Archived: St Mark's Care Home

Updated 7 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 September and 3 October 2017. The first day of the inspection was unannounced, which meant that the staff and provider did not know we would be visiting. We informed the provider of our visit to the service on 3 October 2017. The inspection was carried out by one adult social care inspector 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.

Before the inspection we reviewed all the information we held about the service, which included notifications submitted to CQC by the provider. We emailed the local authority commissioning team and the safeguarding team at the local authority to gain their views.

We had not requested a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

During the inspection we reviewed a range of records. This included four people’s care records including care planning documentation and medicines records. We also looked at six staff files, including supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the manager, acting deputy manager, activity co-ordinator, two nurses, four care staff and an agency care worker who was providing one to one support to a person who used the service. After the inspection we spoke with the registered manager on the telephone and exchanged numerous e-mails. During the inspection we spoke with 10 people who used the service and seven relatives. After the inspection we spoke with an additional two relatives on the telephone.

Updated 7 December 2017

St Mark’s Care Home provides personal and nursing care to a maximum of 39 people who are living with a dementia or a mental health condition. At the time of the inspection there were 35 people who used the service.

St Mark’s Care Home is an established service, which had been previously registered under a different provider. This is a first inspection of a newly registered service.

This inspection took place on 26 September and 3 October 2017. The first day of the inspection was unannounced, which meant that the staff and provider did not know we would be visiting. We informed the provider of our visit to the service on 3 October 2017.

The service had a 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of the inspection the registered manager had taken on an additional role for the provider so was not working full time at the service. However, the clinical services manager was acting as an interim manager. For the purpose of the report we will refer to them throughout as the manager.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

We received mixed reviews when we asked people, staff and relatives if there were enough staff on duty to meet the needs of people. We spoke with the registered manager after the inspection who told us they would review people’s needs and speak with the provider with a view to increasing staffing levels.

We have made a recommendation about reviewing staffing levels.

Since the registration of the new provider no new staff had been employed. However, the manager told us about the pre-employment checks that were made to reduce the likelihood of employing people who were unsuitable to work with people.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.

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. However, further work was needed to ensure decision specific Mental Capacity Assessments and best interests decisions were in place when people lacked capacity.

People were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services.

There were positive interactions between people and staff. We saw staff treated people with dignity and respect. Staff were kind, caring and interacted well with people.

Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care need. Staff encouraged people to actively participate in meaningful leisure and recreational activities that reflected their social interests and wishes, and maintain relationships with people that mattered to them. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the management team. Quality assurance processes were in place and regularly carried out to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met. Feedback was sought from people who used the service through regular meetings’. This information was analysed and action plans produced when needed.