CQC report explained · a nursing home
What the CQC found at St Teresa's - Care Home with Nursing Physical Disabilities
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People generally felt safe and well cared for. Inspectors found safe recruitment, risk assessments, medicines systems and infection control arrangements, but staffing cover could be difficult when staff were absent at short notice.
- Effective?
- Good
- Staff had relevant training and supervision. Care plans guided staff, dietary needs were recorded, and people received support from health and social care professionals.
- Caring?
- Good
- This area was not inspected during this focused visit. The report says no concerns were identified in the information held, so a previous rating was used.
- Responsive?
- Good
- This area was not inspected during this focused visit. The report says no concerns were identified in the information held, so a previous rating was used.
- Well-led?
- Good
- There had been four manager changes since the previous inspection. The new managers had introduced organisational procedures, listened to staff and used audits and provider oversight to monitor the service.
What inspectors found, October 2020
Rated Good; inspectors found safe, effective care and stronger management, but staffing cover and recent management changes need watching.
This was a focused inspection after concerns about staffing and management. Inspectors visited on 21 and 24 September 2020. They spoke with six people, 11 staff and eight relatives, and reviewed care, medicine, staffing, recruitment and quality records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. People generally said they felt safe and well cared for. Inspectors found suitable recruitment checks, trained staff, safe medicines systems, appropriate infection control and care plans that reflected people's needs.
Staffing problems were linked mainly to sickness or people not attending shifts. The home had changed staff deployment, extended some shift times and used agency staff when needed. There had also been four manager changes since the previous inspection, but the new management team had improved oversight and involved staff in changes.
This was not a full inspection of all five areas. Caring and Responsive were not inspected because no concerns were identified in the information held. Their previous ratings were used in calculating the overall rating. The overall rating stayed Good, as it had been at the previous inspection.
People felt safe
People and most relatives said they felt safe and well cared for. Staff had safeguarding training and understood how to report concerns.
“People said they felt safe and well cared for.” from the report
Care was planned
Care plans included people's needs, risks, choices and preferences. Staff followed the plans and reviewed them when people's needs changed.
“Care plans contained sufficient guidance, information and direction for staff to meet people's needs.” from the report
Skilled staff
Inspectors found staff had relevant training, supervision and experience. New staff worked alongside experienced staff until they were confident to work alone.
“People received effective care and treatment from competent, knowledgeable and experienced staff who had the relevant skills and qualifications to meet their needs.” from the report
Infection control
The home had Covid-19 arrangements covering protective equipment, handwashing, cleaning, testing and visiting. Staff were observed using protective equipment correctly.
“Staff were seen wearing personal protective equipment (PPE) appropriately throughout this inspection.” from the report
Staffing when people are absent
needs fixingMost people said staffing was sufficient, but staff reported difficulties when people were sick at short notice or did not attend shifts. The home used extra shifts and agency staff and continued to monitor staffing.
“Difficulties arose when staff went sick at short notice or did not turn up for shift.” from the report
Recent management changes
needs fixingThere had been four manager changes since the previous inspection. The new managers were making changes and staff said they were still getting used to some new processes.
“Since the previous inspection there had been four manager changes.” from the report
One concern about how someone was spoken to
minorOne person said they were sometimes unhappy with how staff spoke to them. The registered manager agreed to investigate and take action if needed.
“One person told us they were sometimes unhappy with how they were spoken to.” from the report
- 01How do you cover shifts when staff are sick or do not attend, and how often do you use agency staff?
- 02How have the four recent manager changes affected day-to-day care and communication with families?
- 03What action was taken after the concern about how one person was spoken to?
- 04What activities are available for people who want to take part, and how do you record their choices?
- 05How can families raise concerns and find out what action has been taken?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings were used in calculating the overall rating. This explanation was written from the published report of 21 October 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.
What inspectors found, March 2018
Rated Good; inspectors found kind, personalised care, but staffing pressures and gaps in specialist feeding training needed attention.
This was an unannounced comprehensive inspection on 24 and 29 January 2018. Inspectors spoke with people, relatives, staff and health professionals. They observed care, looked around the home and checked care records, recruitment files, staff rotas, training records and other service records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People generally said they felt safe and well cared for. Inspectors saw staff treating people with kindness, respect and patience. Care plans were personalised and medicines systems were described as robust.
Inspectors identified pressure caused by sickness, more complex needs and the availability of one nurse across the home. They also found that specialist training for some feeding regimes had not yet been provided to staff on all units. They recommended reviewing staffing needs to make sure care was provided promptly.
Kind and respectful care
Inspectors saw staff being kind, patient and respectful. People said staff supported them well and helped them feel at home.
“The staff were kind, patient and treated people with respect.” from the report
Personalised support
Care records described people's choices, communication methods, preferences and support needs. Staff used this information to help people make daily decisions.
“Care plans were personalised to the individual and gave clear details about each person's specific needs and how they liked to be supported.” from the report
Safe medicines systems
Inspectors found medicines records were completed appropriately and checked regularly. Staff had training and followed procedures for medicines, including controlled drugs.
“Medicine administration records (MAR) were kept as necessary to record when people took their medicines. We saw these were completed appropriately and audited regularly.” from the report
Staffing pressure
needs fixingSome people experienced long waits for help, and staff said they could be stretched when several people needed two-person support. Inspectors recommended a review of the staffing assessment.
“It is recommended the service review the current staffing needs assessment to ensure appropriate numbers of staff are available to provide care and support to people in a person-centred and timely way.” from the report
Specialist feeding training
needs fixingSpecialist training for individual feeding regimes had been provided on one unit but not on the other two. The manager said this would be prioritised.
“The deputy manager told us specialist training to support individual feeding regimes had been provided to staff on one of the three units but had not yet been provided to staff on other units.” from the report
Unclear signs
minorSigns for the units were difficult to read and communal toilets were not clearly marked. Inspectors said this could make it harder for people with visual or learning impairments to find their way around.
“There was insufficient signage available to help people orientate around the service.” from the report
- 01How many staff are on each unit during the day and night, and how do you adjust this when people's needs increase?
- 02Have all staff who may support individual feeding regimes completed the specialist training?
- 03How do you prevent delays when several people need two staff members or nursing support at the same time?
- 04Has clearer signage for the units and communal toilets now been installed?
- 05How are people and their families involved when feeding times or other care arrangements need to change?
This was an unannounced comprehensive inspection covering the premises, care and nursing support, with ratings given for all five CQC questions. This explanation was written from the published report of 20 March 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.
Every inspection of St Teresa's - Care Home with Nursing Physical Disabilities
3 rated inspections over 5 years: the service has held its Good rating throughout.
- October 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at St Teresa's - Care Home with Nursing Physical Disabilities →
- March 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at St Teresa's - Care Home with Nursing Physical Disabilities →
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- September 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 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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