The inspection took place on 27 February and 7 March 2018. The first day of inspection was unannounced. This meant the provider and staff did not know we would be coming.

St Cuthberts House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Cuthberts House provides care and support for up to 28 people who have enduring mental health issues. At the time of the inspection there were 26 people living there. It currently has an all-male client group.

The service had a registered manager in place. 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 previously inspected St Cuthberts House in September 2015, at which time the service was meeting all regulatory standards and was rated ‘Good’.

At this inspection we found the service had deteriorated to Requires Improvement.

At this inspection we found that there was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. This related to the Registered Manager failing to notify the Care Quality Commission of incidents regarding abuse and a receipt of a Deprivation of Liberty Safeguard authorisation.

You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe living at the service. Staff had completed training in safeguarding people and the registered manager actively raised any safeguarding concerns with the local authority.

Risks to people’s safety and wellbeing were assessed and managed. Environmental risk assessments were also in place.

People commented on an ongoing issue with communal toilets and them being left in an unclean manner. We have made a recommendation about the maintenance and cleanliness of communal toilets in the home.

There were enough staff to meet people’s needs. Staff continued to be recruited in a safe way with all necessary checks carried out prior to their employment.

People continued to receive their medicines in a timely way and in line with prescribed instructions. Staff had their competencies checked regularly and medicines audits were completed by the registered manager.

Staff received up to date training, regular supervisions and an annual appraisal to support them in their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to access a range of health professionals and information of healthcare intervention was included in care records.

People told us the service was caring. Staff treated people with dignity and respect when supporting them with daily tasks.

People had access to advocacy services if they wished to receive support. Some people had active local advocacy services or Independent Mental Capacity Advocates (IMCAs) involved in decision making relating to specific aspects of their care.

People’s physical, mental and social needs were assessed prior to them moving into the home. Care plans were personalised, reviewed regularly and included people’s personal preferences.

There was a range of activities available for people to enjoy in the home. People were also supported, where necessary, to access activities in the local community including going to a local club, library and shopping.

There were audit systems in place to monitor the quality and safety of the service. The views of people, relatives and staff were sought by the registered manager via annual questionnaires. Ther

People who used the service told us that they were happy with the service provided by the staff. They said that staff responded promptly and politely and that they had been asked about what help they needed when they started to use the service. They also said that they were consulted about any changes to their care. People spoken to were aware that they had a care plan and that any changes in their care had been discussed with them.

We were told that the food was ‘good’ and that there was ‘enough to eat’.

People we spoke to said that they knew who to go to if they had any concerns and that they were confident that staff would ‘sort it out’ or discuss their issues with the manager. We saw the manager dealing directly with issues during our visit.

People confirmed that they had been given a copy of the complaints procedure and that they would feel able to use it, if necessary.

People living in the home said that they were happy with the service provided by the staff. They said that staff responded promptly and politely to any requests for assistance. People said that they were asked about what help they needed when they started to receive a service and consulted about any changes in their care provision.

One person said that he felt that the staff “always ask me what I want to do and another that he had visited the serivce before moving in and that he had been asked “all about my likes and dislikes”.

People were aware of having a care plan in place and said that they were satisfied that they were consulted about their care and support. They said that they thought that staff were aware of their needs and were kind and helpful. People said that they felt safe living in St Cuthbert's and could speak to staff if they had any concerns. Most people said that they would speak to the manager as he was very approachable.

This was an unannounced inspection which took place over three days, 29 and 30 September and 7 October 2015. The last inspection took place on 23 May 2013. The service was meeting the regulations in force at the time.

St Cuthbert’s is a care home situated in a residential area of Low Fell in Gateshead. It is registered to accommodate up to 28 people who require personal care and have enduring mental health issues. At the time of the inspection there were 27 people living there. It currently has an all-male client group.

The service had a registered manager who had been registered for 19 years and re-registered in 2010. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 that people’s care was delivered safely and in a way of their choosing. They were supported in a manner that reflected their choices and supported them to remain as independent as possible. Where people needed further support this was acted upon.

People’s medicines were managed well. Staff watched for potential side effects and sought medical advice as needed when people’s conditions changed. The advice of external healthcare professionals was sought as people’s needs changed over time.

Staff stated they were well trained and encouraged to look for ways to improve their work. Staff felt valued and this was reflected in the way they talked about the service, the manager and the people they worked with. Staff were encouraged to access training to meet the needs of people who used the service. Staff shared skills in working with people and supported each other to provide a consistent approach.

The service was in the process of having additional building work carried out. People had been involved in decisions about the decoration of their rooms, these were personalised and comfortable.

People, relatives and external professionals were complimentary of the service, and were included and involved by the staff and manager. They felt the service being provided met people’s needs well.

There were high levels of contact and supervision between the staff and people who used the service, seeking feedback and offering support as people’s needs changed. People felt able to raise any questions or concerns and felt these would be acted upon.

Staff were seen to be caring and to have a good relationship with people. Relatives and external professionals said the staff team knew how to care and were innovative in finding ways to improve people’s quality of life. People told us the staff team was consistent and staff knew them well.

The service had a registered manager who was considered approachable and supportive by people, relatives, staff and external professionals. People and their relatives told us the registered manager helped to bring positive values into the services through support and mentoring of the staff.