St Cecilia

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 inspection we rated this key question good. At this inspection 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were supported by a service and a culture where every event was an opportunity for learning. The registered manager and staff communicated continually throughout the day. Staff were encouraged to share their learning with each other to promote consistency in care and to improve outcomes for people. Health and social care professionals were complimentary about how the service worked as partners, sharing information to ensure people’s needs were met. The registered manager had oversight of all accidents, incidents and events within the service. Monthly analysis of events took place to identify themes and patterns with a view to preventing a reoccurrence of adverse events, for example, reducing falls for a person.

The service 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.

People felt confident their needs would be met by staff and information would be shared to promote continuous care. Staff told us information was available to them if they needed to speak with external professionals. This included, if a person was admitted to hospital. People’s needs, and care requirements were detailed within their care plans and risk assessments on the providers electronic system. A summary sheet or printed care plan was available if the person went into hospital or moved to another care service, this promoted continuity of care for people.

The service 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 bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

People told us they were safe and content living at the service and their relatives agreed. Staff had received training in safeguarding adults; they told us how they would raise concerns and were confident the registered manager would act immediately. Safeguarding procedures were in place to ensure people were protected from avoidable harm. We observed staff supporting people in safe ways throughout the inspection, for example, using equipment. Safeguarding was a topic for discussion, not only during annual training but in general conversation throughout the day. Posters displayed within the service reminded people of contact details for reporting concerns, together with easy ways to report, for example the use of a QR code. Records showed safeguarding referrals had been made as necessary and this included notifying CQC of certain events as required by law. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications, authorisations, and conditions.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were protected from avoidable harm and involved in balancing their freedom with safety. People told us they felt safe in their environment. Relatives agreed they had no concerns about safety within the service. Risks to people’s wellbeing and safety had been identified, assessed and measures put in place to reduce them. Records detailed how staff should work to ensure safety, especially when supporting people with individual health conditions. We observed staff working in safe ways in accordance with people’s risk assessments. The providers electronic care planning system ensured risk assessments could be updated as things changed.

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

People and their relatives were complimentary about the service, describing it as homely. The registered manager and provider told us there was an ongoing programme of redecoration and refurbishment. We observed various works during our inspection. Equipment and utility checks were in place and closely monitored to promote safety. A dedicated staff member was responsible for maintenance within the service and undertook comprehensive checks. There was a programme of works and reminders of expiry dates. The service used external specialists and contractors to undertake some checks particularly where there was need for a specialism, such as gas and fire safety. We checked certificates were in place for all household checks carried out by external professionals. The providers electronic compliance system was used to record all checks, testing and monitoring. This had ensured oversight was accessible to both the registered manager and the provider.

The service 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.

People told us staff were there when they needed them, relatives told us there were always staff available and supporting people. Staff received training and support to ensure they could carry out their role, records confirmed staff training had taken place. Staff told us they felt fully supported by the management team. Formal supervisions were carried out and the registered manager told us they could access support at any time. Throughout the inspection, we observed staff attending people in a timely manner, including spending time chatting and enjoying the day. People’s needs had been assessed in relation to staff skills and competencies, so the registered manager understood how many staff were needed to provide safe care. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. However, we found some gaps in records. The registered manager put plans in place to strengthen the process during the inspection, and we were fully assured by the actions taken.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and their relatives told us the service was clean and tidy; this included people’s own bedrooms and all communal areas. Staff received training in infection prevention and control. Dedicated staff were employed and ensured the service was kept clean. We observed the service to be clean and hygienic. Personal protective equipment (PPE) was worn correctly by staff. Safe infection prevention and control procedures were in place and were supported by the providers policy. Infection control procedures and audits were in line with published good practice guidance. Staff had plentiful supplies of cleaning materials, products, and PPE.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

People received their medicines safely as prescribed. Staff were knowledgeable about people and their medicines, and people’s preferences were considered. When medicines were prescribed to be taken ‘as required’ there was personalised information in place to guide staff when these might be needed. When people were prescribed medicines in the form of patches, then removal of previous patches, and sites of application and rotation were recorded. Medicines were stored safely and there were appropriate arrangements for disposal. Medicines which required stricter control by law were managed safely, and accurate stocks checks were carried out. Staff carried out temperature checks to ensure medicines were stored in accordance with the manufacturer’s guidance. Staff had training and competency checks to make sure they gave medicines safely.