St Giles Charity Estates

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There were effective systems in place for reporting, investigating and learning from all incidents, accidents and complaints. These events were used as a learning opportunity and any lessons learnt were shared with the staff team. For example, following a fall (unwitnessed), an accident form was filled. Body map done. Investigation was completed and the then lesson learned was identified and shared with the staff.

The registered manager analysed all accidents, incidents, near misses and complaints to identify patterns and action had been taken to prevent recurrence.

Staff were confident in the management’s ability to thoroughly investigate and feedback following incidents or accidents that they had reported.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had effective and safe admission process in place. People, their family and if required health professionals were involved in the process to ensure their needs were assessed and care was planned.The hospital pack contained clear and detailed guidance for staff and external professionals, which would support a smooth transfer in an emergency.

The personal emergency evacuation plans (PEEPs) were up to date and provided clear guidance for people, staff, and external professionals responding to an emergency evacuation of the service.

Staff had good awareness of the people they cared for and the support they needed. People’s care plans contained relevant information such as health conditions, medication, and ability, and was kept up to date and easily accessible, for instance if required by the emergency services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider had a clear safeguarding policy in place. The policy explained how staff could report concerns, including reporting them to outside agencies if needed. Staff and managers had completed safeguarding training.

When we spoke with staff, they understood how to raise a concern and who they should report it to. At the time of our visit, no one using the service needed to be subject to Deprivation of Liberty Safeguards (DoLS). However, the registered manager understood the DoLS process and knew when an application would be required.

The provider was submitting statutory notifications when required. There was a system in place to make sure incidents were reported to the correct authorities, investigated properly, and that outcomes were shared. People using the service, and their relatives or representatives, were kept informed during investigations.

The registered manager was aware of the Duty of Candour and understood their responsibility to be open and honest when things go wrong.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

There were systems in place to assess, manage and monitor risks to people. Risk assessments covered areas such as falls, nutrition and skin care. Care plans were detailed and gave staff clear guidance on how to support people safely and reduce the risk of harm. These were reviewed regularly.

People told us they felt safe and that staff understood their needs. One person said, “Oh yes, there is always someone around. I have a bell if I need them. The staff are all very good.”

However, one person’s catheter care plan did not include all the necessary information. Staff were relying on the catheter passport completed by healthcare professionals. Although we found no evidence of poor care, the lack of clear written guidance in the care plan could lead toinconsistent support. We raised this with the registered manager, who addressed it straight away.

There were also systems in place to make sure staff received the right training and had the skills and knowledge to support people safely.

The provider had systems in place to monitor and maintain the safety of the care environment, equipment, and facilities. These systems were generally effective; however, they did not always identify all potential risks promptly. Where issues were identified, appropriate and timely action was taken to reduce risks and support the delivery of safe care.

There were systems in place to monitor the safety and maintenance of the building and equipment. However, the audit process had not identified that some windows did not have restrictors fitted. We raised this with the registered manager. A risk assessment was completed straight away, and an order was placed for new window restrictors.

Furniture was secured to the walls to reduce risk. People, relatives and visitors spoke positively about the décor, facilities and overall environment. Equipment used to support people was easy to access and stored safely when not in use.

The home was clean, well lit, had clear signage and wide corridors free from hazards, which supported people to move around safely. One person told us, “Yes, it’s safe if you want to go around it.”

Overall, systems were in place to help make sure the environment and equipment were safe and properly maintained, although improvements were needed in identifying some risks more promptly.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were enough staff on duty, and they were visible around the home. People told us staffing levels were sufficient to meet their needs. One person said, “There is always somebody to talk to. At night there is always someone senior on duty.” Relatives also spoke positively about the staff and said support was provided without delay.

Staff had been recruited safely and in line with safer recruitment procedures. Rotas showed that shifts were fully covered. New staff completed an induction and essential training to make sure they had the right skills for their role. Their competency was checked regularly. Staff received ongoing support through supervision and appraisals, and good practice was recognised.

There were clear arrangements for team working. Staff told us they worked well together and communication within the team was good.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had an infection prevention and control policy that staff could access. Staff had received training and understood how to use and dispose of personal protective equipment (PPE), such as gloves and aprons. We saw staff following good hand hygiene practices and using PPE correctly to reduce the risk of infection.

However, we observed some staff walking along the corridor while still wearing gloves and PPE. This was raised with the manager and was dealt with immediately.

The home was visibly clean and free from unpleasant odours. Three staff members worked each day to cover housekeeping and laundry duties. There was enough PPE and cleaning products available.

Cleaning was taking place and there was a system in place to record this. However, the recording was not detailed or consistent. Daily cleaning and deep cleaning of rooms were not clearly documented. We raised this with the manager, and this was addressed straight away by introducing a clearer and more structured cleaning record chart.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The provider had a medicines policy in place. Medicines were managed safely. Staff had completed medicines training, and their competency had been assessed.

Medicines were stored securely, including controlled drugs, which were only accessible to authorised staff. Room temperatures were monitored. Liquids and creams with a limited shelf life were dated when opened. For transdermal patches, staff recorded the date applied, the site used, checks completed and the date removed.

Medication Administration Records (MAR) were completed correctly, and any refusals were recorded. ‘As required’ (PRN) medicines had clear protocols in place. We checked medicine stocks and found they matched the service’s records.

One person told us, “I take six tablets. They were giving them all at the same time and I felt sick. I said about it and now they are split through the day and I feel better.”

Regular medicine audits and reviews were carried out. Where issues had been identified, action had been taken to improve practice.