St Michaels

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. At this assessment the rating has changed to 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.

The provider had a process for staff to report incidents, near misses and safety events. The registered manager reviewed these reports which enabled them to identify trends, learn lessons and improve people’s care. Records showed learning from these events was shared with the staff team. We saw an example of how this process had led to a reduction in a person experiencing falls by altering their morning routines.

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.

Staff worked in a joined-up way with external professionals such as GPs, district nurses and social workers to ensure continuity in people’s care. Staff knew people well which enabled them to ensure communication between services was efficient and effective.

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 told us they felt the service was a safe place to live. One person said, “Feel very safe; I feel better because I have staff around.” People also told us they were confident staff would act quickly to keep them safe if they had any concerns. A relative told us, “[Loved one] is absolutely safe. [Loved one] has been there 4 years and the way staff are with (them) I know they are safe.”

The registered manager worked with local authority safeguarding teams and other external professionals to ensure any safeguarding issues were dealt with quickly and effectively. Records showed timely investigations had been carried out and actions taken to reduce the possibility of similar issues occurring in the future. A relative told us, “I was very impressed recently with the way they dealt with a safeguarding issue.” They went on to explain how the situation was managed in a quick and efficient way.

Staff understood their roles and responsibilities in safeguarding the people they cared for. They received regular training about how to manage safeguarding issues.

Where people were subject to restrictions to keep them safe, Deprivation of Liberty Safeguards (DoLS) were in place and followed, including completion of mental capacity assessments. DoLS authorisations were kept up to date and any conditions were complied with.

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

Risks to people’s health, safety and welfare were assessed. Plans were in place to guide staff about how to support people to manage risks such as skin care, epilepsy, nutrition and mobility. We saw examples of how people were supported with mobility aids to help them move around the service whilst staying safe. A relative of a person who was at risk of falls told us, “[Loved one] uses a walker to get around. Each and every time a member of staff is by [loved one’s] side, not interfering, allowing [loved one’s] independence, just keeping an eye that [loved one] is safe.”

One person described how staff had helped them to understand the risks to their health, safety and welfare when they moved into the service. They said staff worked with them to find safe ways to stay as independent as possible whilst minimising risks.

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

The registered manager worked with the provider’s maintenance team to ensure any repairs and building maintenance tasks were completed quickly. There was oversight and servicing of areas such as fire safety, equipment safety and water testing.The provider had an annual service improvement plan to address areas identified by the registered manger such as furniture and flooring replacements, and redecoration.

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 told us there was always enough staff on hand to help them when they needed. A relative said, “There always seems to be enough staff and they are friendly and professional.” Staff told us there were enough staff on duty to keep people safe and meet their needs. They told us how the team supported each other to cover for any absences such as illness.

During both of our visits to the service we saw staff responded quickly to people’s needs whether they were in communal or private areas. We observed a lunchtime meal and saw people who needed support received this in a timely way, and in line with their care plans.

The provider had processes in place to ensure they made safer decisions when employing new staff. This included Disclosure and Barring Service (DBS) checks, previous employment information and evidence of the right to work in this country for overseas staff.

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 told us staff kept the service clean and tidy. A relative said, “I was pleasantly surprised when I (first) walked in, it smelled lovely…. Absolutely clean everywhere.” Cleaning schedules were in place and the registered manager regularly checked they were being followed.

Staff demonstrated a good understanding of infection prevention and control (IPC) processes. We saw they followed good hand washing techniques and used personal protective equipment (PPE) at the right times and in the right way.

Care plans guided staff about how and when people liked to receive their medicines, including medicines people took only when they needed them (known as prn). We saw staff administering people’s medicines in line with their care plans. Staff had received training in medicines management and their competency was assessed routinely.

However, medicines stocks and recorded balances were not always accurate. We found a small number of instances where medicines administration records did not balance with medicine stock counts. The registered manager took immediate action to address the issue and provided assurance people had received their medicines as prescribed.