St George's Nursing Home (Oldham)

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 as 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.

Safety incidents were logged on a spreadsheet with subsequent actions to be taken. The incidents were discussed at staff and management meetings, promoting learning and improvement.
The leadership team were open and transparent and wanted to drive improvement. Staff were encouraged to report any concerns to management. Where incidents had occurred the management team shared all relevant information with healthcare professionals as appropriate, ensuring the safety of people supported and the best outcomes moving forward. During the inspection it was identified that there was confusion about whether a person’s medication had been discontinued. The management team investigated this and found miscommunication between the pharmacy and staff. They took swift action to amend the system that was in place to ensure the risk of miscommunication occurring again was mitigated.
Where audits had identified changes and improvements were needed there was a clear plan for achieving these.
 

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.
People living at the home had good continuity of care which was achieved through transparent and positive relationships with other healthcare professionals. An employee from the local GP surgery visited the home 3 days a week and conducted a ward round once a week. This enabled a consistent and open dialogue about the people in the home and their needs.

Healthcare professionals all spoke positively about the service. They told us “They provide up to date and relevant information and are able to update me on any changes in the service users health” and “I have undertaken a number of annual mental health reviews with service users resident in St George’s Care home and nursing staff have always been willing to participate in these and share information about care and treatment plans.”

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.
Staff received face to face training in safeguarding and the provider included safeguarding in their monthly analysis. People were supported by staff to stay safe and where appropriate mental capacity assessments were undertaken and reviewed as necessary.
Staff surveys included checking people’s understanding of keeping people safe from abuse, harm and discrimination and safeguarding was also discussed at staff and nurse meetings. One of the nurses we spoke to told us there was safeguarding champion at the home and a clear process in place if any safeguarding concerns were raised.
Care plans included detailed risk assessments and these included families or advocates input where people lacked capacity. One care plan documented a recent review which identified that a person would be best supported by 3 people during personal care in order to maintain their comfort and dignity and subsequently manage potential aggression.
 

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.
Risk assessments were completed with a good level of detail. People were not restricted unnecessarily and there was a balanced approach to risk which supported people and their choices. For example, one person had started to experience falls due to their declining mobility. They were seen by an occupational therapist and it was documented in their care plan that they should, “be encouraged to walk a few steps at a time and also to sit on the chair and get out of bed”.
 

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 provider employed maintenance staff who were visible on our visits to the home. A regular health and safety meeting was held with the maintenance and management teams where any issues or projects were discussed.
The environment in the home facilitated the service and the needs of the people well. The facilities and equipment were well maintained and all necessary checks and servicing were in place. We did identify one specialised bath which was not in working condition and also very dirty. We advised that as it was not in use it would be preferential to close off the bathroom until it had been refurbished and was in full working order. Management confirmed this had been done. The rooms and bathrooms that had been refurbished had been done so to a high standard and included speakers in the bathrooms to help to keep people calm and safe during showering and personal care by playing relaxing or chosen music.
 

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.

Staffing levels across the home were consistently good, as evidenced by the staff rota and our onsite observations. Each unit had a nurse scheduled on duty, along with sufficient numbers of care staff. Staff generally worked on the same unit, which helped ensure continuity of care, as they were familiar with people’s needs and the individuals knew and trusted the staff supporting them.

Staff were recruited safely and the provider used its own in house agency which enabled consistency in staffing and training. We did identify that a more structured interview process would be beneficial and some improvements to the recruitment documentation system when staff moved from the agency to permanent staff.

Training was all completed face to face and covered areas relevant to the needs of the people they supported, such as crisis prevention and all staff completed the care certificate. This is a set of standards for health and social care support workers,
 

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 provider employed domestic staff who we observed cleaning while we were in the home. The units were clean, tidy and spacious and we observed staff wearing PPE when assisting people with eating. There was PPE available on all the units and hand sanitiser on the corridors. Work was being carried out to refurbish some of the rooms and bathrooms and those that were completed looked clean and modern.

Hand washing posters were in place and the infection control notice board displayed information about handwashing, donning and doffing of PPE, hand hygiene as well as the contact details for the local authority infection prevention and control team.
 

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

Medicines were generally handled safely and medication charts were completed accurately. However, we did identify two errors in documentation when we visited the service. These were rectified, lessons were learned, and no harm was caused.

Medication administered on an ‘as-needed’ basis was given safely. However, more detailed and clearer documentation regarding the use and dosage of paracetamol-containing medications was required.

Fridge temperatures were recorded, and covert medicines were administered appropriately with the necessary authorisations in place. Fire risk assessments had been completed in relation to emollients and creams and fluid thickeners were managed correctly.

The nurses, who were responsible for administering medications received medication training and regular competencies and supervisions. The care staff also received training in medication awareness.