Galilee Care

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 inadequate. The service was in breach in relation to safeguarding people from abuse, safe care and treatment, safe deployment of staff and competency of staff and lack of robust recruitment practices. At this assessment we found the breaches had been met since our last inspection and the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The service had active oversight of care given through active engagement with people and those who cared for them, spot checks on staff whilst they supported people and use of digital systems. The provider now conducted audits, analysis, targeted training and ensured staff were updated using staff meetings and electronic devices. Where concerns were identified or raised the provider analysed and made improvements to the service. We saw an example where the provider had reviewed late call attendance and reallocated staff geographically and therefore reduced travel time and ensured that people were supported in a timely way.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People were referred to other healthcare partners when the provider identified when people needed support. For instance, people at risk of pressure ulcers were monitored and referred to district nurses when clinical care was needed. A family member told us “One of the carers on Saturday noticed when washing their back, it was like a blister, I dry dressed it and on Monday the district nurses came round, and they looked at it and dressed it. I was quite surprised, I was quite grateful for (carer) noticing”. Staff now assessed and organised care with people to ensure it was person-centred and delivered in the way they preferred. A family member told us, “They do a 90-day assessment with (parent) and write it up on the app, it’s all documented”. Care plans recorded people’s wishes regarding DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decisions.

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

All staff were trained and understood how to recognise harm, to keep people safe and how concerns should be reported. We saw evidence that the service is now proactive in speaking with people who received care, how it met their needs and made safeguarding referrals to local authorities when people were at risk. The service ensured staff were trained in the Mental Capacity Act 2005, that capacity assessments were carried out in consultation with those who knew the person well, and that all assessments were appropriately documented.

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. The service now ensured comprehensive risk assessments were completed which provided appropriate guidance to staff on how to keep people safe, such as guidance to reduce the risk of falls. The registered manager told us they involved people in the creation of care plans and risk assessments and respected peoples wishes about key decisions.

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

The service now ensured an environmental assessment was conducted and retained in each care plan to ensure that the person and the care staff were protected. The service, where necessary, referred people to health care providers to obtain equipment that would support them such as making a request for bed rails for a person who had suffered from falls from their bed. The service ensured regular audits and servicing of equipment took place to keep people safe – such as hoists. This provides mechanical means so that less able persons can be moved or transferred from one place/position to another.

The service made sure there were enough qualified, skilled and experienced staff. However, they did not always make sure staff were supported through clinical oversight. The service did not have a delegated healthcare agreement in place. A delegated healthcare agreement is an arrangement where a qualified healthcare professional authorises a trained care worker or personal assistant to carry out certain healthcare tasks, while the professional remains responsible for the overall outcome. The provider has now sought support from a qualified healthcare professional to perform this role and a delegated healthcare agreement is in place.

The service now conducted regular quality assurance checks on staff whilst they provided care to people, which was used to provide feedback and improve performance. The service now ensured appropriate employment checks when staff had been recruited and staff received appropriate training both online and face to face. Staff had been trained to support people with specialist care and had been assessed to understand how to provide good care and reduce risk such as infection. For instance, staff had been trained to support people with catheter care which supports people who have difficulty in controlling their bladder. Staff had their competency assessed which means having the proper training, skills, and knowledge to look after a catheter safely, reducing the risk of infection and injury to the patient. The service now had an automated system that calculated travel time between care visits which improved punctuality and ensured staff were able to remain for the time allocated.

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 conducted annual hand hygiene audits to ensure staff followed correct procedure to keep people safe. The service now conducted regular audits and quality assurance assessments of staff whilst they delivered care, including infection prevention control which was followed up to ensure compliance to keep people safe. We saw examples where the service had sought to support people who chose to eat food past its sell by date and liaised with support agencies to keep them safe. Staff were trained and were able to explain best practice on how to provide personal care to reduce the risk of infection.

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.Staff were trained andwerecompetency assessed to ensure they understoodhow to manage medicines safely.Care plans documented the medical support peopled needed andif people managed their own medication. The servicenowauditedpeople’smedicationusageusing anelectronic systemand manually when that system was unavailable. The serviceensured people were supported when they wished to manage their own medication.People'smedicationwas regularly reconciled by senior staff– which meansthe amount of medication is checkedto ensure it has been taken.