CQC report explained · a residential care home
What the CQC found at St Michaels House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People and relatives said they felt safe. Risks were assessed, medicines were managed safely, there were enough staff and infection control measures were in place.
- Effective?
- Good
- This question was not included in this focused inspection.
- Caring?
- Good
- This question was not included in this focused inspection, although inspectors observed communication that could be disrespectful.
- Responsive?
- Good
- This question was not included in this focused inspection. Care plans were being developed to improve people's choice and control.
- Well-led?
- Requires improvement
- Leadership and management were inconsistent. Staff lacked some specific training, respectful practice was not consistent and quality audits did not always have action plans showing that improvements were completed.
What inspectors found, August 2021
St Michaels House is Rated Good overall, but well-led Requires Improvement because staff training, respectful communication and quality monitoring needed improvement.
This was an unannounced focused inspection on 9 July 2021. It followed concerns about staff skills, training and the culture of the service. The inspection looked at Safe and Well-led, including infection control.
Inspectors found people were safe. Staff understood people's risks, medicines were managed safely, there were enough staff and infection control arrangements were suitable. People and relatives said they felt safe and praised the staff team.
The home was not always well-led. Some staff lacked training for people's specific needs, including PEG training, and inspectors saw language and actions that could be disrespectful. Quality checks did not always have formal action plans to show that improvements had been completed.
The overall rating stayed Good, as did Safe. Well-led fell from Good to Requires Improvement. The manager arranged the missing specialist training for the next working day, and CQC asked for an action plan and said it would monitor progress.
People felt safe
People and relatives told inspectors they felt safe with the staff. Staff knew how to identify and report safeguarding concerns.
“People and relatives spoke about how they and their family member, felt safe in the service and with the staff that supported them.” from the report
Risk management
Risk assessments covered areas such as nutrition, skin care and moving and handling. Staff could explain people's support needs and when extra help might be needed.
“Where risks were identified these records detailed how staff should support the person safely.” from the report
Safe medicines and staffing
Staff were trained to give medicines and records supported this. Inspectors also saw enough staff available to support people.
“Staff had been trained to administer medicines and records supported this.” from the report
Positive partnerships
Professionals said the team worked with them to support people and adapt care plans, including during the COVID-19 pandemic.
“Professionals spoke about how the service worked with them to gain positive outcomes for people.” from the report
Specialist training was missing
seriousStaff did not initially have all the training needed for people's specific support needs, including PEG training. The manager arranged training for the following day, but this was a significant gap at the inspection.
“The registered manager did not ensure staff were adequately trained to support people with specific training to meet their needs.” from the report
Respectful communication
needs fixingInspectors saw language and actions that could be disrespectful. The report says staff did not intend to offend, but this showed they did not fully understand their responsibilities.
“We observed staff using language and actions that could been seen as disrespectful towards people.” from the report
Improvement actions were not tracked clearly
needs fixingThe home had quality checks, but did not always use formal action plans to show what had been completed and put into practice.
“Where actions were identified there was not an action plan following this to show actions had been completed and implemented into the service.” from the report
Manual handling checks
needs fixingThe manager arranged manual handling training but had not followed it with competency checks for staff. The manager said manual handling champions monitored practice day to day.
“The registered manager placed staff on manual handling training, however they did not follow this up with a competency assessment to check staff knew how to support individual people.” from the report
- 01Have all staff now completed the specialist training needed for the people staying here, including PEG training?
- 02How do you check and record that staff are competent in individual people's manual handling needs?
- 03What action has been taken to make sure staff always speak to people respectfully?
- 04How do your audits now record who is responsible for each improvement and when it has been completed?
- 05What progress has been made on the action plan requested by CQC?
This was a focused inspection of Safe and Well-led, with infection prevention and control included; the other key questions were not inspected and their ratings were not given in this report. This explanation was written from the published report of 18 August 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, March 2021
St Michaels House was inspected but not rated; inspectors found strong infection control, with the admission process needing review.
This was an announced, targeted inspection on 12 February 2021. It checked infection prevention and control during the coronavirus outbreak. The inspection was not a full review of all aspects of care.
Inspectors were assured that the home managed visitors, distancing, personal protective equipment, testing, cleaning, ventilation and infection outbreaks safely. There were enough staff to meet people's needs safely.
The home was inspected but not rated. The report recommends reviewing the admission process so it follows current guidance.
Infection control
The home had policies and risk assessments for managing COVID-19. It was clean, well ventilated and had enhanced cleaning arrangements.
“Enhanced cleaning regimes were in place and staff followed these. The service was well ventilated and clean.” from the report
Staffing
Inspectors found there were enough staff on duty to meet people's needs safely.
“The provider ensured there were enough staff on duty to meet people's needs safely.” from the report
Testing and protective equipment
Staff were trained to use protective equipment safely, and testing for staff and people using the service was organised regularly.
“Staff were trained in how to use their PPE in line with national guidance. Testing for staff and people was well organised and regularly done.” from the report
Admission process
needs fixingInspectors recommended that the provider review its admission process to make sure it follows current guidance.
“We recommend that the provider reviews their admission process to ensure this is in line with current guidance.” from the report
- 01What changes have you made to the admission process since the inspection?
- 02How do you currently manage testing for people using the service and staff?
- 03How are visitors and health or social care professionals allowed into the home?
- 04How often are enhanced cleaning and ventilation arrangements checked?
- 05What is your current plan for preventing or managing an infection outbreak?
This was a targeted inspection of infection prevention and control only; the service was inspected but not rated and other areas were not assessed in this report. This explanation was written from the published report of 25 March 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.
Every inspection of St Michaels House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Inspected but not ratedSafe: Inspected but not rated
- March 2020Goodstayed GoodSafe: GoodWell-led: Good
- August 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016
Registered with the Care Quality Commission on 16 April 2016.
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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