CQC report explained · a residential care home
What the CQC found at St Michaels Rest Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, good infection control and systems to manage risks and medicines. One medicine was stored incorrectly and some medicine records were incomplete, but this did not affect people's safety.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Requires improvement
- People did not always have enough meaningful activities or social interaction. Inspectors also found mixed communication with relatives and concerns about how some informal complaints were handled.
- Well-led?
- Requires improvement
- The service had quality checks and action plans, but some records and checks were not reliable. There was no registered manager, and frequent management changes had unsettled staff.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found people were safe, but activities, communication and service oversight needed improvement.
This was a focused inspection on 8 and 14 November 2022. Three inspectors visited the home, reviewed care plans, medicines, staff files and quality checks, observed care, and spoke with people, relatives, staff and health and social care professionals.
The home was rated Good for Safe. Inspectors found enough staff, safe recruitment, good infection control, safe medicine systems and well-managed risks. Improvements had been made since the previous inspection, and the home was no longer breaching regulations.
The home was rated Requires Improvement for Responsive and Well-led. People did not always have enough meaningful activities, and communication with some relatives and professionals was poor. Records and checks were not always reliable, and there was no registered manager at the time of the inspection.
The overall rating was Requires Improvement. The inspection was focused, so the other key questions were not inspected during this visit and their previous ratings were used to calculate the overall rating.
People were kept safe
Staff knew people's risks and how to support them. Safeguarding, emergency planning and risk management arrangements were in place.
“Risks to people were well managed.” from the report
Clean home and infection control
The home was clean and tidy, with cleaning schedules and arrangements to manage infection risks.
“The home was clean and tidy throughout.” from the report
Kind and knowledgeable staff
Staff knew people well and were described as respectful, kind and committed to providing care.
“Staff knew people well, they treated them with respect and kindness.” from the report
Improvements since the last inspection
The provider had improved infection control, environmental safety and some quality systems. The home was no longer in breach of regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Too little to do
needs fixingInspectors saw people spending long periods without meaningful activities or engagement. The provider was recruiting an activity coordinator and had started using external entertainers.
“During the inspection we saw people spending long periods of time with nothing to do.” from the report
Mixed communication
needs fixingSome relatives said they did not receive enough information about their loved one's wellbeing or activities. Some professionals also reported poor communication.
“Some relatives spoke about poor communication.” from the report
Care records were not always reliable
needs fixingInspectors found conflicting oral care records and a weight entry that had not been checked when it suggested significant weight loss.
“Improvements were needed to some aspects of record keeping in relation to oral care.” from the report
Medicine checks missed an error
needs fixingOne medicine was not stored or recorded in the stock check correctly, and the medicine audit had not identified this.
“Although medicines were generally well managed, we identified one medicine that had not been stored or added to the stock check correctly.” from the report
Leadership was unsettled
needs fixingThere was no registered manager, and several managers had led the home since the previous manager left. The new manager had been in post for three weeks at the inspection.
“There was no registered manager at the home.” from the report
- 01What activities are now available each day, and how are they adapted for people living with dementia?
- 02How will you give relatives regular updates about their loved one's wellbeing, care and activities?
- 03How do you check that oral care is being provided and recorded accurately?
- 04What has been done to correct medicine storage and stock checks, and how are these now audited?
- 05Who is responsible for the home while the manager's registration application is being processed, and how are you reducing management changes?
This was a focused inspection of Safe, Responsive and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 15 December 2022 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, December 2020
St Michaels Rest Home was rated Requires Improvement; inspectors found infection control, safety checks and management records were not consistently reliable.
Inspectors visited on 16 October 2020. This was an unannounced, focused inspection after concerns about safety and management. They looked only at Safe and Well-led, including infection control during the Covid-19 pandemic.
They found that people were generally protected from abuse, received medicines on time and had suitable staffing. However, some areas were not clean, infection control practices were inconsistent and some environmental risks were not managed properly. Records about medicines and other management information were also incomplete or out of date.
The home was rated Requires Improvement overall. Safe was rated Requires Improvement, and Well-led remained Requires Improvement. The other three ratings were not inspected at this visit and were carried forward from the previous comprehensive inspection.
Medicines
Inspectors observed medicines being given safely and at the right times. There were individual instructions for medicines that were to be given only when needed.
“People received their prescribed medicines in a timely manner.” from the report
Staffing and recruitment
Staffing levels allowed people's needs to be attended to safely. Recruitment checks included criminal record checks, references and employment history.
“A thorough recruitment procedure was followed before people worked in the service.” from the report
Safeguarding
Staff knew how to recognise abuse and what action to take. The manager worked with the local authority when safeguarding concerns were raised.
“Staff knew about safeguarding procedures and knew how to contact the local authority to discuss a safeguarding concern” from the report
Supportive management
Inspectors saw a relaxed and inclusive culture. Staff and relatives described the manager as supportive and approachable.
“The registered manager promoted a relaxed and inclusive culture in the service.” from the report
Infection control and environmental safety
seriousSome areas were not clean, and staff did not always follow good infection control practice. Equipment and the environment also presented risks, including trip hazards and a missing lift safety certificate.
“The provider failed to assess the risk of, prevent, detect and control the spread of infection.” from the report
Management systems and records
seriousQuality checks did not consistently identify risks or ensure records were accurate and complete. Medicine storage records and information given to people were among the areas needing improvement.
“The provider had failed to establish and operate effective governance systems to assess, monitor and mitigate the risks to people's health, safety and welfare.” from the report
Training and staff feedback
needs fixingStaff said supporting unpredictable behaviour could be stressful, and appropriate training had not yet been provided. Some relatives also said they had not been given regular opportunities to provide feedback.
“The registered manager had not ensured staff had received appropriate training to support them in this role.” from the report
- 01What changes have been made to cleaning, hand hygiene, mask use and staff Covid-19 training since the inspection?
- 02Has the lift received its required safety examination, and how are environmental trip and slip risks now checked?
- 03How are medicines storage records and other care records checked for accuracy and completeness?
- 04What training is now available for staff supporting people whose behaviour can be unpredictable?
- 05How are relatives and staff now asked for feedback, and how are concerns about missing laundry or belongings being monitored?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 3 December 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 Rest Home
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2019GoodSafe: GoodResponsive: GoodWell-led: Requires improvement
- September 2018
Registered with the Care Quality Commission on 25 September 2018.
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
19 live-in carers within about an hour of East 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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.