CQC report explained · a residential care home
What the CQC found at St Mary's Gate Euxton
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were stored and recorded safely, and there were enough staff. Fire safety and night staffing had improved since the previous inspection.
- Effective?
- Good
- Staff received induction, training, supervision and competency checks suited to people's complex needs. People were supported with nutrition, healthcare and decisions made under the Mental Capacity Act.
- Caring?
- Good
- Staff were kind and respectful, understood people's communication and preferences, and protected their privacy and dignity. Families were involved in care planning.
- Responsive?
- Outstanding
- Care plans were highly detailed and personalised. People were supported to communicate, maintain relationships, access the community and take part in a wide range of activities.
- Well-led?
- Good
- The home had a registered manager, a consistent staff team and systems to monitor care and address risks. Families, staff and outside professionals were encouraged to share their views.
What inspectors found, May 2018
Rated Good overall; inspectors found safe, kind care and outstanding personalised support, with improvements made since the previous inspection.
This was an unannounced inspection on 21 March 2018. One inspector spoke with staff, relatives and a visiting professional, observed care, checked the building and reviewed care, staff and safety records. Three people were living at the home, which supports people with profound learning disabilities and complex needs.
The home was rated Good for Safe, Effective, Caring and Well-led. It was rated Outstanding for Responsive. Inspectors found enough suitably trained staff, safe medicines management, detailed care plans, respectful communication and good support with health needs, activities and community life.
At the previous inspection in December 2016, the home had breached Regulation 12 because of fire safety and night staffing concerns. By this inspection, fire safety arrangements had been improved and night staffing had increased. The report says the home was no longer in breach.
Highly personalised care
The home tailored support to each person's communication, health, mobility and daily routines. Families and professionals were involved in planning.
“People who used the service received an excellent personalised service that met their individual needs and preferences.” from the report
Meaningful activities
People were supported to use local services, maintain interests and take part in activities adapted to their mobility needs.
“People were supported to access specialist services that provided numerous activities including, ice skating, horse riding, skiing and trampolining” from the report
Kind and respectful staff
Inspectors saw positive interactions and found that staff understood people's preferences, communication and signs of discomfort or distress.
“Staff were kind, caring and knew how to personalise care to meet people's individual needs.” from the report
Good specialist training
Staff training covered the physical, psychological, communication and healthcare needs of the people living at the home.
“Staff received high quality training and competency assessment in all aspects of the physical and psychological needs of the people being supported.” from the report
Improvements since 2016
The home improved its fire arrangements and increased night staffing after the previous inspection.
“This ensured people were now better supported as some of the care they received required two members of staff.” from the report
Inspectors raised no specific concerns in this report.
- 01How are the two night staff arranged now, and can two staff respond immediately when a person's care requires this?
- 02What fire safety improvements were made, and how are the alarm and fire doors checked now?
- 03How would you learn and record my relative's non-verbal signs of pain, distress, choice and consent?
- 04Which health professionals would be involved in my relative's care, including support for eating, drinking, posture or epilepsy?
- 05How would you support my relative to continue their hobbies, family relationships and activities in the local community?
This was an unannounced inspection covering all five CQC questions and the overall rating; it also checked whether issues identified at the December 2016 inspection had been addressed. This explanation was written from the published report of 26 May 2018 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, February 2017
Rated Requires Improvement; the home provided kind, person-centred care, but fire safety, staffing risks and management checks needed improvement.
Inspectors visited on 6 and 7 October 2016. They reviewed all four people's support plans, medicines records, staff records, safety checks and management information. They also observed care, medicines administration, mealtimes and the home environment, and spoke with staff, managers and family members.
The home was caring and responsive. Staff treated people with kindness and respect, knew them well and supported a wide range of activities, holidays and family links. Medicines were managed safely, staff training was good and people's health and nutrition needs were monitored.
The home was not always safe or well-led. Fire arrangements needed improvement, including evacuation planning, alarm testing and fire doors. Inspectors were also not assured that staffing was safe when only one carer was present, including overnight. Support records, mental capacity paperwork and quality checks did not always contain or identify everything needed.
The overall rating Requires Improvement means inspectors found important shortfalls that needed action. Effective, Caring and Responsive were rated Good, while Safe and Well-led were rated Requires Improvement.
Kind and respectful care
Inspectors saw staff treating people respectfully and protecting their privacy and dignity. People were clean, well presented and supported in a calm atmosphere.
“Every interaction we saw in the home was undertaken with dignity and respect.” from the report
Meaningful activities
The home supported people to take part in varied activities, including skiing, horse riding, trampolining and adapted cycling. Activities were chosen around individual interests and abilities.
“Staff sought out services that provided fun activities usually thought of for only fully mobile people.” from the report
Safe medicines systems
Inspectors observed medicines being prepared and given safely. Records, checks, staff competency testing and guidance for as-needed medicines were described as strong.
“The medication management systems in the home were very good and people's medicines were always handled and administered safely.” from the report
Good family involvement
Families were involved in care planning, regular meetings and quality discussions. Complaints were followed up and actions were shared with staff.
“Families of people who lived in the home told us they felt involved with the care and support their loved ones received.” from the report
Fire safety and evacuation
seriousThe alarm system could not confirm that the whole building's system was working. Fire doors were propped open, and some people needed two staff to evacuate when only one might be available.
“We found the provider needed to take further action to ensure the people in the home were protected in the event of a fire.” from the report
Single-carer staffing risks
seriousAt some times, including overnight, one carer could be responsible for all four people. Inspectors were not assured that the risks of delays, emergencies or two-person care had been properly assessed.
“We were not assured all the risks associated with support being provided by one carer had been appropriately assessed.” from the report
Incomplete mental capacity records
needs fixingMental Capacity Act assessments and best-interest decisions were detailed for one person but not for the other three. This could affect the support for applications to restrict people's liberty.
“The other three support plans did not include the same detail.” from the report
Care information was not always together
needs fixingSome support plans were less comprehensive and important information was held in different places. Inspectors recommended bringing the information together so staff could find what they needed.
“For others information was in different places.” from the report
Quality checks missed problems
needs fixingThe home carried out regular audits, but these had not always identified the shortfalls found by inspectors. The provider was asked to use the audits more effectively.
“However as can be seen throughout this report the audits and monitoring in place had not always identified the need for improvements.” from the report
- 01What changes have been made to the fire alarm system, fire doors and emergency evacuation plans since the inspection?
- 02How do you make sure two staff are available whenever a person's care plan or evacuation plan requires this?
- 03How is staffing arranged overnight and when people go out on activities?
- 04Have all Mental Capacity Act assessments and best-interest decisions been completed and kept with the relevant support plans?
- 05How do your current audits identify and correct problems with safety, staffing and care records?
This was the first comprehensive inspection of the home, covering all 16 regulations; the previous January 2014 inspection used the old method and covered five regulations. This explanation was written from the published report of 23 February 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 Mary's Gate Euxton
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- February 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 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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Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
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