St. Giles Care Home

St Giles Care Home is a care home providing personal care and accommodation to up to 66 people. The service provides support to older people and people with dementia. At the time of our inspection there were 51 people using the service.

People’s experience of using this service and what we found.

Medicines were not always managed safely. We were not always assured the provider was promoting good hygiene practices.

The provider had safeguarding systems and processes to help keep people safe. Staff knew about the risks to people and followed the assessments to ensure they met people's needs. People felt safe and were supported by staff who knew how to protect them from avoidable harm.

People were supported to access healthcare professionals when their needs changed. Staff received training and competencies to ensure they were skilled to meet people’s needs. People were offered a choice of food and the environment was warm and welcoming.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service mainly supported this practice.

Staff sought people's consent before providing care and support. People's individual communication needs were considered to support them to be involved in their care.

Staff had been recruited appropriately and had received relevant training, so they were able to support people with their individual care and support needs.

Different activities were available for people to get involved with. Care plans contained information about people’s preferences and staff knew people well.

Complaints were responded to in a timely way and information about the support people wanted to receive at the end of their life was recorded.

Staff spoke positively about working for the provider and felt well supported. Staff were able to approach the management team at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service was good (published on 21 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. A decision was made for us to inspect and examine the information we had reviewed. As a result, we undertook a comprehensive inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has remained good. This is based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Giles Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We were assured that this service met good infection prevention and control guidelines as a designated care setting. We found the following examples of good practice.

• A self-contained unit within the home could care for people safely who had tested positive for Covid-19 in hospital and needed to transfer to a care home under the Winter Discharge Designation Settings scheme.

• Staff were deployed to work solely within the unit. They did not work in other health or social care services which reduced the risk of cross transmission.

• The registered manager had won a local ‘excellence in care’ award and had been named a ‘Covid Hero’ in July 2020 for their contribution to meeting the needs of people who had tested positive for Covid -19.

• Specialist cleaning equipment had been purchased and was used to deep clean the environment. Items that were difficult to clean were sanitised effectively which reduced the risk of cross infection.

• Risk assessments were completed to ensure visits with people could be undertaken safely during the pandemic. Visits were booked and times were staggered to avoid potential infection transmission.

• Staff had been supported in a variety of ways including being taught simple techniques and coping strategies to manage their levels of anxiety during lockdown.

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 staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes.

There was a registered manager in post at the time of this inspection. A registered 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.

At this inspection we found that the provider had made a number of improvements in respect of décor and furnishings in the home and most people were happy with the service they received. However, there were some people who felt that the service could be improved because staff did not have time to spend quality time with them. Some relatives felt that the service was not always responsive to people’s needs in terms of a timely response. We saw 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.

People were kept safe from harm because they were supported by sufficient numbers of staff to keep them safe. Staff that supported people had been appropriately checked for their suitability to provide care to people who required it. Staff received training and support to equip them to carry out their roles in a safe, caring, helpful and kind way. Staff ensured that people’s privacy and dignity were promoted and respect was maintained. Staff supported people to remain as independent as possible.

People were protected from abuse and avoidable harm because staff had received training and understood the different types of abuse and knew how to escalate any concerns that needed to be investigated. The registered manager ensured concerns were raised with the local authority when people living in the home had received poor care by other providers. Effective systems were in place to ensure that concerns and complaints raised by people were investigated and people were responded to.

Staff had the knowledge and skills they required to care for people appropriately and had knowledge about the Mental Capacity Act 2005; staff ensured that people’s rights to consent to their care were upheld. Where people lacked the capacity to consent to their care, appropriate actions were taken to provide care to people within their best interests and in the least restrictive ways possible to safeguard their human rights.

People were supported to eat and drink sufficient amounts of food and drink to remain healthy. Food was prepared in ways that kept them safe from choking and people were given choices at all meal times. People received support from health professionals where required. People’s health needs were met by a variety of health professionals that visited the home or by attending appointments at local hospitals.

People were asked for their feedback on the service through a variety of ways that included meetings, surveys and complaints and compliments.