Archived: St Giles Nursing Home

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

All the people spoken with told us that they felt safe in the home. All the staff we spoke with told us that they felt that the people who used the service were well cared for, their needs were met and that people were safe.

The care records showed how people wanted to be supported and provided most of the information that staff needed to ensure people's wellbeing and safety. Some records needed to be updated so that they accurately reflected people's needs.

Staff had received training and support so that they could care for people safely and knew how to raise concerns if they had any suspicions of abuse.

We saw that systems were in place to ensure that people received their medicines as prescribed however; we did see that sometimes food supplements prescribed for one person were given to another person who had not been prescribed them. This could mean that people were given supplements that were not appropriate for them.

Staff we spoke with had only a basic knowledge of the Deprivation of Liberty Safeguards (DoLS) process and the Mental Capacity Act. DoLS is a legal framework that may need to be applied to people who lack capacity and may need to be deprived of their liberty to protect them from harm and/or injury. The registered manager told us that she needed to update her knowledge regarding the recent High Court decision and its impact on making DoLS applications. We saw that assessments of need and risks were not in place for people who were sat in chairs that they could find it difficult to get out of. This meant that their right to get up and walk around may be being restricted.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law to ensure that the service was safe but some improvements could be made.

Is the service effective?

All the people we spoke with told us that the staff knew their needs and how to assist them. We saw that people looked well-presented and drinks and call bells were accessible at all times. Two people told us that they had lived in the home for two years and had no complaints. One person told us, 'I wake up about 5.30am, but they (staff) don't bring a drink as they are busy getting people up.' We saw that although some records needed to be updated people received appropriate support to meet their needs. One person told us that they felt that staff didn't spend enough time with them when providing care and this meant they felt that care was often rushed. This meant that people's care needs were usually met.

We saw that people sitting in communal areas of the home had more contact with staff than those people who remained in their bedrooms. We were told by people that staff contact for people in their bedrooms was often task centred. One person who remained in their bedroom told us, 'I don't have much to do in here, I get lonely'. This meant that the service was not always effective in providing people with meaningful activities to occupy them.

We saw that people's health needs were met with the involvement of a variety of health care professionals. We saw that some people lived in the home on a long term basis and some were admitted to the home so that they were supported to develop their skills so that they could return home or to more suitable long term provisions.

We saw that systems were in place to ensure that people had access to the medicines they needed to meet their medical needs. People were supported to eat and drink to meet their dietary and hydration needs and to prevent them developing skin damage where possible.

We found that effective recruitment procedures were in place that ensured that only suitable staff were employed. Staff received support to provide effective and safe care through the provision of training and supervision with senior staff when their work practices were discussed.

Overall, we found that the provider had adequate processes and systems in place to provide an effective service.

Is the service caring?

Most people that we spoke with told us that staff were polite and caring. One person told us, 'The staff are good'. A relative told us, 'They are good staff, we are pleased'. However, one person told us, 'Staff are generally polite and respectful one or two are more abrupt'. Another person told us that it was, 'Better to have X on your side' but they also said that the staff member was good at their job. Before our inspection we had received some concerns about the way a member of staff sometimes spoke to people. During our inspection we saw that one person who told us they were usually given tea to drink but preferred coffee was told by a member of staff, 'Here's coffee, you only have to ask'. This indicated that sometimes people could be spoken with in a way that may leave them feeling uncared for.

Staff that we spoke with knew the care and support needs of people and this ensured that personal care was provided in a way that people preferred. During our inspection we observed that people's privacy and dignity was not always observed. We saw two staff walk into two bedrooms without knocking and waiting to be invited in. This showed that staff did not always respect people's privacy. We saw one person transferred with a hoist and their dignity was not preserved on three occasions. We saw interactions where puddings were put in front of people and there was no explanation of what the pudding was. This meant that interactions did not always show care for people.

Overall, we found that the provider had processes and systems in place to meet the requirements of the law to ensure that the service was caring but improvements could be made.

Is the service responsive?

The provider had a complaints procedure in place and people told us that they knew how to raise any concerns, if needed. We saw records that indicated that complaints were recorded and actions taken to investigate and address areas of concern raised with the provider. This meant that comments and complaints were listened to and acted on.

We saw that care plans and risk assessments were in place to meet people's needs however, we saw that they were not always updated to ensure that people's changing needs were identified and plans put in place to meet them safely.

Before our inspection we had received some concerns that people did not always receive appropriate care following a fall. At this inspection staff were able to tell us what actions they would take to ensure that people's needs were met. People told us that they received the support they needed to see a healthcare professional.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law to ensure that the service was responsive.

Is the service well lead?

There was a registered manager in place who was aware of their legal responsibilities.

Systems were in place to ensure that the quality of the service was reviewed and monitored on a regular basis and took the views of staff, relatives and people living in the home into account.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law to ensure that the service was well lead.

We saw that people were dressed in individual styles that reflected their age and gender and that the interactions with staff were friendly and supportive. People told us they were happy living at the home and that their health and personal care needs were being met. This meant that they received care and support in the way they preferred and in a respectful manner.

We saw that staff ensured people received adequate support to ensure that their nutritional needs were met. People received appropriate support to eat their meals. One person told, "There are choices of meals each day."

Staff received training and support that enabled them to care for people in line with their assessed plan of care and protect them harm. One person told they felt safe with staff. Another person told us, "They (staff) do a good job."

Complaints were investigated and responded to in a timely manner so that people felt valued and listened to.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them.

People were dressed in individual styles that reflected their age, gender and the activities they were doing.

People told us that they were happy living at the home and that their health and personal care needs were being met. They told us that they received care and support in the way they preferred and in a respectful and timely manner.

We saw that systems were place to ensure people receive adequate nutrition

Staff were knowledgeable about people's needs so that they were able to meet people's needs in the way that they preferred. Staff were supported to carry out their roles safely so that people were protected from the risk of harm.

People living in the home were protected from the risks of abuse and unsafe care.

The provider ensured that there was adequate monitoring of the service to ensure that people received a good service that met their needs.