St Nicholas Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Systems were in place to ensure people’s needs were fully assessed before moving into St Nicholas Care Home. The risk assessments and care plans of people demonstrated this. People had the opportunity to visit the service, for some people this included multiple visits to meet the staff and other people who used the service. This planned approach enabled the management team to observe and assess people to ensure their needs were compatible with people already living at the service.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Risk assessments and care plans reflected professional guidance received about people’s care needs and we observed staff following this guidance when assisting people. For example, staff were knowledgeable about people’s eating and drinking needs and the risks associated with this. This included when people needed a modified diet or required a thickening agent to be added to drinks, because of a known choking risk.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Family members told us they felt well informed about people’s care. comments included, “Staff keep me up to date about [Name]” and “[Staff] are every good and they keep us informed all the time.” Staff told us they were kept up to date with people’s current and changing needs through care plans which were updated regularly and through daily handover meetings. One staff member said, “As soon as we arrive on shift, we have a handover meeting to discuss people and any other important changes.” Referrals were made for people to other health and social care professionals when needed. Referrals were appropriate and made in a timely manner based on people’s needs.

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff supported people to access health appointments and other health services when needed. Family members were confident any health concerns would be addressed and resolved. Family members commented, “Any problems I can go to [the registered manager]. [Name’s] hearing aid went missing, they sorted it out” and “[Name] lost a couple of pounds in weight which is a lot for them. Staff have made a referral to a dietician.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. For example, for people at risk of malnutrition, systems were in place to record and monitor food and fluid intake. When people were at risk of pressure wounds, people received appropriate repositioning care to avoid a breakdown in their skin integrity. Some people who were being supported to develop daily living and independence skills to enable them to move on to more independent support in the future. We received positive feedback how people were supported to do this. Realistic goals were agreed with people and regularly reviewed. One person shared how they had developed more confidence whilst living at the service which has enabled them to access the community independent of staff support.

People consented to their care and treatment. For people who did not have the mental capacity to consent, or make specific complex decisions, the provider had assessed their capacity and made decisions in their best interests. Decisions were made in consultation with others and the leadership team had ensured they had obtained the correct legal authorisations for these decisions. However, we identified in some parts of the service, bedroom doors were locked when not being used. Not all people were able to hold their own bedroom key which meant they needed to ask staff to open the doors to their personal space. We were told this decision had been made with people’s families as in some cases other people had been entering rooms and personal items had been damaged, or mislaid. However, we raised with staff that such decisions needed to be made an individual basis and staff needed to demonstrate how they had considered the principles of the Mental Capacity Act 2005 when making this decision.