CQC report explained · a residential care home
What the CQC found at Saint Jude Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2023
Requires Improvement; inspectors found caring staff and a clean home, but weaknesses in records, medicines checks and quality monitoring.
Inspectors visited the home without warning on 28 September and 4 October 2023. They spoke with people, relatives and staff, observed care, and checked care plans, medicines records, staff files, training information and management systems.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also rated Requires Improvement. Inspectors found people were generally protected from abuse, staff knew people's needs, the home was clean, and healthcare referrals were made promptly.
There were important weaknesses. Medicine administration records had gaps, some risk and care records lacked enough detail, staff understanding of mental capacity rules was not always strong, and audits did not find all these problems. The provider breached Regulation 17 on good governance. The home had also remained Requires Improvement since the previous inspection and had held that rating for two consecutive inspections.
Staff understood people's risks
Staff knew people's needs and understood what action to take to protect them from harm.
“Staff understood people's needs and risks and knew what action to take to keep people safe from harm.” from the report
Clean environment
Inspectors found the home clean and hygienic. People and relatives also gave positive feedback about cleanliness.
“The home was clean and hygienic throughout. Domestic staff were on site throughout the day and worked hard to maintain a clean environment.” from the report
Healthcare support
The manager worked with healthcare professionals and records showed timely referrals when people's needs changed.
“When people's needs changed, records showed they were referred to external health professionals in a timely manner.” from the report
Open management
The provider was receptive to inspectors' concerns, and people, relatives and staff said the manager and provider were visible and approachable.
“People, relatives and staff told us the manager and the provider were visible and felt they could approach them with any concerns they had.” from the report
Weak quality monitoring
seriousThe home's audits did not identify all the problems inspectors found. Accident and incident analysis was still inconsistent, despite a recommendation at the previous inspection.
“The provider failed to ensure there were effective governance arrangements in place to ensure all concerns related to quality and safety were identified and acted upon in a timely manner.” from the report
Medicine records
needs fixingInspectors were assured that people generally received medicines as prescribed, but multiple gaps showed that records were not always completed after medicines were given.
“However, multiple gaps on medication administration records (MAR) evidenced they were not always completed when medicines were administered.” from the report
Risk and care records
needs fixingSome records did not show measures introduced to reduce falls risk. Pre-admission assessments and some nutrition plans also contained too little information.
“For example, the records for 2 people did not include information about the use of sensor mats that had been introduced when an increased risk of falls was identified.” from the report
Mental capacity understanding
needs fixingStaff responsible for mental capacity assessments did not always understand Deprivation of Liberty Safeguards processes. Some applications had been made when they were not necessary.
“We found no evidence people had been unlawfully deprived of their liberty in practice. However, we found DoLS had been applied for when this was not necessary due to staff misunderstanding the principles.” from the report
Specific staff training
needs fixingMandatory training was completed, but completion of additional training for people's specific needs was low among staff.
“However, when additional training was required to meet people's specific needs, such as training for managing periods of emotional distress, we noted completion rates were low amongst staff.” from the report
- 01How are you now checking that medicine administration records are completed every time medicines are given?
- 02What changes have you made to analyse accidents and incidents for patterns and trends?
- 03How do you make sure care plans record sensor mats and other measures used to reduce falls risk?
- 04What training and checks now ensure staff understand Mental Capacity Act and DoLS processes?
- 05Has the digital care planning system been introduced, and how do you check that it is finding problems the previous audits missed?
This was an unannounced inspection prompted partly by a serious injury notification and focused on Safe, Effective and Well-led; the report does not give separate Caring or Responsive ratings. This explanation was written from the published report of 21 December 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found major progress in safety and management, but risk records and learning from incidents still needed work.
This was an unannounced focused inspection on 14 and 16 June 2022. One inspector spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home had improved significantly since its previous inadequate rating. There were enough staff, recruitment checks were safer, medicines were managed safely, and infection control had improved. The home was clean and visits followed guidance.
Some important weaknesses remained. Incident reviews did not fully identify patterns or lessons. Some risk and care records were not fully person-centred or up to date. The overall rating and the ratings for Safe and Well-led were Requires Improvement.
The previous inspection found breaches of regulations and placed the service in special measures. At this inspection, the provider was no longer in breach and the service left special measures. CQC said it would continue to monitor progress.
Safer staffing and recruitment
Recruitment procedures had improved and inspectors found enough suitably qualified staff to meet people's needs.
“There were enough suitably qualified staff to support people.” from the report
Medicines were managed safely
Medicines were stored and administered safely. Staff responsible for medicines had training and competency checks.
“Medicines were safely managed, stored and administered.” from the report
Improved infection control
The home was clean, cleaning schedules reflected best practice guidance, and visiting followed national guidance.
“The home was clean throughout and cleaning schedules reflected best practice guidance.” from the report
Caring relationships
Inspectors found that staff knew people well and had developed kind, caring relationships. People and relatives were positive about the care.
“It was clear that staff knew people well and had developed kind caring relationships with them.” from the report
More open management
Staff said they felt better supported and that management listened to feedback. People and relatives said the manager and staff were approachable.
“Staff felt more supported in their roles and felt management listened to their feedback.” from the report
Incident learning was incomplete
needs fixingMonthly incident reviews had been introduced, but they did not fully identify patterns, trends or themes. This meant opportunities to improve safety could be missed.
“Analysis of incidents was not completed thoroughly.” from the report
Some risk plans were not current
needs fixingSome risk plans were not fully person-centred or did not reflect people's current needs. One swallowing risk plan had not been updated after an urgent referral, although it was updated during the inspection.
“One person had been referred for an urgent swallowing assessment due to increased risk of choking, but the plan had not been updated” from the report
Care records were not always complete
needs fixingA couple of records did not reflect people's current needs because they had not been updated promptly. These issues were addressed during the inspection.
“Further improvements were needed to ensure they were always accurate and complete.” from the report
- 01How do you now identify patterns and lessons from accidents and incidents?
- 02How do you make sure every risk plan reflects the person's current needs, including swallowing and choking risks?
- 03How quickly are care records updated when a person's needs change?
- 04What checks confirm that staffing levels remain suitable for the people living here?
- 05What progress has been made since this inspection towards achieving a Good rating?
This was a focused inspection of Safe and Well-led, including infection control and previous warning notices; the other key-question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 26 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Saint Jude Care Home
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- December 2021Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015
Registered with the Care Quality Commission on 30 January 2015.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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