CQC report explained · a residential care home
What the CQC found at St Josephs
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable staffing, safe medicines arrangements, up-to-date risk assessments and regular checks of the environment and equipment. Staff understood how to recognise and report abuse.
- Effective?
- Good
- Staff had the skills and training to support people, including people with complex needs. The home worked with health professionals and supported people to make choices, although inspectors discussed improving the choices available at mealtimes.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well, supported their communication needs and involved them in decisions about their care and daily life.
- Responsive?
- Good
- Care plans contained detailed, individual information about people's needs, preferences and communication. Activities and complaints processes were in place, but end-of-life wishes and key family communications were not always clearly highlighted in records.
- Well-led?
- Good
- Audits, feedback and management checks were used to monitor quality and make improvements. People, relatives and staff were encouraged to share their views, and leaders worked with health and social care professionals.
What inspectors found, October 2019
Rated Good; inspectors found safe, kind and personalised care, with some improvements needed to meal choices and end-of-life records.
Inspectors made an unannounced visit on 30 September 2019. They spoke with eight people living in the home, two family members, six staff, managers and a visiting professional. They reviewed four care records and other records about medicines, staffing, training, safety and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, were settled and happy, received medicines on time and had staff available when needed.
Inspectors found detailed care plans, suitable staffing, good support from trained staff and kind relationships. They noted that meal choices could be improved. They also found that end-of-life wishes and important family communications were not always clearly highlighted in care records.
Safe medicines and staffing
People said medicines arrived on time and staff were available when needed. Inspectors found accurate medicines records and enough suitably trained staff.
“Medication Administration Records [MAR] were accurate and easy to follow.” from the report
Kind relationships
Staff knew people well and treated them warmly. Inspectors observed positive relationships and support that respected privacy, dignity and personal choices.
“Staff knew people well and displayed positive, warm and familiar relationships with the people they interacted with.” from the report
Personalised care planning
Care records gave staff useful information about people's needs, preferences and communication. Inspectors found evidence that people were involved in planning and reviewing their care.
“Care plans contained the information necessary for staff to be aware of people's needs and how best to meet their needs.” from the report
Quality monitoring
The home used audits, feedback and management checks to identify shortfalls and make improvements. Families and people living there were given several ways to share their views.
“There were a series of quality assurance processes and audits carried out internally and externally by staff and visiting managers for the provider.” from the report
Meal choices
needs fixingInspectors found mealtimes sociable and saw people being supported, but they discussed with managers how the choices available could be improved.
“We made some comments when we fed back to the managers of the service to further improve people's meal time experience with regard to the choices on offer.” from the report
End-of-life records
needs fixingThere were no people receiving end-of-life care during the inspection. However, inspectors found that end-of-life wishes and key communications with families were not always clearly recorded.
“Considerations such as any specific end of life wishes, and key family communications were not always highlighted in care records” from the report
- 01What meal choices are available each day, and what changes have been made since inspectors discussed improving the choices on offer?
- 02How will you record and review a person's end-of-life wishes and important communications with their family?
- 03Who is currently responsible for managing the home, and how is the acting manager arrangement being monitored?
- 04How are people and their families involved in reviewing care plans and deciding activities?
- 05How do you use complaints, surveys and meetings to make improvements?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided; the previous inspection in 2017 was also rated Good. This explanation was written from the published report of 23 October 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.
What inspectors found, April 2017
St Josephs was rated Good; inspectors found safe, kind and responsive care, with some records needing improvement.
This was an unannounced inspection on 2 March 2017. Inspectors spoke with six people living at the home, seven staff members and a health professional. They observed care and checked medicines, care plans, recruitment, training, health and safety records, and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, liked the staff and received the support they needed. Inspectors found enough staff, safe medicines management, suitable training and respectful care.
The home had improved since the previous inspection in April 2016. Improvements had been made in medicines management and protecting people's legal rights. Inspectors noted some gaps in medicine room temperature records and said care plans were accurate but too clinical and not personal enough.
Kind and respectful staff
People described staff positively. Inspectors saw staff spend time talking with people, respond patiently and respect privacy and choices.
“Staff engaged in discussions and answered people's repeated questions patiently.” from the report
Safe staffing and medicines
There were enough staff to meet people's needs promptly. Medicine records were clear, stocks matched the records and medicines were stored correctly overall.
“We found that medication including medication requiring refrigeration was stored correctly.” from the report
Support with health and decisions
People were supported to access health care and make decisions for themselves where possible. The home kept track of legal safeguards where people lacked capacity for particular decisions.
“People had been assessed to establish whether they would benefit from the protection of a DoLS.” from the report
Activities and choice
People could choose where and when to eat, take part in activities and go out. Staff supported individual interests such as jigsaws, sewing and shopping.
“People were supported to occupy their time doing the things they enjoyed.” from the report
Visible management and checks
The manager was present and approachable. The home used audits, surveys and action plans to monitor and improve the service.
“A series of audits and checks were in place at the home to check the safety and quality of the service.” from the report
Medicine temperature records
needs fixingThere were gaps in the recording of the medicine room temperature. The room reached 25 degrees on some days, which inspectors said was the maximum safe storage temperature for some medicines.
“The temperature of the fridge and medication room had been recorded although we saw some gaps in this recording” from the report
Care plans were not personal enough
needs fixingCare plans contained the information staff needed, but they were written in a clinical style and did not describe people's personalities and daily details well enough.
“We found that care plans contained the information needed to support people but were written quite clinically.” from the report
People's views may not be fully reliable
minorSome people needed staff help to complete surveys, and not everyone could or wanted to attend meetings. Inspectors discussed finding better ways to gather people's views.
“Several people had required support from staff working at the home to complete their survey form which may have affected their answers.” from the report
- 01How are medicine room temperatures checked now, and what happens if the temperature is too high or a check is missed?
- 02How have care plans been changed so they describe each person's personality, preferences and daily routines?
- 03How do you make sure people can share their views without staff support affecting their answers?
- 04How do you check that routine health appointments and other important information are easy for staff to find?
- 05What improvements were made after the previous inspection's concerns about medicines and people's legal rights?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 6 April 2017 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 Josephs
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 January 2011.
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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