St Anne's Nursing Home

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 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.

The service actively sought feedback and looked for opportunities to improve. A family member told us, “There was a meeting last week that we attended which other residents and relatives also attended. It was feedback for staff to see what they could do.”

We saw evidence that complaints and incidents led to learning and steps to prevent future occurrence. The service used a digital tracking system that helped to ensure recording, actions and outcomes took place within expected timeframes. This also enabled oversight by senior staff and prompt escalation if needed. Any changes made because of such issues were communicated with staff and additional training provided if required. People who raised concerns were also informed of outcomes.

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.

Care plans we viewed showed clear planning and assessments when people moved to St Anne’s. Partners told us they worked collaboratively to support transfers between services. They told us additional information was requested by St Anne’s if it was needed. Where people had complex needs that St Anne’s felt they may not be able to meet, this was communicated honestly in the best interests of the person concerned.

Partners in healthcare told us, “They [transitions] are on the whole very smooth, and the staff make sure that hiccups of any kind are dealt with swiftly and efficiently.”

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. A clear and thorough safeguarding policy was in place. This was reviewed regularly and updated as required. Staff we spoke to demonstrated knowledge of safeguarding signs, as well as what action to take if they were concerned someone was at risk of or had experienced harm. They were able to explain how to raise concerns, who to raise them to and where to escalate outside of St Anne’s should there be a need to.

A member of staff said, “Safeguarding is about raising a concern on behalf of a resident. It could be how they are being treated, any worries. It is about protection of vulnerable residents.”

There were clear records of any safeguarding concerns raised. These were tracked through a digital system that helped to identify actions needed, actions taken, outcomes and learning. This was overseen by senior staff. Concerns were shared with relevant agencies, including local authority teams, CQC and family members where there was consent to do so. Partner agencies told us, “Staff, including managers and nurses, are available, approachable, and willing to engage during safeguarding processes. They share reports and concerns, meet with professionals when needed, and are generally receptive to recommendations.”

St Anne’s was a part of a voluntary local scheme aiming to prevent abuse in residential homes. The Green Heart ‘No’ to abuse campaign was a joint local NHS and social services initiative designed to keep safeguarding and signs of abuse in the forefront of staff consciousness. This zero-tolerance approach to abuse involved working with the founders of the scheme to show commitment, staff understanding and sharing of information to support people in raising concerns. Being part of this scheme meant staff were able to demonstrate this commitment and knowledge.

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.

Risks were assessed and measures were put in place to support people without unnecessary restriction. For example, people who were at risk from walking unaided but unable to recognise this risk had aids in place such as sensor alarms which would alert staff who could then support them.

People who wished to smoke were supported to outside spaces to do so and supervised where necessary. Risk assessments were undertaken and well recorded with regular reviews should needs change at any time.

One person who liked to keep their door open but could disturb other people by doing so, was moved to an alternative room. This enabled them to be comfortable and removed the risk of causing disruption to others.

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

We observed a clean, hazard free environment. Domestic staff were visible throughout the day and a log of their routine cleaning tasks was maintained and any issues documented. In relation to cleanliness, a person we spoke to told us, “It is very good here. The communal areas are very clean as well”.

The service carried out regular maintenance checks to ensure safety of the environment and equipment. This was clearly recorded with any actions highlighted and followed up with review dates for reinspection.

Safety equipment such as bed rails, hoists and grab rails was appropriately maintained and regularly inspected for defects.

Fire safety audits were conducted including external audits to ensure robustness in this area. Any risks identified were responded to and followed up as needed. There were safe and well-practiced fire evacuation procedures in place, with consideration for people’s individual needs and equipment to support those less mobile.

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.

During our visit, we saw enough staff available to support people throughout the day. We reviewed staff rotas which showed adequate staffing levels over night.

People told us they felt safe with staff and had no concerns about their ability to perform their roles. One family member said, “They treat [relative] too well! Yes, I think [relative] feels safe around them.”

A partner healthcare agency told us, “They [staff] know the people they work with really well, they work hard to build trust with both residents and families”

We saw evidence of safe and thorough recruitment processes. New staff had all undergone criminal records checks and references sought prior to them beginning work at St Anne’s. Staff files we viewed showed relevant experience across differing roles.

Staff received a good standard of induction, supervision and ongoing training.

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.

St Anne’s had a clear infection prevention policy. This detailed how to respond in the case of an infection outbreak, who should be notified and steps to take to keep people and staff safe.

In the event of an outbreak, relevant parties were notified, including NHS, CQC, local authority and family members. The situation was monitored and updates provided to ensure those who needed to be kept up to date were.

We observed staff wearing personal protective equipment (PPE) appropriately when carrying out their roles, whether in relation to personal care, food hygiene or cleaning tasks. Staff told us the items they required were always in good supply.

We observed good practice in the kitchen where we saw food was stored and dated correctly and the area in which it was prepared was clean and at a suitable temperature.

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 received medicines safely and as intended by the prescriber. Electronic Medicines Administration Records (EMARs) were in place which provided staff with accurate information about the medicines. It was not always clear from MARs when medicines were to be crushed or given covertly. Therefore, there was a risk that people would not receive the right medicines support that they required. We fed this back to staff and changes where promptly made to ensure this was clear.

Medicines were administered in a timely manner, including time sensitive medicines.

There was no evidence found of inappropriate use of medicines to control behaviour. Medical equipment was periodically checked and tested. Care plans mostly had the necessary information to support people with their prescribed medicines and largely identified medicines with additional risks that should be managed and monitored. However, we found that in some instances, care plans did not always have all the necessary information, for example, key side effects about a high-risk medicine or an emergency seizure medicine for a resident with epilepsy. This was highlighted to the provider and resolved during our visit.

Residents whose medicines were crushed or administered covertly had appropriate authorisation from a GP and pharmacist. The provider was registered to receive national patient safety alerts and recorded when these were received along with any action taken if required.