A Care Quality Commission inspection of a Warrington care home based in Collins Green has revealed concerns over safety and leadership with an overall rating of “requires improvement.”
The inspection took place at St Mary’s Continuing Care on Penny Lane, Collins Green, Warrington, in March this year.
The service is a care home providing support for up to 63, including those living with acquired brain injury, early onset dementia, mental health support needs and older people living with dementia. At the time of the inspection 62 people were living at St Mary’s Continuing Care. This was a responsive assessment due to concerns the CQC received about the administration of medicines and peoples safety.
They found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to medicines and good governance.
Governance systems were not always effective enough to monitor and improve the quality of the service regarding medicines and care records. The service has been rated requires improvement following this assessment. The provider supported staff wellbeing and staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Leaders were visible and supportive, helping staff develop in their roles. From the concerns highlighted during this inspection no service user came to any harm.
People’s experience of this service
People and their loved ones were positive about the quality of their care. They felt safe and were fully involved in planning their care and understood their rights. People said they received high quality care from knowledgeable staff who treated them as individuals. One person’s loved one said, “I cannot question the care my loved one receives.” People and their loved ones described how staff treated them with respect and ensured they were treated with dignity and respect. People and their loved ones felt able to complain and where confident action would be taken, and improvements would be made. One person’s loved one told us, “St Marys is a safe environment for my loved one I can go on holiday and relax as I have no concerns all the equipment profiling bed, reclining chair is provided my loved one is given the choices where they want to sit, what they want to eat and do”.
Regarding safe, at the last assessment, the CQC rated this key question good. At this assessment the rating changed to requires improvement. This meant some aspects of the service were not always safe and there was an increased risk people could be harmed.
This service scored 59 (out of 100) for this area.
The provider did not always work well to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services. We found inaccurate information in peoples care plans including important information such as deprivation of liberty assessments, preferences and inconsistent information. Staff demonstrated they knew people well and understood their needs, but inspectors found evidence peoples care plans did not contain relevant information. Health professional said they worked with the service to meet people’s needs, and they were always open and worked in collaboration. Referrals were in place for services such as speech and language therapy (SALT), occupational therapy and GPs.
The provider did not always work well with people to understand and manage risks. However, the care, staff did provide to meet people’s needs was safe, supportive and enabled people to do the things that mattered to them. Whilst risks to people’s personal safety had been assessed care plans did not always record the care needed to minimise these risks and keep people safe.
The service did not always make sure the management of medicines was safe, and care plans did not always contain the required information to support staff to administer medicines safely.
Regarding Well-led inspectors looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.
At their last assessment we rated this key question good. At this assessment, the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.
This service scored 61 (out of 100) for this area.
The provider did not have sufficient systems to assess, monitor and improve the quality and safety within the service. Inspectors found audits were completed by leaders but failed to identify gaps they found during their assessment. For example, shortfalls identified with medicines and up-to-date care records. This was a breach of Regulation 17, Good Governance. Following the inspection the registered manager and nominated individual provided evidence they were addressing the concerns highlighted in this assessment.
The registered manager understood the needs of people living at the home, including their individual circumstances. However, as highlighted in this assessment the provider had not always picked up on the concerns highlighted throughout
From the concerns highlighted during this inspection no service user came to any harm.
The Full report can be read here https://www.cqc.org.uk/location/1-1442898828
