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Inspection Summary


Overall summary & rating

Good

Updated 21 April 2018

The inspection was unannounced and took place on 14 February 2018. We agreed with the registered manager to return on 15 February 2018 to complete the inspection. Prior to the inspection we had received concerns about care at the home and the inspection followed up on these concerns and we also discussed the information with partner agencies.

The home is registered to provide accommodation and personal care, for a maximum of 66 people and there were 58 people living at the home on the days of the inspection. Some people lived at the home on a permanent basis whilst others were admitted to the home from hospital on a temporary basis, for a package of care and physiotherapy before returning to their home in the community.

A registered manager was in place. A manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We last inspected St Giles on 13 July 2017, when we rated it as ‘requires improvement.’ We found some people who felt that the service could be improved because staff did not have time to spend quality time with them and some relatives felt that the service was not always responsive to people's needs in terms of a timely response. We also found that improvements could be made to the management of medicines and some aspects of the monitoring of the service such as audits of pressure relieving equipment.

At this inspection we found improvements had been made. People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met.

People felt safe living at the home. Staff were available to people and demonstrated good knowledge about people living at the home. Staff told us training helped them meet the specific needs of the people living at the home and they attended regular training to ensure they kept their knowledge updated.

Staff understood the importance of ensuring people agreed to the care and support they provided and when to involve others to help people make important decisions. The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS) and had submitted the appropriate applications where they had assessed that people were potentially receiving care that restricted their liberty.

People enjoyed a good choice of meals and were supported to access professional healthcare outside of the home, for example, they had regular visits with their GP and any changes to their care needs were recognised and supported by staff.

People said staff were caring and treated them with respect. We saw people were relaxed around the staff supporting them and saw some positive communication with staff. Staff showed us that they knew the interests, likes and dislikes of people and people were supported to enjoy various activities. We saw that staff ensured that they were respectful of people’s choices and decisions.

People were involved in planning their care. Relatives also said they were involved in reviews of people’s care and said staff listened to them. People knew how to raise concerns and felt confident they could raise any issues should the need arise and that action would be taken as a result.

The provider had systems in place to check and improve the quality of the service provided. However, we found that further improvements were needed to ensure care plans reflected the care provided and to ensure medicine audits were robust enough to identify areas for improvement and taken action in a prompt way.

People, relatives and staff were positive about the overall service. The registered manager demonstrated clear leadership and

Inspection areas

Safe

Good

Updated 21 April 2018

The service was safe.

People told us they felt safe living at the home and they were supported by staff who knew how to keep people safe from harm.

People said staff were available to keep them safe.

People were supported by staff to take their medicines as required to support their health needs.

Effective

Good

Updated 21 April 2018

The service was effective.

People were supported by staff who received training and on-going support to enable them to provide good quality support.

Staff were knowledgeable about people’s support needs and sought consent before providing care.

People had a choice of meals and drinks and were supported to access external health professionals to support their wellbeing.

Caring

Good

Updated 21 April 2018

The service was caring.

People’s needs were met by staff who were caring in their roles and respected people’s dignity and privacy.

People were involved in planning their care and said staff respected their choices.

Relatives were free to visit whenever people wanted them to and felt listened to.

Responsive

Good

Updated 21 April 2018

The service was responsive.

Staff were knowledgeable about people’s care needs and preferences in order to provide a personalised service.

People chose how they spent their day and were supported to enjoy a range of activities.

People and relatives felt supported by staff to raise any comments or concerns about the service.

Well-led

Requires improvement

Updated 21 April 2018

The service was not consistently well-led.

The provider had systems in place to check and improve the quality of the service provided. These systems had not consistently identified that action was required to ensure peoples care plans reflected their current care needs and further improvements could be made to the management of medicines.

Staff felt supported by the management team; were clear on their roles and responsibilities and said the registered manager had a clear vision on improvements for the home.