Galanos House

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 78 (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 complete honesty. Staff listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Relatives were informed of any incidents and accidents involving their family member and were involved in discussions about strategies to keep people safe. One relative described open channels of communication and said, “They are good at coming back to me and with honesty."

The provider promoted a culture where staff felt safe to own their mistakes knowing they would be supported to improve their practice. The provider’s quality manager explained, "If something has happened, it is a benefit to everybody. We are not in a blame culture, we look at things openly, honestly and transparently. I have to work as a critical friend, that is part of doing the action plans."

There was a collaborative approach to identifying learning from accidents and incidents to improve the safety of the home. The registered manager told us, “It is about discussing it as a team. On Monday we have a managers’ meeting and a clinical meeting afterwards. We have an agenda regarding falls, weight loss, anything that has happened on the floor. It is very open and about how we can learn.” Any learning was shared with staff and additional training introduced where a need was identified. One staff member gave an example of how it had been identified emergency evacuation processes required improvement. Increased fire drills and training had led to improvements in this area.

Staff said information was shared so they could improve outcomes for people. The handover between shifts evidenced that staff considered learning in relation to each person and this was underpinned by referencing annual reviews and guidance from external healthcare professionals.

Accidents and incidents were analysed by the provider’s quality team to ensure appropriate action had been taken to mitigate individual risks and any service level improvements actioned. Opportunities to learn from safety events in other services and organisations were identified.

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

People and their relatives described robust processes to support their move to Galanos House. This included assessments, meetings and visits to the home prior to admission. One relative told us, “[Name] had assessments, and we were all involved in the transition.”

Where people’s health declined and they needed to move to a different unit within the home for specialist care, this transition was considered and planned with people, their families and staff. One staff member told us about 1 person who had moved units and explained, “The staff set up her new room to look exactly like her old room with all of her belongings being placed in the same way. One of the staff members who knew [Name] very well, moved with her to provide continuity. We wanted to ensure the transition to a different staff team was well managed and there was continuity.”

There were processes to share information about people if they had to be admitted to hospital in the event of an emergency. A staff member always travelled with people which ensured other healthcare professionals had the information they needed to respond to any risks associated with people’s care. People were re-assessed in hospital prior to their discharge back to Galanos House. The registered manager explained, "We actually go and see people before they are discharged and then any medical advice will be incorporated into their care plan, and we present any changes in the handover.”

A diary system ensured external routine healthcare appointments were attended and planned for. Staff always accompanied people to healthcare appointments even if they were being supported by a family member. The registered manager told us this promoted continuity of care because, "Sometimes families don't always hear everything that is said so it is always good to have a second pair of ears.”

External healthcare professionals expressed confidence in the provider’s processes to ensure good transitions between healthcare providers. One healthcare professional told us, “They ensure patients attend regular outpatient appointments following referrals and follow up with hospital or my administration team for any pending appointments.”

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 were relaxed around staff and told us they felt safe living at Galanos House. Comments included: “I don’t know how they choose the staff here, but they really are good”, “I have no complaints, I feel very safe” and “The staff here are all very good, if they weren't the (managers) would soon change them. But I cannot think of any time when the staff haven't been good and polite.”

Relatives told us their observations of staff interacting with people gave them confidence their family members were being well looked after. One relative told us, “I am confident they are looking after him well and I can relax when I go away from here." Another relative said, “I think it is the next best thing to him being at home and for me it gives me peace that he is being very well looked after. As soon as something goes wrong, they are on it.”

Staff had received training in safeguarding people from harm and understood their responsibility to report any concerns. Staff told us they would be aware of subtle changes in people’s behaviours that might indicate they were worried or anxious. One staff member told us they would be concerned if a person was, “Withdrawn or were tearful. Lack of appetite, social withdrawal. If somebody was showing fear in their face when you went near them, I would report it to my line manager, raise my concerns and put it in writing." Another staff member said, “If I couldn’t talk to [registered manager], I could speak to CQC, the police, another member of the management team or Warwickshire [local authority] safeguarding.”

The provider reviewed all safeguarding concerns to ensure the right actions has been taken to maintain people’s safely.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. When people were identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Processes were in place to ensure Deprivation of Liberty Safeguards (DoLS) were managed in accordance with legislative requirements.

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.

People and their relatives had been involved in meetings and ongoing conversations about potential risks to people’s safety. One relative told us, “We are involved in decisions, and we have meetings, and they tell me what they are going to do. If they say she is a bit wobbly and wants to walk, they walk with her and keep an eye on her.” Another relative commented, “They have involved us in encouraging her to use her frame to get around and she is using her frame to independently go to the toilet now.”

The provider promoted positive risk taking to enable people to continue living their lives with as few restrictions as possible. The registered manager explained, “We manage the service not afraid of letting people take risks. People become frustrated when we say you can’t do something, so better to say, ‘what is the risk and why do we feel it is a risk’. If someone has been doing something safely for 70 years, that doesn’t need to change because they live here. We find a solution, not a problem.” We saw examples of positive risk taking which benefited people’s lives.

Care plans for people with risks associated to their health conditions such as epilepsy, diabetes, catheter care and Parkinson’s disease contained clear, individualised instructions, reflecting safe and effective systems of work.

Some people could demonstrate anxiety or agitation as symptoms of their health conditions. Staff effectively used behavioural management strategies to support people at such time; for example, in the case of 1 person, staff identified triggers for care refusal and adapted their approach accordingly. This meant staff could safely support people at times of distress without resorting to restrictive interventions such as medication.

Whilst most risks were identified and managed, we identified 1 person who had a food allergy did not have a risk assessment and care plan in place. Managers assured us the person had capacity to manage their condition but acknowledged the risks of staff not having information to respond to the risk in an emergency. Extra checks needed to be implemented to ensure all aspects of people’s care plans were updated to reflect changes to their nutritional needs.

Another person had recently been admitted with a pre-existing wound. Although a dressing plan was in place, a full wound care plan had not yet been completed due to time constraints following 4 new admissions in the same week. The wound care plan had been prioritised for completion.

Staff had a clear understanding of their role in supporting people to manage risks. Clinical staff told us care staff were proactive in reporting any changes to people’s health such as redness, bruising, or skin damage, even when these appeared minor. This vigilance ensured any escalating risks to people’s health and safety needs were promptly addressed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Each person had a full assessment of their needs when they moved to Galanos House to ensure they had the right equipment to mitigate any identified risks and promote their independence. A member of therapy staff explained, “Every single resident, I do an initial assessment. I will look at what needs they have got, what furniture they need, what mattress they need and cognitively what support they need.” This staff member gave examples of how they had worked with people and other staff to adapt equipment to maintain people’s safety whilst respecting their preferences and choices.

Staff at all levels worked together to ensure the environment was safe. Staff told us any issues were escalated and the maintenance team informed. There was maintenance cover 7 days a week so issues with equipment or within the environment could generally be promptly addressed.

There were systems to ensure the health and safety of all. Service folders confirmed the servicing and maintenance of premises and equipment had been completed in accordance with the provider’s maintenance schedule.

The provider’s fire risk assessment was up to date and there was accessible information about what support people would need to evacuate the home in an emergency.

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.

People and relatives mostly considered that staffing levels were good. They described a consistent team of staff who were visible and around to assist as needed. They told us staff appeared competent and well trained and had the skills to meet people’s needs. Comments included: “There always seems to be someone around”, “They are certainly competent and well-trained” and “It appears to be well run and not short staffed.”

We received mixed feedback from staff about staffing levels in the home. Some staff told us staffing levels were adequate but other staff felt it was sometimes difficult to meet people’s needs, particularly when there was unplanned staff absence. Our observations during the inspection were that staff were available and did not appear rushed. However, there were occasions during the day, for example during handover, when staff were not immediately available to respond to people’s requests for support. The registered manager assured us staffing levels were based on an assessment of people’s needs and could be flexed to respond to any changes in those needs. A healthcare professional told us staff worked as a team to ensure people’s safety was maintained and commented, “If an emergency bell goes off, the domestic and cleaners keep an extra look out because they know there are less care staff on the floor."

Two practice development facilitators based in the home offered comprehensive inductions for new staff and ensured training was maintained and consistently reflected best practice.

Staff told us the training and support they received enabled them to carry out their roles and responsibilities safely.

The provider followed recruitment procedures to ensure all required checks were completed before staff started work at the service. Enhanced Disclosure and Barring Service (DBS) checks were carried out. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

Staff were supported by a team of over 50 volunteers. Volunteers had the same recruitment checks and training as permanent staff so they could engage with people safely.

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.

People and their relatives raised no concerns about the cleanliness of the home with 1 relative commenting, “It is spotlessly clean.” Relatives told us they were informed of any infection outbreaks by email and notices on the entrance to the home.

Staff had a good understanding of when to use personal protective equipment to prevent the spread of infection and received regular training in infection control practices. The provider engaged with external healthcare professionals to embed good practice into the home. One healthcare professional told us they had no concerns about infection prevention and control and commented, “They are always open and willing to engage.”

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.

People and their relatives were positive about the management of medicines at Galanos House. They told us people’s prescribed medicines were regularly reviewed, and staff were responsive when people required pain relief.

Records demonstrated people received their medicines as prescribed. Electronic medicines administration records (EMARs) were completed accurately, with no unexplained gaps or omissions identified. Medicines were ordered, stored and disposed of safely.

Some people were prescribed medicines on an ‘as required’ basis (PRN). PRN protocols were completed in a person-centred manner, reflecting GP or prescriber recommendations. Clinical staff demonstrated confidence in administering PRN medication via syringe drivers and confirmed they had received appropriate training. Where people received their medicines via a patch applied directly to their skin, best practice guidelines were followed and application sites recorded on body maps.

People received their medicines from trained, skilled, and competent staff. Staff observed during medication rounds were confident, professional, and patient, allowing people adequate time to take their medicines. Staff administering medication demonstrated a clear understanding of how to report medication errors and escalate incidents appropriately.

Records confirmed people’s medicines were reviewed regularly with other healthcare professionals. This demonstrated effective systems for ensuring medicines were prescribed at the correct doses and intervals and remained effective.