CQC report explained · a residential care home
What the CQC found at St James House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors were assured about infection prevention, PPE, testing, cleanliness, visiting arrangements and the management of outbreaks. They recommended that the home always record vaccination checks for professional visitors.
- Effective?
- Good
- This area was not assessed during this targeted inspection.
- Caring?
- Good
- This area was not assessed during this targeted inspection.
- Responsive?
- Good
- This area was not assessed during this targeted inspection.
- Well-led?
- Requires improvement
- This area was not assessed during this targeted inspection.
What inspectors found, February 2022
St James House was rated Requires Improvement; inspectors found good infection control but gaps in records for professional visitors.
This was an announced, targeted inspection on 19 January 2022. One inspector looked at infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19.
Inspectors found staff had infection control training and used personal protective equipment correctly. The home had increased domestic staff hours to support cleanliness. People could keep in touch with relatives and receive visitors using procedures to reduce infection risks.
The home was meeting the requirement to check that non-exempt staff and professional visitors were vaccinated against COVID-19. However, it did not always keep a record of these checks for professional visitors. The overall rating was Requires Improvement, but Safe was inspected and not rated.
Infection control training
Staff had received training on infection control and the safe use of personal protective equipment. Inspectors saw PPE being used in line with government guidance.
“Staff had received training on infection control and the safe use of personal protective equipment (PPE).” from the report
Cleanliness
The home increased domestic staff hours to help maintain high standards of cleanliness.
“The provider had increased the number of hours worked by the domestic staff in the home to ensure high standards of cleanliness were maintained.” from the report
Contact with relatives
The home supported contact with relatives and provided visiting arrangements designed to reduce the risk of infection.
“The provider was supporting people to maintain contact with their relatives in line with guidance in place at the time of the inspection.” from the report
Infection prevention arrangements
Inspectors were assured that the home had arrangements covering PPE, testing, hygiene, admissions and managing outbreaks.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Incomplete vaccination records
minorThe home was checking vaccination status, but it did not always keep a record of checks for professional visitors. Inspectors made a recommendation to improve this.
“We have recommended the provider ensures a record is always maintained of such checks for all professional visitors.” from the report
- 01How do you now record vaccination checks for every professional visitor?
- 02What happens if a professional visitor cannot show that they are vaccinated or exempt?
- 03What infection control training have staff completed, and how do you check that PPE is being used correctly?
- 04How would visiting arrangements work if indoor visiting had to be restricted again?
- 05What staffing pressures were present during the inspection, and what measures are in place to manage them?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; Safe was inspected but not rated, and the other areas were not assessed. This explanation was written from the published report of 9 February 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.
What inspectors found, March 2020
St James House was rated Requires Improvement; inspectors found kind, effective care but unsafe medicines management and weak oversight.
Inspectors visited without notice on 3 March 2020. They observed care, checked the building, spoke with people, a relative, staff and a health professional, and reviewed care, medicine, staff and management records.
The main concern was medicines. Records showed that people had not always received medicines as prescribed. There were 53 medicine errors in the three weeks before the inspection, including 23 where people did not receive their prescribed medicines. Inspectors found no evidence of harm, but said the medicines systems were not safe enough.
People told inspectors they felt safe and that staff were kind and respectful. Staffing, recruitment, training, care planning, food, activities and links with health professionals were generally good. The home was clean, although flooring was due to be replaced to reduce odour.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Effective, Caring and Responsive remained Good.
Kind and respectful staff
People spoke positively about staff's kindness, respect and support for independence.
“People told us they felt safe in the home and that staff were always kind and caring.” from the report
Enough trained staff
Inspectors found enough staff to meet people's needs promptly. Staff had the training and support needed for their roles.
“There were sufficient numbers of staff on duty to meet people's needs.” from the report
Personalised care
Care plans included people's needs, preferences, backgrounds, communication needs and interests. People were involved in reviewing their care.
“Care plans provided detailed information for staff to follow to ensure they met people's needs in the way they wanted.” from the report
Good activities and food
People enjoyed the meals and could ask for alternatives. They could take part in activities such as bingo, dominoes and chair-based exercise.
“People enjoyed the food provided in the home.” from the report
Medicines not always given safely
seriousPeople did not always receive medicines as prescribed. Inspectors found 53 medicine errors over three weeks, including 23 where people missed prescribed medicines.
“Medicines were not always safely managed. Records showed people had not always been given their medicines as prescribed.” from the report
Medicine checks were too weak
needs fixingThe home's audits identified errors but did not clearly record what managers did afterwards or whether professional advice was sought.
“Although errors had been identified through the audit process, these records failed to show what action the management team had taken or whether they had contacted other professionals for advice.” from the report
Odour in communal areas
minorThe home planned to replace flooring in a ground floor corridor to help reduce an odour.
“The provider had plans to replace the flooring in the ground floor corridor to help reduce odour in the home.” from the report
- 01How many medicine errors have happened since the inspection, and what evidence shows they have reduced?
- 02How are medicine administration records checked each day, including missed signatures and missed doses?
- 03What action is taken when a medicine error happens, and when is advice sought from health professionals?
- 04What progress has been made with the action plan sent to CQC?
- 05Has the flooring been replaced, and has this resolved the odour in the communal areas?
This was an unannounced planned inspection covering all five CQC questions, with care and the premises both assessed. This explanation was written from the published report of 28 March 2020 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 James House
8 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2020Requires improvementdown from Good
- October 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: Requires improvement
- July 2015Inspected but not ratedSafe: Requires improvement
- March 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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