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Care Services

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St Denys Care Home, Newport, Barnstaple.

St Denys Care Home in Newport, Barnstaple is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults under 65 yrs, caring for people whose rights are restricted under the mental health act, learning disabilities and mental health conditions. The last inspection date here was 22nd February 2019

St Denys Care Home is managed by Dr F J Fernandez-Guillen & Mrs M N Guerra-Jimenez.

Contact Details:

    Address:
      St Denys Care Home
      16 Newport Terrace
      Newport
      Barnstaple
      EX32 9BB
      United Kingdom
    Telephone:
      01271343295
    Website:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2019-02-22
    Last Published 2019-02-22

Local Authority:

    Devon

Link to this page:

    HTML   BBCode

Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

24th January 2019 - During a routine inspection pdf icon

St Denys is a care home without nursing for up to 12 people with predominately mental health issues. The accommodation is provided in a large terraced house with bedrooms on ground and first floor. There is easy access into the local town.

Rating at last inspection

At our last comprehensive inspection completed in November 2017 we rated the service as overall requires improvement with requirements in recruitment and good governance. In October 2018, we followed up with a focussed inspection to check they were meeting therequirements we had set. We found they had been met, which meant their overall rating had improved to Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

The service had a registered manager who was also the registered provider. 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 said they felt safe and well cared for by a staff group who understood their needs.

Care and support was being well planned with good liaison with healthcare professionals where needed. One healthcare professional said “I have been impressed with the way they have helped (name of person) settle in. They are doing better than I expected.”

People were supported by sufficient staff with the right skills. Staff treated people with respect and dignity. Care and support was being delivered in a kind and compassionate way.

Staff had support and training to help them do their job effectively. They felt valued and listened to. Staff said there was a good team work approach within the home. They worked in a way which encouraged people to retain as much independence as possible. Risks had been clearly identified and where needed measures had been put in place to reduce those risks.

People were supported to maintain a healthy balanced diet. Healthcare needs were monitored. Some people were supported to attend appointments and access the local community. Most people had a level of independence which meant they could organise their own social outings. Some activities were organised in house and for group outings to the local amenities.

Systems and audits ensured the quality of care and support were being reviewed and improved. People were enabled to have their voice heard.

Further information is in the detailed findings below

10th October 2018 - During an inspection to make sure that the improvements required had been made pdf icon

We undertook an announced focused inspection of St Denys on 10 October 2018. This inspection was done to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection completed November 2017. The team inspected the service against two of the five questions we ask about services: is the service well led, is the service safe? This is because the service was not meeting some legal requirements. We also received some information of concern about staffing levels. We did not find anything to substantiate this during this inspection.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection

Following the last inspection, we met with the provider to discuss their action plan. This included what they would do and by when to improve the key question(s) of well led and safe to at least good.

We found both key areas had improved to good and the breaches we identified had been met. Recruitment was robust and ensured correct checks and references had been obtained before a new staff member had been recruited. Improvements had been made to medicine storage. This included a air conditioner which kept the storage area cool at all times. Improvements had been made to the laundry area and the way laundry was handled. This ensured better infection control processes were in place. Improvements had been made to the governance systems. This included more regular audits and checks on records and provision of care to people.

St Denys is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 12 people in an adapted building. At the time of inspection, there were 11 people living at St Denys.

The registered provider is also the registered manager. 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 said they felt safe and well cared for. Comments included "This is the best place ever." Another said "We are very well looked after."

There were sufficient staff with the right skills to meet peoples needs. Staff felt valued and supported to do their job.

People risks were being well managed.

Staff understood what constitutes abuse and who and when they should report any concerns. they had received training and there were policies and procedures to direct them what to do if the registered manager was not available.

The home was clean and well maintained. There was a programme of refurbishment which had included improvements to the laundry, new carpets in some areas. The registered manager said this as a continual programme. They had recently repainted the front of the home and improved the patio leading to the laundry area.

2nd November 2017 - During a routine inspection pdf icon

The inspection took place on 2, 15 and 28 November 2017 and was unannounced. At the last inspection in December 2016, we found six breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because peoples’ risks assessment were not up to date; care plans did not describe how to support the person and reduce the risks; staff had not been adequately trained; staffing levels were insufficient to meet people’s needs; recruitment procedures were not robust; people had not been protected from the risk of abuse, governance systems and quality assurance had not identified issues and concerns. The service was rated as requiring improvement overall.

Following the inspection, we also met with the provider and asked them to complete an action plan to show what they would do, and by when, to improve the key questions ‘Is the service safe?’; ‘Is the service effective?’; Is the service responsive?’ and ‘Is the service well led?’ to at least good. After the meeting, the home submitted an action plan showing how they were going to address each of the breaches. The action plan recorded that they expected to have completed all the actions and be compliant with the regulations by the middle of June 2017. This inspection was carried out to see whether they had made the necessary improvements to meet the relevant requirements.

St Denys is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 12 people in an adapted building. At the time of inspection, there were 11 people living at St Denys.

At this inspection, we found there were some improvements to the service, which meant the provider was now meeting some of the regulations. However, some improvements were still needed as we identified continuing breaches of three regulations. We have therefore rated the service as still requiring improvement overall. This is therefore the second consecutive inspection where the service has been rated Requires Improvement. The breaches of regulation at this inspection were related to quality assurance, staff recruitment and safe care, particularly in relation to infection prevention and control.

People and their relatives said they liked the home and the staff. Comments included “Won’t hear anything but good from me about this place”; and “Made friends so I’ve got company. Excellent food. Can’t think of anything to improve.” A relative commented “Very lovely staff…always helpful and chatty.” Health and social care professionals who visited the home said they thought there had been improvements to the home. A professional commented they thought the home was “Very good.”

The service had a registered manager who was also one of the providers. 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. The registered manager was present in the home on most days of the week. They worked alongside staff which gave them an insight into working practices. The registered manager provided supervisions and appraisals to staff. This gave staff an opportunity to reflect on their work as well as identify training needs. The other provider visited the home each week and also worked in the home on some weekends. They provided a second tier of quality assurance in the home.

There were sufficient staff to meet people’s needs. The provider kept staffing levels under review to ensure they were able to support people to go to appointments and other events, when needed. However st

6th December 2016 - During a routine inspection pdf icon

St Denys is registered to provide care and support for up to 12 people who live with a mental health condition.

At the last inspection in December 2015 the provider was not meeting all the legal requirements in relation to staffing levels. We issued a requirement to ensure improvement. We asked the provider to take action to make improvements to staffing levels. We requested a report to say what action had been taken, however, no report was received.

This focused inspection took place on 6 December 2016 and was unannounced. Before the inspection we were made aware of concerns about the governance at the two GP practices which are owned and managed by the same providers. We also received concerns about staffing levels and unsatisfactory levels of activity for people using the service. As part of this inspection we looked at these concerns and found there had been no improvement to staffing levels. As a result we decided to change the focussed inspection into a comprehensive inspection. A second announced visit took place on 20 December 2016.

At the time of the inspection there were 11 people living at the service. This included one person who lived independently in an upstairs flat. The other 10 people had private bedrooms and shared living space consisting of a kitchen, dining room and sitting room. There was also an additional kitchen for people to make themselves drinks and a small conservatory in the backyard. This was used as a smoking room.

There was a registered manager in post who was also one of the two registered providers. 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.

The registered provider had not carried out an analysis of need and risk as the basis for deciding sufficient staffing levels. As a result, staffing levels were insufficient to fully support people’s needs. With only one member of staff on duty during the afternoon shift, this meant that activities for people were curtailed, as the member of staff had to undertake cooking, housekeeping and cleaning duties. There was no spare capacity to support people living at the service to undertake rehabilitation activities as part of the goal of achieving independence.

Staff and healthcare professionals commented on the absence of the registered manager who worked part time at the service. A lack of managerial presence had resulted in poor communication. Limited managerial time available meant that various quality assurance checks were not being consistently maintained. Auditing systems were not always being used nor being consistently monitored and reviewed to mitigate risks to people using the service.

An undertaking made at the time of the previous inspection in December 2015 to protect managerial time for the deputy manager had not been kept. Poor record keeping meant that it was not possible to establish that recruitment practices were consistently safe, nor which staff had received what training, including safeguarding and safe medicines administration. .

The service provided was kind and caring. People living at the service enjoyed the freshly prepared food and felt they were treated with dignity and respect by care workers.

People all had individual care plans which reflected their individual needs and wishes. Risk assessments had been undertaken on each individual but were not always reviewed and updated in a timely way.

The service had established relationships with local healthcare services so that people living there could benefit by receiving care as required. People received their oral medicines as prescribed.

However, not all aspects of the management of medicines were safe, in particular the use of prescribed creams and homely remedies. The

22nd July 2013 - During a routine inspection pdf icon

We inspected this service in September 2012 and found two areas which required improvements to help protect people. These were in outcome 16, where we found systems for auditing people's finances was not robust enough. Also in outcome nine, we found the storage of medications was not secure enough. Both these areas have been addressed and on this inspection we found these outcomes to be fully compliant.

We spoke with eight people during this inspection. We heard how they were involved in the everyday running of the home, helping with cleaning, cooking and shopping. Everyone expressed satisfaction with their care and support. We heard from one person who was newer to the service about how they had been assisted to settle into their new environment. They told us ''staff have been very kind and helpful, I am glad to be here as I feel much safer now.'' Another person told us ''They staff are all good, they help me with my showers and look after my medications. They are a good lot.''

We saw care and support was being well planned and staff had training and support to do their job effectively. There is no registered manager in post at present, but the provider has put in place some interim arrangements to ensure care plans and risk assessments were being kept up to date. Staff we spoke with confirmed they were having regular meetings and supervision sessions to enable them to have in put into how the home was being run.

28th September 2012 - During a routine inspection pdf icon

We brought forward a scheduled inspection of St Denys on 28 September 2012 after we received some concerning information. We focussed on the outcomes for people with regard to nutrition and hydration, management of medicines, the suitability of accommodation, staffing and quality assurance. We found that improvements were needed with regard to the management of medicines and quality assurance.

Ten people were living in the home when we visited. We looked at the records of three people in detail; and spoke with ten people about their experiences at the service. We observed interactions that took place with people using the service. We spoke with four staff and the provider. Following the visit, we also spoke with healthcare professionals that support people living in the home.

People told us that they were satisfied with the variety and quality of food available. For example, we were told “We have very nice meals...they’ll always do something different if you don’t like what’s on offer”. We heard that health eating was encouraged and people had successfully lost weight by attending a local slimming club.

People were prompted to take medicines that were prescribed for them by their GP and they told us these were regularly reviewed with them. People’s comments were “We always get given what the doctors have prescribed for us” and “My key worker phoned up the doctor for me about getting my flu jab”.

The accommodation was comfortable and well maintained. People told us that they were encouraged to personalise their rooms. For example, people’s comments included “XXX is taking me to choose some paint soon to have my room decorated how I want it”. We also heard that new carpets had been fitted and bathrooms had been upgraded.

People told us that if they needed support, it was given promptly. However, on the day we visited, a member of staff was off sick and for a short period of time this meant that there was only one member of staff on duty and some people had to wait for support until this was covered. People expressed some frustration, but this was quickly resolved when another member of staff came on duty.

People said that the home “Is well run and we have regular meetings”. Two healthcare professionals told us that the aims of the service were in keeping with good practice and promoted wellness and recovery.

At this inspection, we found that there were some risks associated with medicines because the provider did not have secure enough arrangements in place to ensure that medicines were stored suitably. Some quality assurance checks had been ineffective which could put people at risk. We have made compliance actions about the management of medicines and quality assurance.

6th October 2011 - During a routine inspection pdf icon

We carried out an unannounced inspection on the 6th October 2011. We spoke to eight people who live at St Deny’s and overall they were all happy with the care and support which they receive. Comments included:

“I am happy here and the staff are really supportive”.

“I have settled in really well here”

“Get treated as a human being here, which you don’t get in some places”.

About staff people said:

“They are all very good, they have been very encouraging to me”.

“Staff always knock on my door and will listen to me if I say I want time on my own”.

People told us that they are involved in the planning of their care and are given choices when it comes to how they are supported on a daily basis and what activities they want to do.

Staff had good opportunities for training and support and people who lived at the home were positive about the staff approach and felt safe and comfortable with the staff group who worked with them.

Good systems were in place to ensure that the views of people living at the home and staff were used to drive up any improvements.

1st January 1970 - During a routine inspection pdf icon

This unannounced comprehensive inspection took place on 16 and 17 December 2015. St Denys is registered to provide care and support for up to 12 people with mental health conditions. At the time of the inspection there were 11 people living at the service.

There was a registered manager in post who is also the registered provider. 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.

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection, one person who had moved to St Denys had had a DoLS at their previous home which had been approved. However since DoLS are location specific, it was no longer valid, although the person’s need for a DoLS remained. The registered manager said they would speak with the DoLS assessment team as a matter of urgency to complete an application which was applicable to this service.

We brought forward this inspection in light of receiving some information of concern which indicated there may not be enough staff to meet everyone’s assessed needs.

We found staffing levels needed to improve and the rota needed to more accurately reflect what management support was available and on what days. The service had taken a person back following a period of assessment in another service. Their needs had increased significantly and they needed one to one support at key times to enable them to get out into the community. The registered manager said they had been working on recruiting staff to enable them to offer additional staffing at key times. They said in the interim, they and the other registered provider had been coming in to support people and staff on a more frequent basis. This was not however reflected in the staffing rota. Staff said they were stretched to complete all cleaning and cooking tasks as well as provide care and support to people.

When we last inspected, we found improvements were needed in relation to recruitment. At this inspection we saw there had been improvements and all checks and references were being completed before new staff were started as part of the staff team. Some of the checks were not readily available within the recruitment files, but by the second day, had been found.

When we last inspected we found improvements were needed in respect of safe management of people’s medicines. During this inspection we found improvements had been made and the management of medicines was safe, but further improvements were identified to make the system robust and fully protect people.

Staff reported they would like more specialist training in areas such as working with people who present with challenging behaviour and understanding specific mental health conditions. We were assured by the registered manager this training had been planned and was due to be delivered in the coming months.

People said their needs were being met by staff who knew them and treated them with respect and dignity. People confirmed they were supported to have their healthcare needs, including seeing their GP and specialist community nurses when needed.

Care and support was being well planned and any risks were identified and actions put in place to minimise these. People had access to their plans when requested. One person told us they found it ‘‘makes me anxious to see my file. I talk to staff if I need anything.’’ Daily records showed people’s personal, health and emotional needs were monitored.

The provider ensured the home was safe and that audits were used to review the quality of care and support being provided. This took into consideration the views of people using the service and the staff working there.

 

 

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