The inspection took place on 22 January 2019 and was unannounced.

St Joseph’s Covent Nursing Home is a ‘care home’ located in Stafford. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Joseph’s Covent Nursing Home accommodates up to 46 people in one adapted building. At the time of this inspection there were 40 people using the service.

The service had two registered managers in place. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection of the service on 8 January 2018 we found people were not always protected from avoidable harm because unexplained injuries had not been investigated and reported to the local safeguarding authority as required. Action had not been taken to reduce the likelihood of similar injuries occurring again.

At this inspection we saw improvements had been made and now incidents were identified, recorded, referred and investigated appropriately.

We also found improvements had been made to the management of risks. Most assessments were personalised meaning they reflected people’s individual needs and preferences.

People felt that activities could be improved and the registered managers could demonstrate they were looking to address this.

People received their medicines safely and appropriately. Improvements to recording processes meant that records now reflect this.

There were sufficient numbers of staff on duty at any one time to meet people's needs in a safe way. The registered managers had recruited a full complement of staff to ensure a consistent staff team.

Staff received regular support and supervision and the provider followed safe recruitment procedures to ensure that appropriate staff were employed. Staff felt well trained to carry out their role effectively and meet people’s individual needs. Competency was regularly checked to ensure effective care was delivered.

There were effective systems in place to reduce the risk of the spread of infection.

The provider followed the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their care and support. People’s decisions and choices were listened to and respected.

People's health and well-being was monitored and supported and needs were being met by staff and with the appropriate support from health professionals. People's nutritional and dietary needs were catered for.

Staff were kind and respectful and they knew people well. People's privacy was respected and staff supported people to maintain their dignity. Staff had a good knowledge of people's needs. We received positive feedback regarding staff and how peoples’ needs were met.

Care plans were sufficiently detailed and person-centred, giving members of staff and external professionals relevant information when providing care to people who used the service. Information was reviewed and updated to ensure staff could deliver responsive support as people’s needs changed.

There were effective procedures in place to respond to any concerns or complaints. The registered managers responded promptly and effectively to ‘niggles’ and this ensured that issues were responded to informally and quickly.

The registered managers were approachable and responsive. People were involved and consulted about the running of the home. People who used the service and their representatives were regularly asked for their views about their support through questionnaires and feedback forms. The registered managers also spent time observing care and support to enable them to gather views informa

This inspection took place on 8 January 2018 and was unannounced.

St Joseph’s Covent Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Joseph’s Covent Nursing Home accommodates up to 46 people in one adapted building. At the time of this inspection there were 44 people using the service.

At the last inspection the service was rated good. At this inspection the service was rated requires improvement. This is the first time the service has been rated Requires Improvement”

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not always protected from avoidable harm because unexplained injuries had not been investigated and reported to local safeguarding authority as required. Action had not been taken to reduce the likelihood of similar injuries occurring again. You can see what action we told the provider to take at the back of the full version of the report.

Risks were assessed however risk management plans in place were not consistently followed.

People told us they received their medicines as prescribed however we found some issues which showed that medicines were not always managed safely and people did not always receive their topical creams as intended.

Staffing levels were sufficient to meet people's needs and staff had their suitability to work in a care setting checked before they began working with people. Premises were kept clean and tidy and people were protected from the risk of infection.

People’s needs and choices were assessed and the assessment process was suitable. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported by trained staff however some staff needed more support to check they had understood the training they received. Staff received regular supervision and felt supported in their roles.

The environment was adapted to meet people’s needs and there were plans in place to improve the decoration of the home. There was a good choice of food, which people enjoyed and they received support to meet their nutrition and hydration needs. Healthcare professionals were consulted as needed and people had access to a range of healthcare services.

Staff were kind, caring and compassionate with people. People were supported to express their views and encouraged and supported to make their own choices. People were treated with dignity and respect and their independence was respected and promoted.

People’s diverse needs were not always fully assessed and planned for to ensure they received fully personalised care. People had access to activities though some people felt they were repetitive.

People received dignified support, in line with their wishes at the end of their lives, where this was required.

People knew how to complain and concerns were acted upon though plans were not always put into place to reduce the likelihood of the same concerns arising again.

Systems and processes in place to monitor the quality and safety of the service needed some improvement, as the issues we identified during the inspection had not been identified through these processes. However, the registered manager was receptive to feedback and contacted us following the inspection to tell us about improvement they had already started to make.

The registered manager was freely available to p

The inspection took place on 15 September 2015 and was unannounced.

St Joseph’s Convent Nursing Home provides nursing care for up to 41 older people. At the time of the inspection there were 40 people in residence.

There was a registered manager in charge of the day to day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medicines were safely stored and managed.

People were protected from the risk of harm because staff knew how to recognise and report any suspected abuse. Any risks to people were assessed and action taken to ensure people’s safety and welfare in discussion with the person and their family and supporters.

Staff felt supported and felt they received sufficient training to meet people’s needs. Staff knew how to support people who did not have capacity to consent and helped them make decisions in their best interests. Further training was planned. People’s health needs were met and reviewed regularly. People’s nutritional needs were assessed and food and drink provided in sufficient quantities to maintain their welfare and to meet their preferences.

People were treated with compassion and kindness. People said they felt extremely happy with the care they received and made positive comments about the care staff supporting them. Our observations throughout showed people’s privacy and dignity were respected at all times. People’s wishes regarding their end of life care were sought and agreed. The service promoted high standards of care and compassion to ensure people and their loved ones were supported.

People’s spiritual, social and recreational needs were supported, they were informed of any events within the home and their views were sought regarding any hobbies and interests they may wish to pursue. Staff knew of people’s individual histories and their care needs. There were plans in place to ensure people’s needs could be met as they wished.

Complaints procedures informed people how they could make a complaint and people told us if they had any issues they felt able to raise them with the staff or management.

Staff told us that the management team were very supportive and there was clear leadership. Staff meetings and annual appraisals took place to ensure staff were performing to the standard expected of them.

The views of people who used the service and their relatives were sought at admission and annually, any comments were analysed by the registered manager in order to continually improve the service provision.

A system for the audit of the quality of the service had been introduced by the new provider; this was an on going process and included a Health and Safety review. An action plan has yet to be developed.