St Michaels Support & Care improved from Requires Improvement to Good across all five key questions, successfully remediating all four prior regulatory breaches relating to staffing, medicines, infection control, dignity, and consent. Minor residual concerns remain around inconsistent care plan updating at two schemes and one undocumented end-of-life wish.
Concerns (5)
moderate
Care planning
: “at two other schemes the care plan document was not updated when reviews took place or there were any changes.”
moderateCare planning: “One care plan we viewed had not been adequately updated for two years.”
moderateRecord keeping: “changes in people's care needs were not updated within their care plan. This meant that staff would need to read three separate documents.”
minorEnd-of-life care: “staff told us that they knew about a person's end of life wishes, but this had not been documented in their care plan.”
minorInfection control: “we visited one person's flat which required some attention to its cleanliness.”
Strengths
· Staff demonstrated good understanding of safeguarding and whistleblowing procedures, with a dedicated 'Tell us' phone line displayed at all schemes.
· Previous breaches of Regulations 10, 11, 12, and 18 were all remediated; provider no longer in breach of any regulation.
· Detailed, regularly reviewed risk assessments in place with staff able to articulate individual risks.
· Robust medicines management including regular audits, competency assessments, and timely administration confirmed by people using the service.
· Comprehensive staff induction, regular supervision, annual appraisals, and responsive training programme including staff-requested topics.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies; supporting people to live healthier lives and access healthcareGood
effective: Ensuring consent to care and treatment in line with law and guidance (MCA)Good
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Planning and promoting person-centred, high-quality care with openness; duty of candourGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood