Guardian Supported Living Ltd Also known as St Georges Community Hub

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 requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

Improvements were required to ensure staff were safely recruited and had adequate time to undertake training. We found gaps in staff members knowledge around MCA Community DoLS practices.

This left people at risk of avoidable harm and was a breach of regulation 18 staffing.

This service scored 59 (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. For example, incidents were reviewed for any trends to prevent similar incidents occurring. One staff member told us, “We have a handover at the start of the shift, this gives us an opportunity to share learning”.

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. For example, incidents were reviewed for any trends to prevent similar incidents occurring. One staff member told us, “We have a handover at the start of the shift, this gives us an opportunity to share learning”.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from harassment, abuse and neglect. The service shared concerns appropriately. People told us they felt safe with the staff. One person said, “I feel safe”. Staff received training in safeguarding and knew what to do if they suspected abuse including how to contact the police or the local authority to keep people safe.

Staff we spoke with confirmed they had received safeguarding training and were able to state what action they would take in response to witnessing abuse, including contacting the local authority’s safeguarding team. When safeguarding concerns were raised, the registered manager dealt with these appropriately and recorded all actions taken. Staff knew how to recognise abuse and protect people from the risk of harm. People told us they felt safe with care staff who were kind, caring and good at their jobs.

We found gaps in staff knowledge around the Mental Capacity Act and Community DoLS practices. For example, staff told us they would not allow one person to access the community on their own due to being vulnerable. As a result, they would accompany them when they wanted to access the community. We found no MCA assessment or best interest meetings had taken place in relation to accessing the community. However, records indicate that people had not been restricted as they had not asked go outside alone.

The provider was open to feedback and had started to make the required improvements to the Mental Capacity Act and Community DoLS practices.

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 to people's individual health and wellbeing were assessed and action taken to minimise those risks. Where risks were identified, people's care records described the actions staff should take to minimise them. For example, care records described actions in relation to people displaying distressed behaviour.

The provider detected and controlled potential risks in people’s homes. The provider completed environmental risk assessments to check if it was safe for staff to carry out care in a safe environment. This included checks around fire safety. We saw detailed instructions for staff within care plans stating how to ensure kitchen utensils were put away safely.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The provider’s training matrix had missing staff names, and several staff members completed many training topics on the same day. For example, one staff member completed 13 training topics in 1 day that would be difficult to complete and understand in such a short space of time. Staff we interviewed had gaps in their knowledge, for example despite completing the required training, staff had no knowledge of the mandatory Oliver McGowan training. The Oliver McGowan Mandatory Training on Learning Disability and Autism is the government's preferred and recommended training for health and social care staff. In addition, we found the provider did not complete any knowledge tests to demonstrate staff understood the training they had completed.

We found a number of staff members had been recruited via the international recruitment scheme. The majority of staff had been recruited with two character references rather than an employment reference. It was not always clear from recruitment records why an employment reference had not been obtained or why the staff member’s last adult social care role had not been contacted. Character references were received via personal email addresses and a follow up telephone call made to the referee. However, the provider’s recruitment policy did not detail how the identities of referees were to be verified, such as requesting identification documents or the referee sending forms via their employment email address.

The provider was open to feedback and has started to make the required improvements to training and recruitment.

The provider assessed and managed the risk of infection. People and relatives told us that staff attending to them would wear appropriate personal protective equipment (PPE). Audits by the registered manager of observed staff practice showed staff wore appropriate personal protective equipment (PPE). Staff confirmed they had completed training and always had access to supplies of PPE.

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. Medicines were stored securely and safely. People's care plans detailed how they preferred to take their medicines including clear protocols for medicines given 'as and when' needed. Staff received training in medicine administration and competencies were completed.