24 March 2023
During an inspection looking at part of the service
St Michael’s Home is a residential care home providing personal care to up to 21 people. The service provides support to older people, some of whom have a diagnosis of dementia. At the time of our inspection there were 15 people using the service.
People’s experience of using this service and what we found
At our previous inspection of St Michael’s Home we identified serious shortfalls in the provider’s oversight of the service which had resulted in people not always receiving safe care and treatment.
At this inspection we found improvements had not been made and people continued to be at risk. This included risks related to people's health and care needs as well as environmental risks. The home was not clean and infection control was not effectively managed. Medicines were not managed safely which placed people at risk of harm. The systems and processes for learning lessons were not robust. The provider had increased staffing levels however people and staff did not think there were enough staff to provide safe care. Staff had received training about how to protect people from the risk of abuse.
Systems to assess, monitor and improve the service were not effective in identifying shortfalls and securing improvements. Opportunities to learn lessons and make improvements to the service had not been taken. There was a lack of effective leadership and there was not a registered manager in place at the time of our inspection. Staff did not always work effectively with other health professionals to ensure people received appropriate care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 16 June 2022).
At our last inspection we found breaches of the regulations in relation to safe care and treatment and the governance of the service. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.
At this inspection, we found the provider remained in breach of regulations.
Why we inspected
We received concerns in relation to the quality of care people received and the management of the home. As a result, we undertook a focused inspection to review the key questions of safe 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 requires improvement to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Michael’s 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 found breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of the full version of this report.
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 will re-inspect within 6 months of the date we published this report to check for significant improvements.
If the registered provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question, we will take action in line with our enforcement procedures. This usually means we will start processes that will prevent the provider from continuing to operate the service.
For adult social care services, the maximum time for being in special measures will usually be 12 months. If the service has shown improvements when we inspect it, and it is no longer rated inadequate for any of the 5 key questions, it will no longer be in special measures.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.