St Anthony's

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 changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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 fostered an open and positive safety culture based on honesty and transparency. Incidents were reviewed, lessons were identified, and learning was shared to improve practice. The registered manager also carried out monthly incident reviews to ensure action was taken to reduce the risk of further harm.

The service showed strengths in its learning culture, with leaders and staff receptive to feedback and responsive to issues identified during the inspection. When concerns were raised, prompt action was taken, including updating documents and clarifying guidance to reduce risk. One staff member told us that lessons from incidents and accidents were discussed in team meetings.

The registered manager worked with people and healthcare partners to support safe systems, pathways and transitions. Relatives said good access to GPs and other health professionals had a positive impact on people’s care and support.

Before people moved into the service, a pre-admission assessment was completed to confirm the service could meet their needs. Relatives told us staff made prompt referrals when their loved ones needed specialist support for a health condition.However, some care plans did not consistently reflect the most up-to-date information available at the time of inspection, and relevant details were at times recorded across different sources, including communication records. This meant staff may not always have had access to the most current information within care plans.

The registered manager maintained strong, consistent relationships with a range of healthcare professionals, including GPs, community nurses and pharmacists. We brought this to the attention of the registered manager who told us they would review people’s care plans.

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

People and relatives said they felt safe with staff and knew how to raise concerns about their safety. One relative said, “I feel the home is a safe place, and [person] is looked after well.”

Staff had a good understanding of how to safeguard people from the risk of harm. One staff member told us, “There are several types of abuse, including neglect, sexual, physical, emotional and financial abuse. I would report it to my manager. We have a safeguarding poster in the office with all the numbers to call.”

The provider worked with people to understand and manage risks in a holistic way. Staff delivered care that was safe, supportive and enabled people to do what mattered to them.

Although some risk assessments lacked detail, risks had been identified, linked to the outcomes for the people reviewed, and measures were in place to reduce the risk of recurrence. However,

care records and risk assessments were not consistently reviewed or updated. This meant staff may not have had clear or accurate information to manage risks safely.

We identified one person at risk of seizures for whom staff were unaware that a risk assessment was needed. The registered manager took prompt action in response to this feedback.

The provider identified and managed environmental risks to support safe care. Equipment, facilities and technology were maintained to help keep people safe, and people told us the care home was a comfortable place to live.

Some areas of the home looked tired and would benefit from refurbishment. However, a programme of improvement was already underway.

We found the kitchen freezer was broken and needed replacing. The registered manager took prompt action to address this. We found food within the fridges and dry cupboard which were not labelled and all fridges required deep cleaning. The registered manager took prompt action following feedback to address these concerns.

The provider had a health and safety policy and carried out checks to help maintain a safe environment for people, staff and visitors, including gas, water and fire safety checks. External fire and legionella risk assessments had not yet been completed in the last 3 years, although staff were carrying out regular fire and water checks. The registered manager provided evidence that appointments had been arranged for these assessments to take place.

The service was staffed by people who had the right skills, experience and support to meet people’s needs safely and effectively. People and their relatives felt there were enough staff to care for people. One person told us, “They are very good and come straight away.”

Staff completed training and supervision relevant to their role.Staff were recruited safely. Prospective staff went through a series of background checks to ensure they were suitable to work with vulnerable people.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff followed infection prevention and control protocols, including appropriate use of personal protective equipment and regular audits.

Relatives had no concerns about the hygiene and cleanliness. People we spoke with told us they felt bedrooms were clean and staff wore Personal Protective Equipment (PPE) when required. We observed staff using PPE appropriately and there was sufficient stock available.

The provider did not always ensure medicines and treatments were safe and met people’s needs, capacities and preferences.

One person was using medicated patches, and the manufacturer’s leaflet clearly stated that patches must not be applied to the same site again for 14 days, as this could cause irritation.Staff were not recording where patches had been applied to demonstrate site rotation in line with manufacturer guidance. During discussions, we were not consistently assured of staff understanding of all associated risks, including safe application practices.

There was no risk assessment in place for the use of emollient cream where some people smoked. The registered manager was not aware this was required; however, they took prompt action following feedback.

The provider had a system for medicines to be ordered, stored and disposed of safely. People were supported to take their medicines safely by staff whose competency was regularly assessed.

Senior staff carried out regular medicines audits to help identify and address any issues. By the end of the assessment, the management took action to rectify some of the concerns raised in relation to medicine management and completing relevant risks assessments.