CQC report explained · a residential care home
What the CQC found at St Joseph's
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, detailed assessments of risks and generally safe medicines management. Two missing protocols for medicines given as needed were put in place immediately after the inspection.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found knowledgeable managers, a positive staff culture and systems for checking quality and learning from mistakes. Repositioning charts and fluid output records were not always accurate.
What inspectors found, March 2023
Rated Good; inspectors found improvements in safety and leadership, with some records still needing better accuracy.
The unannounced inspection took place on 7 March 2023. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They also observed care and checked care, medicines, training, recruitment and quality records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, detailed risk assessments, safe medicines practice overall, good infection control and systems for learning from accidents and incidents. People and relatives generally said they felt safe and communication was good.
This was a focused inspection of Safe and Well-led only. The other key questions were not inspected during this visit, so their previous ratings were used in calculating the overall Good rating. The previous overall rating was Requires Improvement, published on 8 August 2019.
Detailed risk planning
Risks to people's health and wellbeing were identified and assessed in detail. Staff had guidance on how to reduce risks and recognise changes in health.
“Risks to people's health and well-being had been identified and thoroughly assessed.” from the report
Safe medicines practice
Medicines were ordered, stored, administered and disposed of safely overall. Staff who administered them had been trained and assessed as competent.
“Medicines were ordered, stored and disposed of correctly and administered by staff who had been trained and assessed as competent in safe medicines practice.” from the report
Positive leadership
Inspectors found an open culture where staff could raise concerns and managers used incidents and safeguarding issues to look for improvements.
“Managers and senior staff promoted a culture of honesty and learning from mistakes.” from the report
Good communication
Relatives said communication was good and that they could share feedback and ideas with the home.
“Relatives told us communication was good and they felt able to share feedback and ideas.” from the report
Some care records were not accurate
needs fixingRepositioning charts and fluid output records did not show the same accuracy as other records. The registered manager said this would be addressed with staff.
“However, we found repositioning charts and fluid output records did not demonstrate the same level of accuracy.” from the report
Two medicines protocols were missing
needs fixingTwo protocols for medicines to be given as needed were missing when inspectors checked. The manager acted immediately to put them in place.
“We found two instances where protocols were missing.” from the report
Some people waited for assistance
minorInspectors found there were enough staff overall, but three people said they sometimes had to wait for help.
“However, 3 people told us they sometimes had to wait for assistance.” from the report
- 01How do you now check that repositioning charts and fluid output records are complete and accurate?
- 02How do you make sure every as-needed medicine has a clear protocol for staff to follow?
- 03How do you adjust staffing during busy times so people do not wait too long for assistance?
- 04What improvements have been made since the previous Requires Improvement rating in 2019?
- 05How will you tell families about any further problems found through your quality checks?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 18 March 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, August 2019
Rated Requires Improvement; inspectors found kind, responsive care, but safety records and management checks were not consistently reliable.
The inspection took place without notice on 15 and 16 July 2019. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They observed care and reviewed care plans, medicines records, food and drink charts, complaints, audits and training records.
People were generally treated with kindness and respect. Their care needs were assessed, care plans were in place, and people had access to food, drinks, activities, healthcare and pastoral support. Staff knew people well and usually understood how to reduce risks such as falls.
The inspectors found important safety and record-keeping problems. Staff did not always follow guidance for medicines given through skin patches, and food and fluid charts were sometimes late, incomplete or inaccurate. Some staff also felt night staffing levels might be too low, although the manager was reviewing this.
The home had improved since the previous inspection and was no longer breaching regulations. However, it remained Requires Improvement because improvements had not yet been fully embedded. Safe and Well-led were rated Requires Improvement, while Effective, Caring and Responsive were rated Good.
Kind and respectful care
People and relatives described staff as caring and supportive. Inspectors saw staff protecting people's dignity and involving them in choices.
“People and relatives told us they had no complaints.” from the report
Good understanding of risks
Staff knew people well and followed risk plans, including plans to reduce falls. The use of bedroom alert lights had reduced falls.
“Staff knew people well and followed risk management plans.” from the report
Personalised support
People had individual care plans and a short overview of their needs for staff to use. Staff responded to individual anxiety and communication needs.
“There was a detailed 'at a glance' snapshot of people's individual needs and how these should be met, which provided key information for staff.” from the report
Activities and faith support
People could take part in activities and continue their hobbies. The home supported people's pastoral and faith needs, including access to Mass and quiet spaces.
“People's pastoral and faith needs were met.” from the report
Medicine patch instructions
seriousStaff did not always follow the manufacturer's instructions for skin patches. Records showed that recommended rest time for the skin was not always given.
“Staff did not always follow the manufacturer's guidance related to the administration of medicines.” from the report
Food and drink records
seriousFood and fluid charts were sometimes completed late, left incomplete or recorded inaccurately. This meant staff might not know how much a person had drunk.
“Staff did not consistently complete or record accurate information, on important charts related to people's food and fluid intake.” from the report
Night staffing review
needs fixingSome staff said seven staff were not enough at night. The manager was reviewing whether an additional night worker was needed because people's needs had changed.
“Some staff felt levels at night were not enough.” from the report
Management checks
needs fixingQuality checks did not always cover the areas where problems were found. For example, medicine audits did not check whether manufacturer's instructions were followed, and food and fluid charts were not always checked properly.
“Improvement was needed in the managerial oversight of important records.” from the report
- 01What checks now make sure staff follow the manufacturer's instructions for medicines given through skin patches?
- 02How do you check food and fluid charts are completed promptly and accurately for each person?
- 03What decision was made about increasing night staffing from seven to eight staff?
- 04How has the April 2019 staffing restructure been embedded, and how do senior carers now oversee each wing?
- 05What further training has been completed in diabetes care, skin integrity, nutrition and hydration?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided; the inspection followed the home's previous Requires Improvement rating. This explanation was written from the published report of 9 August 2019 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 Joseph's
4 rated inspections over 7 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 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 30 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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