CQC report explained · a nursing home
What the CQC found at St Michaels Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2018
Rated Good; inspectors found safe, kind and responsive care, with improvements since earlier staffing problems.
This was an unannounced comprehensive inspection. Inspectors visited on 27 September 2017, 3 October 2017 and 15 May 2018. They spoke with people living at the home, visitors, staff, the manager and the provider. They also observed care, checked records, medicines, staffing, training, complaints and quality checks.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. Inspectors found enough staff, safe medicines systems, suitable training, good support with food and health needs, and care that respected people's privacy, dignity and choices.
The report says the home had improved since a 2016 inspection, when there were not enough staff and a warning notice was issued. A focused inspection in April 2017 found that the provider had met the legal requirements linked to that notice. At this inspection, staffing was sufficient, although the manager's application to become registered was still in progress.
Staffing improved
Inspectors found enough staff to meet people's needs and saw that staff responded quickly to requests. Staffing levels had improved since the previous inspection.
“There were enough staff to meet people's needs.” from the report
Kind and respectful care
People spoke very positively about the staff. Inspectors saw staff protecting privacy and dignity, listening carefully and giving people time to do things for themselves.
“Every person we spoke to, without exception was extremely complimentary about the caring nature of the manager and staff.” from the report
Safe medicines
Medicines were stored securely, administration records were completed properly and stock checks matched the records examined.
“People's medicines were stored and administered safely.” from the report
Good leadership and improvement
Inspectors found strong teamwork, an open culture and an improvement plan that recorded actions, responsibilities and timescales.
“The manager provided strong, clear leadership and ensured the service was a person-centred and inclusive.” from the report
Support with meals and health
People could choose what and where to eat, were given enough food and drink, and received referrals to health professionals when needed.
“The mealtime was an inclusive experience.” from the report
Manager registration pending
minorThe manager had applied to become registered with the commission, but the application was still in progress when inspectors visited.
“The manager, although not registered with the commission, provided strong, clear leadership” from the report
Care plans still being updated
needs fixingInspectors said care plans were being reviewed and that some contained personal details, but this work was not yet complete across all plans.
“The care plans were being reviewed to ensure that they were person centred” from the report
- 01What is the current position of the manager's application to become registered with the commission?
- 02How do you calculate staffing levels when people's care needs change?
- 03Have all care plans now been reviewed and made fully person centred?
- 04How do you find out each person's interests and use this information to plan activities?
- 05How do you check that the improvements made after the earlier staffing problem are being maintained?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 1 June 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, July 2017
Requires Improvement; staffing had improved and the warning notice was met, but inspectors had not yet seen consistent good practice over time.
This was an unannounced focused inspection on 4 April 2017. Inspectors checked whether staffing had improved after an earlier inspection found too few care staff and served a warning notice.
Inspectors found that staffing levels had increased and were sufficient to provide safe care on the day. However, some people had waited for personal care, staff interaction was sometimes limited, and staff morale appeared low.
The overall rating was Requires Improvement. Safe was also rated Requires Improvement. The warning notice had been met, but the rating could not be raised until safe staffing practice had been consistent over time.
Improved staffing
The home had increased staffing since the previous inspection. Rotas showed a registered nurse on duty at all times, and inspectors found staffing sufficient for safe care on the day.
“The staffing levels were sufficient to provide safe care for the people using the service.” from the report
Requests were answered
Inspectors saw that staff did not appear rushed and that people's requests were responded to during the inspection.
“Staff did not appear rushed. We saw that people's requests were answered.” from the report
Positive views from some people
Some people said they liked the home and described staff as capable, kind and good to talk to.
“Capable, nice people and good to talk to.” from the report
People sometimes waited for care
needs fixingTwo people said they had sometimes waited for care. One person said they had occasionally waited until 11:00am for personal care.
“For example, one person told us they had on occasions waited until 11:00am for personal care.” from the report
Limited interaction
needs fixingStaff were usually present in communal areas, but inspectors sometimes saw very little interaction between staff and people. Staff morale also appeared low.
“On occasions we saw that there was very little interaction between staff and people.” from the report
Training concerns
needs fixingStaff said they needed more guidance, training and updates. They also raised concerns about induction for new staff.
“Staff told us that they, "Could do with more guidance and training.” from the report
- 01How many care staff and nurses are on duty on each shift now, and how are sickness and agency cover managed?
- 02How do you make sure people do not wait too long for personal care?
- 03What induction, training and training updates do staff receive, and are they given paid time to complete them?
- 04How has the new manager's handover been managed, and how is the provider checking the stability of leadership?
- 05What has been done to give staff more time to talk with people and improve morale?
This was a focused inspection of Safe, mainly checking staffing and the previous Regulation 18 warning notice; it did not provide a new comprehensive assessment of all five questions. This explanation was written from the published report of 1 July 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 Michaels Nursing Home
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- June 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvement
- December 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.