CQC report explained · a nursing home
What the CQC found at St Anthony's
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found risks with medicines, staff competence and management systems, including breaches of regulations.
This was an unannounced focused inspection. Inspectors visited on 17 and 22 August 2023, spoke with people, relatives and staff, and checked care records, medicines records, staff files and quality checks.
The home was not always safe. Inspectors found missed and incorrectly recorded medicines, unsafe medicine storage, incomplete incident records and staff carrying out a clinical task without the right training. Some newly recruited staff were not sufficiently competent or able to communicate well enough to meet people's needs safely.
The home was also not well-led. Quality checks did not reliably find or fix problems. Staff morale was low, and people and relatives were not always asked for feedback. The provider said it took immediate action after the inspection, but the report does not confirm that these changes had been fully embedded.
The overall rating changed from Good at the previous inspection, published on 28 July 2021, to Requires Improvement. Only Safe and Well-led were inspected in detail at this visit. The other ratings carried over from the previous inspection.
Experienced staff
People said they felt safe when supported by experienced staff who understood their needs and preferences.
“People told us they felt safe when they received support from experienced staff who were able to communicate with them effectively.” from the report
Safeguarding
Staff knew how to report abuse, and safeguarding referrals were made when needed.
“Safeguarding referrals had been submitted when needed.” from the report
Mental capacity
Inspectors found that the home was working within the principles of the Mental Capacity Act and had appropriate legal authorisations where needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Working with professionals
The home worked with specialist professionals and the local authority quality team to improve support.
“The provider worked closely with professionals including Speech and Language Therapists (SALT) and occupational therapists to ensure people received the support they needed.” from the report
Medicines safety
seriousMedicines were sometimes missed, late, incorrectly recorded or stored without the required temperature checks. Inspectors said this placed people at risk of harm.
“People's medicines were not always administered safely and as prescribed.” from the report
Staff competence and communication
seriousSome newly recruited staff were not sufficiently competent in moving and handling or in English language skills. This meant people could wait longer or receive care that did not meet their needs safely.
“The induction process was not effective in ensuring staff had the language skills and competence to meet people's needs safely.” from the report
Untrained clinical task
seriousCare staff told inspectors they had removed people's PEGs while waiting for nursing staff, even though they had not been trained to do this.
“Two care staff told us they had removed people's percutaneous endoscopic gastronomy (PEG's) on occasions as they were waiting too long for nursing staff to do this.” from the report
Weak quality checks
needs fixingThe home's audits and care record checks did not reliably identify or fix medicines, risk and documentation problems.
“Systems in place to check the quality of the service were not always effective in identifying concerns.” from the report
Staff morale and culture
needs fixingStaff described morale as very low and said they did not feel supported. People and relatives were aware of the poor culture.
“Staff told us the morale in the home amongst staff was negative.” from the report
Infection control practice
needs fixingAlthough staff had infection control training, inspectors could not be assured that everyone followed the policy. They were told about PPE and bodily-fluid disposal concerns.
“The provider could not always be assured all staff understood and complied with this.” from the report
- 01What changes have you made to prevent missed, late or incorrectly recorded medicines, and how do you check that these changes are working?
- 02How do you assess new staff's moving and handling skills and English language ability before they work independently?
- 03How do you make sure only trained nursing staff carry out PEG-related tasks?
- 04What are the current response times to call bells, and how are these checked now that the previous audit was unreliable?
- 05How are you improving staff morale and making sure concerns raised by staff and residents lead to action?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection published on 28 July 2021. This explanation was written from the published report of 12 January 2024 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 2021
St Anthony's rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced, planned inspection on 22 June 2021. Two inspectors spoke with three people and nine staff, observed care, and reviewed care plans, medicines records, staff files and management records. They also checked infection control arrangements during the COVID-19 pandemic.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable risk assessments, good infection control and investigations into accidents and incidents.
People were described as receiving kind, respectful and personalised care. They were involved in decisions, supported to stay independent and helped to maintain relationships, activities and access to the community.
The Effective and Well-led ratings improved from Requires Improvement at the previous inspection under the previous provider, published on 15 May 2019. Inspectors found that earlier concerns about mental capacity records and governance systems had been addressed.
Safe staffing and medicines
Inspectors found enough staff to respond to people's needs promptly. Medicines records had no gaps, and medicines were stored and checked safely.
“People received their medicines when they needed them, and systems were in place to ensure that medicines were stored and administered safely” from the report
Kind and respectful care
People and relatives gave positive feedback about staff. Inspectors observed compassionate interactions and support for people's dignity, choices and independence.
“We observed many respectful and compassionate interactions during the inspection.” from the report
Personalised communication
The home recorded people's communication needs and used communication passports. Staff had also been trained to use Makaton.
“The home had also created separate communication passports for people.” from the report
Improved leadership
Inspectors found stronger governance systems than at the previous inspection. Regular checks were used to identify issues and make improvements.
“At this inspection we found that the governance systems had been strengthened further.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and regularly review my relative's changing care and nursing needs?
- 02How will you support my relative's particular communication needs, including any communication passport or use of Makaton?
- 03How will my relative be involved in care reviews, and how will you involve family members in decisions if they cannot make a particular decision themselves?
- 04How do you calculate staffing levels when people's needs change, and how do you maintain familiar staff when agency workers are needed?
- 05What activities and community visits are currently available, and how will you support my relative to maintain family, social and religious connections?
This was an unannounced planned inspection covering all five CQC questions, including infection prevention and control arrangements during the COVID-19 pandemic. This explanation was written from the published report of 29 July 2021 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 St Anthony's
9 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- January 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2019Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2018Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: Inadequate
- June 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2019
Registered with the Care Quality Commission on 31 July 2019.
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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