Care service description

St Peter's Care Home is a large four storey building located on Herne Bay seafront. Accommodation includes 43 single rooms, all with en-suite facilities. Communal areas include lounge areas on each floor, two dining areas, an activity room, a library, a hairdressing room and a large garden. The service provides personal care and accommodation for up to 43 older people some of whom may also be living with dementia.

Rating at last inspection

At the last inspection, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People told us they felt safe living at St Peter’s Care Home. Risks to people were assessed, managed and reviewed and action taken by staff to keep people as safe as possible. People were protected from the risks of abuse and staff were confident to raise any concerns with the registered manager.

The registered manager followed safe recruitment processes to make sure staff employed were of good character. There were sufficient staff on each shift and this was regularly reviewed. People received effective care from staff who had the knowledge and skills to carry out their roles.

Changes in people’s health were identified quickly and staff contacted people’s health care professionals for support. People’s medicines were managed safely and people received their medicines in the ways their healthcare professional had prescribed. People were offered a balanced diet and food they liked.

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. Staff knew the importance of giving people choices and gaining people’s consent.

Staff understood the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called DoLS.

People were treated with kindness, compassion, dignity and respect by staff who knew them and their relatives well. People and their relatives were involved in planning their care and support. People received care and support that was individual to them and their needs and preferences.

People had enough to do during the day were supported to follow their interests and take part in meaningful social activities. Staff supported people to maintain relationships with their families and friends.

Complaints were investigated and action taken to address any concerns when needed. People and their relatives told us they had no complaints.

People, their relatives and staff felt the service was well-led. The management team encouraged an open and transparent culture. Regular and effective audits were completed. Action was taken when shortfalls were identified. Notifications had been submitted to CQC in line with guidance.

We used a number of different methods to help us understand the experiences of people who used the service. These included observing the care and interactions between the people who used the service and staff. We also spent time speaking to relatives and people who used the service.

People told us that the service responded to their health needs quickly and that staff talked to them regularly about their plan of care and any changes that may be needed. People spoken with and observations made, did not raise any concerns with regard to the quality of care received. All staff spoken with demonstrated an appropriate level of experience and knowledge that enabled them to support the people who lived at the service with their needs effectively.

We saw that the people who used the service were making choices about their lives and were part of the decision making process. People had their own individual routines which were respected. One person who used the service said "Staff are very good. I have no concerns". Another person said “Food is great, lovely choices and plenty of it”. Another person said "If I was unhappy I would talk to the manager. Staff look after me well. I have no concerns".

The provider may wish to note comments were made with regard to ensuring that sufficient audits and checks were carried out to further strengthen the quality assurance systems within the service.

This was an unannounced inspection that took place on 4 and 6 February 2015.

St Peters Care Home is a large four storey building located on Herne Bay seafront. Accommodation includes 43 single rooms, all with en-suite facilities. Communal areas include lounge areas on each floor, two dining areas, an activity room, a chapel and a hairdressing room. The service provides personal care and accommodation for up to 43 older people some of whom may also be living with dementia. At the time of our visit there were 40 people using the service.

There was a registered manager in place who was present during our inspection. 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.

There were effective communication systems and staff shared appropriate information about the people they were caring for so staff had up to date information about people’s needs. Some of the records relating to care plans, although personalised, were not up to date and did not always contain the most up to date information about people so needed updating. Before our visit the registered manager had carried out an audit of care plans and had identified this. Actions were being taken to improve the information in the care plans. There were handovers between shifts so staff knew what people’s needs were.

Staff told us about the training they received. They said that they had good training and felt it supported them to, ‘Give good care’. Training records showed that staff had a range of training including how to care for people with specific conditions such as Parkinson’s disease. We noted that not all staff had received appropriate updates to their initial training. A new training and development programme was in place to address this. New staff received an induction and all the staff we spoke with told us they felt well supported by the registered manager. Recruitment procedures safeguarded people because they were thorough and ensured all appropriate checks were carried out before new members of staff were employed. There was enough staff on duty to support people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the service was currently subject to a DoLS, the manager was seeking further support to ensure no one was at risk of having their liberty deprived. Policies and procedures were in place relating to the Mental Capacity Act 2005 (MCA) and the DoLS.

When people lacked the mental capacity to make decisions the home was guided by the principles of the MCA to ensure any decisions were made in the person’s best interests.

People said they felt safe. One person said, “I feel quite safe living here and I don’t have to worry about anything”. Relatives told us they were confident that their relatives were safe. One relative told us, “M

y life is easier because Dad is so well cared for; they (staff) make sure people are kept safe”. Staff understood how to keep people safe and protect them from abuse. Staff had been trained in safeguarding people and understood the importance of reporting any concerns.

People felt staff were caring and kind and listened to them. People told us they helped them promote their independence and offered support in an unobtrusive manner. Relatives told us that they considered the staff at the service to be respectful and that they, ‘Always had time for people’. Staff knew and understood what people liked and didn’t like. People were listened to and said they received the help they needed in the way they wanted.

People could choose from a range of activities. This included a range of in-house activities such as social gatherings, outside entertainers and making and selling arts and crafts. People attended local clubs where they could meet likeminded people and stay in touch with the community and were planning a variety of trips out in the warmer summer months. People were able to go out on their own if they wanted to. People, who were not safe to do so, were supported by staff. 

Regular church services were held for people of different denominations and people were able to take Communion in private.

People were supported safely with their medicines. Any risks associated with medicines were assessed and managed. Some people chose to manage their own medicines and were supported to do this. People received appropriate health care support. People’s health needs were monitored and referrals made to health care professionals if any concerns were identified.

P

eople were offered and received a healthy and balanced diet. People could choose what they wanted to eat and there was a range of different meals including a vegetarian option. People could choose where they wanted to have their meals.

Staff understood the aims and philosophy of the service, their roles and what their accountabilities were. Staff were motivated and had confidence in the registered manager.

There was a complaints procedure and people and their relatives knew who they could raise any concerns with. Everyone we spoke with either told us that they had no complaints or if they had to make comments, any concerns were acted upon immediately.

There were systems in place for monitoring the quality of the service provided and actions were taken to address any shortfalls.

Systems were in place to make sure that the registered manager and staff learned from events such as accidents and incidents.