St Martins Residential 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 requires improvement. At this assessment the rating has changed to 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.

Incident and accident forms, together with associated logs, were completed in full and reviewed by the registered manager to identify any themes or trends. Incidents were viewed as opportunities to put things right, learn from events, and improve the quality and safety of care provided.

Learning from safety incidents was consistently communicated to staff and acted upon to reduce the risk of recurrence. We viewed an example of how learning from an incident had been shared with staff to increase awareness and improve practice. The service demonstrated a proactive approach to identifying and managing risks, using lessons learned from safety events to help prevent future incidents and promote a culture of continuous learning and improvement.
 

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 registered manager carried out assessments of people’s needs before they moved into the service. These assessments were completed in collaboration with the person and those important to them to develop an individualised plan of care, identify any risks, and ensure continuity of care. The service worked closely with people to gain an understanding of their backgrounds, preferences, and life histories. We reviewed comprehensive “About Me” documents and found that where people were unable to share their own stories, relatives had been encouraged to contribute information so staff could better understand and support people. An emergency folder was also in place containing important documents, and staff were reminded to share hospital passports, medication administration records [MARS], and “Who I Am” documents with external professionals to ensure they had access to relevant information when required.

People were supported to access a range of external healthcare professionals to help meet their needs and maintain their wellbeing. Staff worked effectively with other services and acted on professional advice to ensure people received appropriate care and support. One healthcare professional told us, “I never have any issues here, they are normally very good they will take on any advice that I normally give.”

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.

The service had effective safeguarding systems and processes in place to protect people from abuse, neglect, harassment, and breaches of their dignity. Safeguarding information was clearly communicated to people, staff, and visitors. Staff demonstrated a good understanding of how to recognise and report concerns and were confident in raising issues with the registered manager. Staff also understood their responsibility to escalate concerns where necessary and were aware of external reporting routes, including social services, the service’s trustees, the Care Quality Commission (CQC), and the police. A member of staff told us, “If the manager did not deal with it, I have a responsibility so I would report to the council and the police.” However, all staff we spoke with expressed confidence the registered manager would respond appropriately to any safeguarding concerns raised.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the registered manager understood their responsibility to make DoLS applications when required and did this in conjunction with people’s relatives and advocates.

People and their relatives told us they felt safe living at the service. Feedback was positive, with a relative saying, “I feel [relative] is very safe there, and happy.” Another relative told us, “I know my [relative] is very safe there because they look after them so well, just so kind and caring to [relative].”

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.

People’s care plans and risk assessments contained detailed information and clear guidance to help staff provide safe, consistent, and person-centred support. People’s records demonstrated that risks were managed in line with agreed strategies. For example, people were supported to meet their planned fluid intake targets and, where these were not achieved, senior staff and the registered manager had appropriately reviewed and investigated the reasons to ensure any risks were effectively managed.

The service worked to understand the causes of people’s distress and promoted a least restrictive approach to care. Care plans reflected foreseeable risks and included personalised guidance on how to support individuals when they became anxious or upset. This helped staff respond in a way that maintained people’s independence, respected their rights, and reduced the need for restrictive interventions.

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 reviewed a range of records relating to the safety and maintenance of the environment and equipment, including fire safety documentation, portable appliance testing (PAT) records, and electrical installation certificates. We also viewed the service’s ongoing maintenance programme and planned improvements. There was a clear schedule in place identifying both completed works and future projects, with timescales established to monitor progress. During our visit we observed the installation of a new summer house, which would provide an additional outdoor space for people to use.

Environmental risk assessments were in place and were reviewed as required to identify and mitigate potential hazards. The service had also recently undergone an external health and safety audit, providing additional assurance regarding the effectiveness of its safety arrangements. Staff had received appropriate health and safety training to support them in carrying out their roles safely and effectively.

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.

Appropriate checks had been conducted prior to staff starting employment, including Disclosure and Barring Service (DBS) checks and references. DBS provides information relating to cautions and convictions that are held on the Police National Database. The information received during recruitment checks helps employers to make safer recruitment decisions.

Staff were supported to provide safe and effective care through a structured programme of induction, regular supervision, and annual appraisal. Training relevant to each staff role was provided and refreshed at appropriate intervals to ensure staff maintained the knowledge and skills required to meet people’s needs.

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. The service was clean and we observed appropriate infection prevention and control practices being followed throughout our visit. Staff had access to personal protective equipment (PPE) and suitable hand hygiene facilities to help reduce the risk of infection. Staff had also received infection prevention and control training, ensuring they understood their responsibilities in maintaining a safe and hygienic environment for people, visitors, and colleagues.

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 their medicines as prescribed and staff responsible for administering medicines had received appropriate training and competency assessments. We observed a medicine round during our inspection and found this was completed safely and in accordance with people's needs and preferences.

The service had clear, person-centred guidance in place to support the safe administration of when required (PRN) medicines. However, we noted some PRN protocols did not include information about when concerns should be escalated to the GP. We discussed this with staff who assured us this would be updated. Governance and auditing arrangements for medicines management were in place and provided oversight of medicine practices.