in post who knew the service well. There were systems in place to help ensure the safety and quality of the service provided.

Further information is in the detailed findings below.

St Antony’s Care Home provides accommodation for up to 12 people who require personal care and support on a daily basis. The home can accommodate people living with dementia and/or older people living with mental health issues. At the time of our inspection there were 11 people living at the home most of whom were living with dementia.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found the recreational and social activities limited particularly for those people who wished to remain in the home, or who were unable/unwilling to leave the home.

We saw staff were caring and they treated people with dignity, respect and compassion. Staff were well trained and supported to undertake their roles. Training was refreshed regularly so staff were up to date with current best practise. We saw staff were knowledgeable about the people their cared for and how to meet their diverse needs.

People had their health needs met. This included having access to healthcare professionals when they needed them. People received their medicines as they were prescribed to them. Staff were suitably trained to care for people nearing the end of their life.

People’s nutritional needs were assessed and monitored. Although we noted on the day of the inspection it appeared little thought had been given to the lunchtime meal.

People were asked for their consent before care was provided. If people were not able to give consent, the provider worked within the framework of the Mental Capacity Act 2005. The Act aims to empower and protect people who may not be able to make decisions for themselves and to help ensure their rights are protected.

People were safe living at St Antony’s. Staff were knowledge about what to do if they suspected anyone was at risk of harm. The provider had ensured suitable checks were undertaken prior to any member of staff being employed by the service. There were also a number of audits and checks in place to ensure the safety and people who used the service and staff who worked there. Staff were employed in sufficient numbers to meet people’s needs.

The registered manager ensured that people were able to participate in activities of daily life as independently as possible and if this was not possible, then risks were identified and strategies developed to assist people as much as they were able to.

The provider strived towards continuous improvement. They sought feedback from people who used the service, their relatives and staff. People told us they felt comfortable raising issues and concerns with the registered manager, and these would be taken seriously and addressed. The provider had engaged an external auditor to monitor the quality of care provided.

We made a recommendation regarding activities for people who use the service.

If you want to see the evidence supporting our summary please read the full report.

We considered our inspection findings to answer five questions we always ask:

' Is the service safe?

' Is the service caring?

' Is the service responsive?

' Is the service effective?

' Is the service well led?

Is the service safe?

Care plans detailed that people's needs were identified and met. These plans were regularly reviewed and updated so that they were meeting people's current needs. Any risks were assessed and reviewed regularly to ensure people's individual needs were being met safely. The medicines prescribed to people were stored safely and administered appropriately.

Staff had a good understanding of safeguarding vulnerable adults and how to respond to signs of abuse. This meant that there were mechanisms in place to safeguard people from the risks of abuse and to protect their rights.

The Care Quality Commission monitors the operation of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We saw that policies and procedures were in place and where DoLS decisions needed to be made the appropriate procedure had been followed. This could help to ensure that people's human rights were properly recognised, respected and promoted.

The provider's staff recruitment and selection processes were effective, which meant people who used the service were protected from unsuitable staff.

Is the service caring?

People we spoke with were positive about the care provided at St Anthony's. Comments included, 'they do their best for him' and 'I like most things and most people'. We saw people who used the service were supported by kind, attentive and compassionate staff. Staff treated the people who used the service with respect and dignity.

Is the service responsive?

We found staff continually monitored people's condition and where necessary sought advice and assistance from other community based health and social care professionals

The service had a complaints policy and procedure which was kept in the office. People we spoke with told us they knew how to make a complaint if there was something that they were unhappy with. However, we felt that the complaints policy could be more accessible and written in format that could be understood by the people who lived at the service.

There was some choice of activities available for people who used the service. However, we did not consider that the activity's offered would suit everyone who lived at the home because of the wide range of needs, interests and abilities of people.

Is the service effective?

People received effective support from staff that were trained and supported by the manager. Staff told us they had received specific training to meet the support needs of the people living at the home.

People were supported to be able to eat and drink sufficient amounts to meet their needs.

Is the service well-led?

The service had a registered manager who knew the service well.

The service had quality assurance systems in place. We saw records that showed us any issues identified were addressed promptly. As a result the quality of the service was continuingly improving. An annual survey was completed by people who used the service or their relatives. The results were used to identify any areas for improvement.

Regular audits of the care plans and risk assessments were carried out to help ensure that people received good quality care at all times. There were systems in place to make sure staff learnt from incidents and accidents and other untoward events.

During that inspection we did not consider that the home was meeting minimum standards as laid out by legislation and therefore made a compliance action. This action required the provider to tell us in a report how they would meet these standards. This inspection was undertaken to check that they had complied with what we had required of them. The compliance action we made at our previous inspection related to safeguarding vulnerable adults. After our visit we concluded that the provider had met the minimum standards required of them and therefore the compliance action had been removed.

We also partially toured the building to view the changes that had been made since our last visit.

To get a full picture of the home and how it functioned, the reader is advised to read this report in conjunction with report written following our visit on the 2nd July 2013.

In the last nine months the care home had changed registered provider and this individual had also become the manager registered with the Care Quality Commission. Throughout the report, we refer to the provider who is also the registered manager of the service.

Since the provider had taken over the home, significant improvements have been made. Documentation relating to people who use the service had been totally overhauled so that it focused more on the individual. Staff had undergone a huge amount of training and the environment of the home had also improved.

However, throughout this transition period St Anthony's continued to cater for people with varying degrees of needs from those people with mental health needs who were independent, to those with dementia who required a lot of assistance with personal care. Although the home was able to cater for these varying needs, it required staff to have diverse training and was stressful for some people who used the service.