Fosse Healthcare - St Mary's 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 as good. At this assessment the rating has remained as good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

People's understanding, and that of staff, of what constituted a safety incident, together with the processes in place for reporting and investigating such incidents, provided us with assurances concerns would be identified, managed and addressed appropriately.

This was further supported by feedback from relatives and staff, who did not raise any concerns relating to people's safety. One person said, “They [staff] care; I feel safe here.”

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 managers responded promptly to referrals and carried out timely assessments to ensure people received seamless and uninterrupted care. They worked together with referring agencies, and people and families to ensure smooth transition into the service. When changes to a person's care arrangements were required, the service acted proactively to maintain continuity of support.

The provider worked with people and healthcare partners to understand what being safe meant to them.

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. The provider had an up-to-date safeguarding policy and procedure in place. Staff had completed safeguarding training and demonstrated a clear understanding of their responsibilities to protect people from abuse and avoidable harm. Staff spoke confidently about recognising potential signs of abuse and the actions they would take to keep people safe. One staff member told us, “Different types of abuse could be physical abuse or neglect. We look out for things like new bruising, log this as a concern and report it. We also talk to people to ensure they feel safe and discus with us if they want to any concerns. Managers refer concerns to the local authority and we can to.”

The registered manager demonstrated a good understanding of their responsibilities in relation to safeguarding. They clearly described the actions they would take in response to a safeguarding concern, including making referrals to the local authority safeguarding team, working in partnership with relevant agencies, and submitting notifications to CQC where required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs safely enabling people to do the things which mattered to them.

Managers and staff worked collaboratively with relatives to identify risks to people’s health, safety and wellbeing, and to ensure these were managed effectively. Risks were assessed and regularly reviewed. Care records contained detailed guidance for staff on how to support people safely.

There were effective systems in place to monitor and review risks. This included formal care reviews, regular communication with relatives, home visits, spot checks and observations of staff practice. These measures enabled managers and staff to identify changes in people’s needs promptly and adapt care arrangements where required.

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

People and their relatives consistently told us staff provided support in a safe and attentive manner within their homes.

Environmental risk assessments of people’s homes were completed as part of the assessment and care planning process. These considered potential risks within the home environment and included, but were not limited to, furniture, lighting and flooring. This helped ensure risks were identified and managed appropriately to support people’s safety and wellbeing.

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 to meet people’s individual needs.

The provider ensured there were enough suitably qualified, skilled and experienced staff deployed to meet people's needs safely. Staff received regular supervision and support, including one-to-one meetings and spot checks of their practice. These measures helped to monitor performance and ensure care continued to be delivered safely and in line with people's needs.

People received care from a consistent team of staff. Where changes to staffing arrangements were necessary, people were informed in advance. Staff who were likely to provide cover had previously been introduced to people and had completed shadowing shifts alongside regular care staff. Relatives told us staff took time to understand the individual needs and preferences of their loved ones. This helped to promote continuity of care and positive relationships between people and staff.

Staff told us the training they received equipped them with the skills and knowledge needed to carry out their roles safely and effectively. They spoke positively about the induction process, opportunities to shadow experienced colleagues and the ongoing training provided by the service.

Newly recruited staff were safely inducted into the service. Pre employment checks were carried out to ensure they were of good character.

People and their relatives told us staff were reliable and attended calls as scheduled. They said staff stayed for the agreed duration and completed the tasks identified within people's care plans. One person said, “They do what I ask. They do what they should do and have time to stop and talk a little, I love that."

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 used appropriate Personal Protective Equipment (PPE) when providing care and disposed of it safely after use. One person said, “[SM1][MP2]Yes. They [staff] always wear their protective gloves and aprons.”

Staff told us they had access to sufficient supplies of PPE to support safe care delivery in people’s homes and reduce the risk of cross-infection.

The provider had an Infection Prevention and Control (IPC) policy in place. Staff had completed IPC training and demonstrated a good understanding of the measures required to prevent and control infection, helping to keep people safe.

A medicines policy was in place, and staff had been trained in the safe administration of medicines. Care plans and risks assessments included how people’s medicines were to be managed safely and by whom.

Some people managed their own medicines. Risk assessments and protocols were in place where they did. People who required support with their medicines raised no concerns aroundtheir medicines regime and all reported they received their medicines as prescribed and how they wished for them to be administered.

Records of MAR reviewed confirmed people received their medicines as prescribed. Audits were undertaken to ensure effective oversight of medicines delivery.