About the service: St Petroc’s is a residential care home in Bodmin that provides personal care for up to 30 older people, some of whom are living with dementia. 23 people lived at the service when we visited.

People’s experience of using this service:

We identified several safety risks identified in relation to the environment. People were at increased risk of scalds because hot water temperatures in wash hand basins in bathroom, shower and numerous bedroom areas were too hot. One fire exit was poorly maintained and another wasn’t properly sealed which meant it would not prevent the spread of a fire. Other safety risks included uncovered electric portable radiators, which were hot to touch, and a pressure relieving mattress which wasn’t working properly. An unmarked change of floor level was a slip, trip, fall hazard for people.

We brought these risks to the attention of the registered manager. Since the inspection, they have contacted us to confirm work undertaken to further reduce the risks.

Other parts of the environment and equipment were well maintained. People had detailed personalised risks assessments which showed ways staff reduced individual risks for people, such as falls risks.

People said they felt safe living at the home, and further work was underway to improve security. There were enough staff to keep people safe and meet their needs. People were protected because staff knew about signs of abuse and felt confident to report concerns. People received their medicines safely and on time. People were protected from cross infection by good hygiene measures.

We observed caring interactions between people and staff around the home. However, on the first day of the inspection, people had a very poor dining experience. They waited a long time for their meal and people who needed assistance were not appropriately supported. We fed back our observations of people’s lunchtime experience to the registered manager, who spoke with staff and made sure people’s dining experience the next day was improved. Since the inspection, the registered manager has promoted improved staff practice through regular mealtime observation.

The service was an old Victorian building. Some adaptations in bathroom/toilet areas had been made to meet people’s needs but further improvements in disabled access were needed. For example, some toilets areas were not easily accessible. The registered manager explained refurbishment was currently on hold as the provider was looking at the feasibility of a major extension to create additional rooms. Some improvements in the environment and equipment had been made. The lounge had recently been redecorated. Electric profile beds had been purchased which were easier for people to get in and out of, and minimised moving and handling risks for staff.

Most people said staff treated them with dignity and respect and people looked well cared for. Families could visit anytime and were made welcome. Several people participated in their local community. People and relatives said staff consulted them in decision making, although their involvement was not always well documented.

People said they didn’t always do enough to occupy them and we identified meaningful activities as an area for improvement. People’s care records included personalised details about their life history, preferences and communication needs. Most people's care plans were detailed about their individual needs and preferences, with one exception, which we made the registered manager aware of.

People were supported to have a comfortable, dignified and pain-free death. Where people had expressed any advanced decisions about resuscitation, this was recorded in their care plan. However, records of people’s wishes for their end of life care and any preferred funeral arrangements needed improvement.

People knew how to raise concerns and complaints and any concerns were positively responded to with improvements made in response. Howe

This inspection took place on 11 and 14 July 2016 and was unannounced.

St Petroc’s Care Home is a residential care home which provides care and support to older people, some of whom have dementia. Accommodation is set over two floors, with spacious shared lounges and a dining room. There are also well maintained gardens which people can easily use. The home can accommodate up to a maximum of 30 people. At the time of our visit there were 26 people living at the service.

The service 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.

We observed positive and caring interactions between people and staff. Staff took the time to stop and chat with people and to share appropriate humour. Staff knew the people they cared for well and spoke about them with fondness and affection.

People’s rights were not always protected under the Mental Capacity Act 2005 (MCA). Although staff had undergone training and some were knowledgeable about the principles of the Act and how it applied to their role, some records were inaccurate. For example, some people’s records showed they had the capacity to make decisions for themselves, but then went on to describe best interest decisions staff were making on their behalf. Some people’s relatives had been asked to sign to agree to elements of a person’s care plan without the correct legal authority to do so.

People’s care records did not always reflect changes in their health needs. Some records were kept but these often lacked detail and were not always used to update people’s care plans or risk assessments so staff knew how best to support them.

People enjoyed the meals. They told us they were of sufficient quality and quantity and there were alternatives on offer for people to choose from. People were involved in planning the menus and their feedback on the food was sought.

People had their healthcare needs met. For example, people told us they had their medicines as prescribed and on time. People were supported to see a range of healthcare professionals including district nurses, chiropodists, doctors and social workers.

People were kept cognitively and socially engaged through a range of activities, both inside the service and in the local community. The service employed an activities coordinator and there was an activity on offer each day. People were involved in suggesting activities.

People were kept safe by suitable staffing levels. People told us there were enough staff on duty and that their needs were met in a timely manner. Interactions between people and staff were unhurried. Staff recruitment practices were safe. Checks were carried out prior to staff commencing their employment to ensure they had the correct characteristics to work with vulnerable people.

Staff had sufficient training to carry out their roles effectively. Staff had received training relevant to their role and there was a system in place to remind them when it was due to be renewed or refreshed. Staff were supported by an induction and there was an ongoing programme of staff supervision and appraisals.

There was a safeguarding adults policy in place at the service and staff had undergone training on this subject. Staff confidently described how they would recognise and report any signs of abuse. There were also policies in place around the duty of candour and whistleblowing. This encouraged an ethos of openness and honesty.

People, staff and relatives were encouraged to give feedback through a variety of forums including team meetings, residents’ meetings and questionnaires. This feedback was used to drive improvements within the service. There was a system in place for receiving and managing

We spoke with three people who used the service and spent time observing people and staff during the day. Some of the people who used the service were not able to comment in detail about the service they received due to their healthcare needs.

We saw people’s privacy and dignity was respected and staff were helpful. We saw people chatted with each other and with staff.

We obsevered staff had positive interactions with people. People told us staff answered their call bells promptly. One person told us the staff were “polite and friendly”. Another person said, ”I am very happy here, no complaints”. People told us the food was good and they were offered choices. We were told visitors were welcome. One person said “I can go to bed when I want, if I wanted to go out someone would take me”. Another person told us they were involved in the planning of their care.

We heard care staff ask people what they would like to do and they shared ideas if people could not make a choice.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective).

We spoke with seven people during our inspection visit on 7 August 2012. Everyone was appreciative of the manner in which the staff communicated with them and were in agreement with the use of first names.

People spoken with indicated that their gender preference of carer was respected. This was supported by information seen in care plans examined.

People had a choice of several places in which to sit, the lounge - watching television or taking part in activities, in the dining room or in the entrance hallway watching people going about their business and greeting visitors coming and going.

Everyone said that they got up and went to bed, at a time of their own choosing and could have baths or showers whenever they wished.

One person said of the staff ”they are as good as gold with me, couldn’t be any better, I’m very contented”. Another said, “I couldn’t wish to be in a better place, very peaceful here. I used to have a flat and now I look on this as my little bed-sit”.

Another said “I get on fine with the carers. I quite like it here”

During the morning we saw several people reading current newspapers in the lounge, others reading a book and one person was knitting.

We were told that a Service of Holy Communion was carried out in the home once a month.

Various activities included bi-monthly “mystery” trips out in a mini-bus, monthly trips to a local supermarket and an annual visit to view Christmas light displays in local Cornish villages. In house activities included bingo, cards, reminiscent sessions, movies, skittles, hangman and bowls, all organised by various carers. There was also a weekly visit by a hairdresser.

There were several bookcases throughout the home containing a wide variety of both large print and standard print books. People told us that they liked the choice available and felt included in deciding what activities should be available. The registered manager told us decisions about what to provide were made during residents meetings and review meetings with individuals and/or their representatives.

All seven people that we spoke with were pleased with the food and one person spoke of regaining weight previously lost due to illness. People confirmed that if they were absent from the house at a mealtime a meal would be available on their return.

At lunchtime carers assisted diners in an appropriate manner sitting alongside them and engaged them in friendly and meaningful conversation.

People were asked if they had sufficient to eat before plates were removed.

People who used the service said that they felt safe and secure at St Petroc’s and had no concerns about the security of their possessions.

Everyone spoken with was confident that the staff understood their needs and were fully trained to undertake their roles.

People told us that they understood about the care and treatment they were receiving.

They told us about how their choices and preferences were listened to and how they were involved in making decisions about how their day was organised and spent.

They told us how their privacy and dignity was respected; they told us staff always treated them kindly. People told us about the staff, they told us that they were kind, thoughtful and that they were skilled to meet all of their needs. They said that there were enough staff at all times and that they responded promptly to requests for help.

People told us about the meals provided at the home, they told us there was enough

choice and variety and that the standard of the food was consistently good. For those

people who were not able to talk with us, we observed how they were supported to eat and drink and how their preferences were managed.

Staff and people who use the service told us how peoples care was coordinated by the

input of other health professionals such as the doctor, district nurses and specialist

practioners.

People and staff told us that the home was clean. They told us about the surroundings

saying that they had the right equipment to meet their needs. We looked at the security arrangements in place to ensure their safety. We saw that the home was not securely locked and we were able to walk in unobserved during the day but the home is secured in the evening.

Staff and people using the service told us that their views are sought.

They told us that they were confident that should they wish to comment or complain then they would be listened too and the appropriate action taken.