St Michaels Nursing Home

At our last inspection we rated this question good, this rating remains unchanged. During this assessment we looked for evidence that people were protected from abuse and avoidable harm. We found leaders ensured there was a positive culture of safety based on openness and honesty. Safety events were investigated and reported. Staff worked with people and their families to understand what safe meant for them to plan their care as well as external stakeholders. Staff ensured that the environment was safe for people and that all equipment was in working in order. Leaders made sure there was enough suitably qualified, skilled and experiences staff who received support and supervision so that they could deliver safe care to meet people's needs.

Although there was still more work to be done. Whilst people had risk assessments in place they were not reviewed or updated in a timely way. The management of medicines kept people safe, but leaders needed to ensure that staff monitored the temperature in the clinic room, that first aid kits were easily accessible and that the room was free from clutter. We raised this with the manager and they took immediate action to mitigate the risk we were concerned about.

At our last inspection we rated this question good, this rating remains unchanged. Staff assessed peoples needs on an individual basis and then planned their care, if appropriate families were fully involved too. When required staff worked together with other care professionals to share information and meet the holistic needs of people, this included access to other healthcare providers such as GP and dietitians. Care was planned in line with best practice and standards and was reviewed regularly. Staff ensured that people consented to their care and if they lacked capacity they carried out mental capacity assessments for specific interventions.

At our last inspection we rated this question good, this rating remains unchanged.Staff treated people with kindness, empathy and compassion. People and relatives told us that staff listened to them and understood their individual needs, including cultural social and religious needs. We observed staff responding to peoples immediate needs to minimise individual concerns or distress throughout the assessment. We saw that staff used specialist adaptive equipment, such as sensor mats and hoists to promote peoples independence.

At our last inspection we rated this question as requires improvement, this rating has improved and is now rated as good. Leaders and staff made sure that people were at the centre of the care and treatment. This was evidenced in individual peoples care plans which included end of life care and peoples wishes regarding cardiopulmonary resuscitation. We saw examples of staff working with services outside of the home to ensure that people had access to specialist services to support continuity of care, support and treatment. For example, ophthalmology, audiology and chiropractic services. Leaders had put systems in place for people and their families to share ideas, raise complaints and feedback about the care they received.

At our last inspection we rated this question good, this rating remains unchanged. Leaders and staff had a shared vision and strategy for the service, they understood the challenges and the needs of the people using the service. Leaders had taken action to improve the governance structures and outcomes for people. We found leaders ha clear responsibilities and systems of accountability which they used to manage and deliver a good quality service. They acted on information about risk from internal processes and reports from external stakeholders. Leaders were inclusive, compassionate and capable. In a short timeframe they had built positive working relationships with staff within the home, fostering a culture were people feel they can speak up and their voice will be heard. However, there is still more work to done to ensure that the governance processes are embedded and continue to develop the service.