Archived: St Bennett's Care Home

Updated 26 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Bennett’s Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. St Bennett’s Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent to us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvement they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with eight people who use the service and two visiting friends to ask about their experience of the care provided. We also observed staff interaction with people who use the service. We spoke with three visiting health care professionals.

We spoke with the manager, the provider, two senior care staff, five care staff, two cooks and a domestic. We looked at 16 care files along with a range of medication administration records. We looked at other records relating to the management of the service including staff recruitment and audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included training data, quality assurance records and policies. We also contacted an additional four relatives for their feedback.

Updated 26 October 2022

About the service

St Bennett’s care Home provides accommodation and personal care in one adapted building for up to 27 older people, including people living with dementia and people with a learning disability and or autism. At the time of our inspection, there were 20 people living at the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support: Opportunities of choice, control and independence were limited. Activities to pursue interests, hobbies and make future plans were not supported.

People were not supported to have maximum choice and control of their lives. However, staff provided care and support in the least restrictive way possible and in their best interests; the policies and systems in the service however were not consistently adhered to.

Right Care: Staff were kind, caring and provided dignified care. However, care plans were not fully reflective of people’s current care needs. Care was therefore not consistently personalised.

Right Culture: The management team were in the process of developing a new staff team and showed a commitment in wanting to make improvements at the service. This included developing a positive staff culture and empowering people by improving their care and support experience and opportunities.

Risks associated with people’s care and treatment had not been consistently assessed and planned for. Guidance for staff of how to manage and mitigate known risks was not always available, up to date or sufficient in detail. Environmental health and safety risks had also not been consistently assessed, planned for and monitored.

Medicines were not consistently managed safely or effectively, and best practice guidance was not always followed. Safeguarding procedures did not fully protect people. Where authorisations to deprive a person of their liberty had been granted with conditions, these had not been reviewed and monitored as required.

Staff deployment was not sufficient. The provider did not use a dependency tool to assess people’s care needs. Care staff were also required to complete domestic tasks, and this had a negative impact on their availability to meet people’s care needs.

The provider’s systems and processes to assess and monitor quality and safety were not robust. This impacted on the provider’s oversight and leadership. Care records and documentation was disorganised, not always up to date, insufficiently detailed or missing. The provider’s policies and procedures had not been regularly reviewed to ensure they met current legislation and best practice guidance.

People’s health conditions had not consistently been assessed and planned for. Whilst changes to people’s health were reported to external health professionals and recommendations implemented, record keeping reflecting actions were poor.

People received enough to eat and drink but guidance for staff about people’s individual food and hydration needs lacked detail.

Staff were recruited safely and received ongoing training and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was good (published 28 April 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staff deployment, care planning, risk management and the provider’s systems and processes. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to Inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

The provider took some immediate actions to make improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Bennett’s Care Home on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to risk management, the provider’s systems and processes that monitored the service, medicines management, safeguarding procedures and staff deployment.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.