CQC report explained · a residential care home
What the CQC found at St. Michaels
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable safeguarding and risk arrangements, safe medicine systems and effective infection control measures. Staff understood how to support people with epilepsy and during periods of anxiety or distress.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The report describes kind and respectful relationships, but its previous rating was carried forward.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found clear leadership, a positive culture, regular checks and meetings, and action taken when incidents or changing needs were identified.
What inspectors found, July 2021
Rated Good; inspectors found safe, kind and person-centred care, with no evidence that the concerns investigated had caused harm.
The home provides personal and nursing care for up to five people with autism or learning disabilities. Inspectors visited without notice on 26 May 2021 and spoke with people, staff and the manager. They reviewed care, medicine, recruitment, training and management records.
This was a focused inspection. Inspectors looked only at Safe and Well-led because concerns had been raised about incidents between people, the management of behaviour that could be challenging and the culture of the home. Both areas were rated Good.
Inspectors found enough staff, consistent staffing teams, suitable risk plans and safe medicine arrangements. Staff understood safeguarding, epilepsy and how to support people during anxiety or distress. The home was clean and well maintained.
Inspectors also found a positive culture. People were treated with kindness and respect, involved in decisions about their homes and supported to develop independence. The overall rating remained Good, but ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection because they were not checked during this visit.
Staffing and safety
There were enough staff to meet people's needs, and staffing was increased when support needs changed. Staff teams were consistent and knew people well.
“There were sufficient staff to meet people's needs and keep people safe.” from the report
Personalised support
Staff had detailed knowledge of people's risks and individual support needs. Plans explained how to respond to anxiety, distress, epilepsy and falls.
“People had PBS plans which were specific to their needs and informed staff how best to support them during periods of anxiety or distress.” from the report
Reducing restraint
The home used a restraint reduction plan with specialist support. Inspectors found this had led to a person not being restrained for more than a year.
“The registered manager and staff had worked with the positive behaviour support (PBS) lead to develop a restraint reduction plan, which was so successful that the person had not been restrained for over a year.” from the report
Positive culture
Inspectors saw respectful relationships between people and staff. People appeared happy and were supported to build independence.
“There was a positive culture within the service, which empowered people and staff.” from the report
Involvement and independence
People helped make decisions about their homes and activities. Staff also supported people who wanted to move towards supported living.
“People were fully engaged and involved with the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How are my relative's current risk and positive behaviour support plans reviewed after an incident?
- 02What steps are taken to reduce the use of restraint, and how often is this reviewed?
- 03How would staffing levels change if my relative needed more support in the evening or their needs changed?
- 04How are epilepsy risks, seizures and emergency medical support recorded and shared with staff?
- 05How will my relative and our family be involved in decisions, activities and plans to build independence?
This was an unannounced focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 2 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.
What inspectors found, February 2020
St. Michaels was rated Good; inspectors found safe, caring and personalised support, with one staffing shortfall affecting an outside activity.
This was an unannounced full inspection. One inspector met all five people living at the home, spoke with two people and five staff, observed care, and checked care, medicines, staffing and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff to support people safely within the home, safe medicines systems, trained staff and detailed individual care plans.
The inspection followed concerns about management, staffing, training and staff responses to risks. Inspectors found no evidence that people were at risk of harm from these concerns. The home had improved from Requires Improvement at the previous inspection.
Personalised support
Support was organised around each person's needs, choices and communication style. People were encouraged to gain skills and become more independent.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Safe medicines
Medicines were stored securely, given by trained staff and recorded correctly. Staff were also checked as competent.
“People received their medicines when they needed them, records of medicines given were complete as well as processes to order and dispose of any unwanted medicines.” from the report
Kind and respectful staff
Staff understood how people communicated and how to reassure them. Inspectors saw people responding positively to staff.
“Throughout the inspection staff supported people in a caring and respectful way.” from the report
Activities and community life
People took part in a range of chosen activities, including holidays, public transport, family visits and leisure pursuits. Alternative activities were arranged when plans changed.
“Some people had been on holiday, travelled on public transport, visited family and took part in leisure pursuits such as swimming and visiting theme parks.” from the report
Improved oversight
Regular audits identified shortfalls and assigned actions to named roles. The report says these actions were addressed quickly.
“Action plans showed shortfalls were actioned and addressed quickly and staff were clear about their roles and responsibilities.” from the report
Staffing for community activities
needs fixingOne outside activity could not take place because some people needed three staff each and only two staff were available. The manager introduced a list of staff who could volunteer, and the impact was due to be reviewed.
“Staff rotas showed one occasion where there were insufficient staff to allow an activity outside of the service to occur.” from the report
- 01How many permanent staff are now in post, and has the planned recruitment of eight staff, including a deputy manager, been completed?
- 02How will you make sure there are enough staff for community activities when people need three-to-one support?
- 03How has the volunteer staffing arrangement worked since the inspection, and has its impact been reviewed?
- 04How do you make sure new or agency staff understand each person's communication methods, risks and support plans?
- 05When will each person's care plan and end of life plan next be reviewed with their family?
This was an unannounced full inspection covering all five CQC questions, the care provided and the premises. This explanation was written from the published report of 11 February 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. Michaels
4 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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