St Anselm's Nursing Home

During the inspection we found 6 breaches of the regulations in relation to safe care and treatment, staff training and competency, dignity and respect, person centred care, consent to care and treatment and good governance. The service was previously rated good but has now changed to inadequate.

The learning culture of the service needed to be improved. Incidents were not reviewed to identify if there were trends which could be mitigated. Some incidents were poorly recorded, or were not recorded at all which impacted on learning. When restraint was used in people’s support, de-briefings were not documented, and it was not always clear if restraint was the appropriate course of action. Safeguarding processes were not always followed, for example concerns were not always reported to the local authority when they should have been.

Care plans and risk assessments needed more information and there was a lack or risk assessments and planning for some areas. There were also risks within the environment which were not always well managed. For example, cleaning products and other hazardous items were left unattended and could be accessed by people. Staff had not kept up to date with training and we saw areas where practice needed to be improved.

Medicines were not well managed, and people did not always receive their medicines as prescribed.

Staff made referrals to other health and care organisations for people. However, partners did not always have the information they needed and raised concerns about the standard of care plans. People’s needs were assessed. However, this did not lead to people having up to date care plans and risk assessments and people’s changing needs were not always identified. Staff records were poor and this meant people’s care and treatment could not be monitored as well as it needed to be.

Staff were positive about how they were supported including with equality and diversity needs and well being. Although some staff did feel communication within the staff team could be improved, and some staff felt the managers were not as visible within the service building as they could be.

The culture of the service was not consistent. There were positive areas and areas where improvement was needed. Oversight was in need of significant improvement and quality systems were either lacking or ineffective and had not led to improvement. The management were passionate about the people they supported. However, more needed to be done to improve people’s care and support and quality assurance systems needed to be significantly strengthened. Staff meetings were not being held regularly to improve communication between staff and between staff and management. The provider had not focused on continuous learning and improvement across the organisation.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we user our enforcement powers in response to inadequate care and provide a time frame within which providers must improve the quality of the care they provide. In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.