St Anthony's Residential Home Limited

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 requires improvement. Breaches of regulations were identified in relation the need for consent, safe care and treatment, and safeguarding.

At this assessment the service was no longer in breach of regulations and the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

Accidents and incidents were documented and reviewed by the acting manager to identify any areas of improvement or learning. Where issues were identified, information was shared promptly with all staff to prevent similar events reoccurring.

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 service shared information effectively with partners when people moved between care services. Hospital passports were available to inform first responders and hospital staff of people’s needs if they needed to be admitted to hospital in an emergency.

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.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

At our previous assessment, people had been restricted to their rooms for short periods without authorisation and managers did not understand the requirements of the Mental Capacity Act.

At this assessment, the acting manager and nominated individual now understood the requirements of this legislation. People’s capacity had been assessed and necessary DoLS applications made. Relatives, people using the service and staff did not report any incidents of people being restricted to their rooms.

Staff disciplinary processes had improved since our previous assessment. The service now investigated concerns in relation to staff performance and used staff disciplinary procedures effectively.

Relatives said, “I do feel [My relative] is safe and looked after” and records showed appropriate safeguarding referrals had been made in response to incidents that had occurred. Staff were confident the acting manager and provider would act in response to any concerns they reported. Staff comments included, “There are no safeguarding issues here. I am very black and white if I saw something I would do something about it” and “I would tell the manager or senior, I am positive it would be looked in to and investigated”. Records were now maintained of investigations into staff disciplinary issues.

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.

Risks were identified and mitigated effectively, and people were safely supported to move around the service. Care plans included clear guidance on how to support people’s mobility and detailed how to provide additional support if the person was unwell.

Some individuals were known to become anxious. Their care plans included information about events likely to upset the person and guidance on how to provide effective support and reassurance.

Although no one using the service at the time of the assessment was in need of support to reposition, staff and managers had a good understanding of the support necessary to manage risks to people’s skin integrity.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

All necessary checks had been completed to ensure the safety of the service’s environment, utilities and equipment. Lifting equipment was regularly serviced and necessary tests of utilities had been completed by appropriately skilled contractors.

The service now had systems to monitor and assess the quality of the environment. Flooring in the dining room and snack preparation area had been replaced since our last assessment. Two bedrooms were in the process of being upgraded and redecorated and window restrictors were fitted in occupied rooms.

However, flooring in the laundry area was damaged and required replacement. Flooring in the downstairs corridor had ‘ballooned up’ posing a possible trip hazard. Although quotes had been sought for the necessary repairs, these works had not been authorised prior to the assessment.

Large boxes of Christmas decorations were inappropriately stored in a downstairs corridor near a fire escape. These items where promptly removed when this risk was reported to the provider.

Action had been taken to address structural fire safety issues and regular checks of the service’s fire detection and fighting equipment had been completed. Personal emergency evacuation plans were available detailing the support each person would require in an emergency. Staff told us, “We do a weekly alarm test and a yearly fake evacuation with the staff. Have staff in wheelchairs and things, pretending they are residents”.

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.

The service had enough staff available to meet people’s needs and rotas showed planned staffing levels were routinely achieved. Relatives told us, “They have good staffing, quite often it’s almost 1:1”.

Staff were readily available and responsive to people’s needs. Records showed staff had received regular supervision and training to ensure they had the skills necessary to support people. Staff said, “There is enough staff”, “My training is up to date” and “The training works quite well. I have a couple of outstanding [online training courses] that I will do when I get home”.

Staff were recruited safely. All necessary pre-employment checks including Disclosure and Barring Service (DBS) checks had been completed to ensure prospective staff were suitable for employment in the care sector. Once appointed, the induction process was designed to ensure staff rapidly gained the skills necessary to meet people’s needs. A recently appointed staff member commented, “The induction was pretty good, I shadowed for a couple of weeks, I feel supported” and people said, "When [New staff] first come, they always follow someone until they can be left alone"

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 service was clean and staff understood how to manage infection control risks. Personal Protective Equipment was available and used appropriately by staff when providing personal care. Cleaning schedules ensured all areas of the home were regularly cleaned and audits were completed to check planned tasks had been completed.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

People received medicines as prescribed. Staff had been trained in how to support people safely with their medicines and their competency in this role had been assessed. Medication administration records (MAR) had been accurately completed and medicines that required stricter controls were stored correctly and their use documented appropriately.

However, the service’s medicine trolley was not secured in position when not in use and necessary temperature monitoring checks had not been completed. These issues were discussed with the acting manager and provider, and plans developed to resolve these issues